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Pathophysiology and Pharmacology 2 > Disorders of Exocrine Pancreas and Hepatobiliary > Flashcards

Disorders of Exocrine Pancreas and Hepatobiliary Flashcards

1
Q

Gallbladder

A

stores bile

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2
Q

Exocrine Pancreas

A

aids in digestion of CHO, fats, proteins

produces enzymes & bicarbonate

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3
Q

Liver in Digestion

A

produces bile, synthesizes plasma proteins, metabolizes & eliminates drugs/toxins and stores vitamins glucose/blood

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4
Q

cholelithiasis

A

gallbladder stone formation
most common gallbladder disorder
can cause choledocholithiasis, cholangitis, cholecystitis and cancer

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5
Q

cholelithiasis pathogenesis

A

typically formed in gallbladder
move to bile ducts
obstruct and cause inflammation
usually formed from cholesterol or pigment

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6
Q

cholelithiasis risk factors (five fs)

A 
female
fair
fat
fertile
forty
estrogen replacement therapy
oral contraceptives
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7
Q

cholelithiasis s/s early vs acute

A

e: vague, indigestion, mild gastric distress after fatty meals
a: severe/sudden onset of radiating pain (midepigastric, extends to RUQ/R subscapular region)

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8
Q

bile reflux into liver s/s

A

jaundice
pain
hepatocyte damage

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9
Q

bile duct obstruction

A

pancreatitis
stetorrhea
pruritus

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10
Q

cholelithiasis tx

A

asymptomatic: ursodiol/diet
symptomatic: cholecystectomy

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11
Q

cholangitis

A

inflammation of common bile duct

gallstone impacted into bile/duct inflammation > bacteremia/speticemia/secondary pancreatits

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12
Q

cholangitis s/s

A 
RUQ pain
ab tenderness
fever
jaundice
pruritus
dark-colored urine
clay colored stools (^ bilirubin)
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13
Q

cholangitis tx

A 
lithotomy 
analgesic
antihistamines
nutrition 
abx
antiemetics
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14
Q

cholecystitis

A

acute/chronic inflammation of gallbladder
stone/digestive juices cause inflammation
> bile builds up
> increased pressure
> chemical damage
> tissue ischemia
> damage to gallbladder walls & mucosa
> perforation & necrosis

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15
Q

cholecystitis etiology

A

cystic duct stone
trauma
infection
sepsis

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16
Q

cholecystits s/s

A 
intolerance of fat in diet
epigastric pain (eating)
flatulence
belching
colicky pain
steatorrhea
jaundice
pruritus
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17
Q

cholecystits tx

A

cholecystectomy

abx (metronidazole)

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18
Q

Gallbladder cancer

A

usually on surface lining or epithelium

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19
Q

gallbladder cancer etiology

A 
gallbladder damage (stones, toxins, bacteria, parasites)
main RF = gallstones
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20
Q

gallbladder cancer s/s Early vs Late

A

often subtle/coexisting cholethiasis

intense RUQ pain, jaundice, weight loss, palpable gallbladder

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21
Q

Gallbladder cancer tx

A 
cholecystectomy
whipple resection (remove surrounding diseased tissues)
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22
Q

Pancreas disorders types

A

head
midsection
tail

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23
Q

acute pancreatitis etiology

A 
alcohol abuse
gallstones
viral infections 
trauma
ab surgery
hyperlipidemia
acetaminophen/thiazide diuretics
24
Q

acute pancreatitis alcohol-induced

A

ethanol metabolized
> toxic metabolites released
> tissue injury/sphincter obstruction

25
Q

acute pancreatitis gallstone-induced

A

obstruction
> trapped digestive enzymes
>autodigestion of pancreatic tissue
>acute inflammatory response

26
Q

acute pancreatitis s/s

A 
ab pain
tachycardia
hypotension
fever
jaundice
paresthesia
cullen sign (bruising around umbilicus)
turner sign (bluish flank area)
steatorrhea
27
Q

acute pancreatitis critical s/s

A

low urine output
hypoxemia
restlessness
confusion

28
Q

acute pancreatitis tx

A

based on condition & response
pain relief
fluid replacement
NPO

29
Q

chronic pancreatitis

A 
obstruction or strictures of pancreatic duct
usually alcohol abuse
calculi (stones)
tumors or cysts
smoking
cystic fibrosis
primary scelorosing cholangitis 
toxicity
IBD
genetics
30
Q

chronic pancreatitis s/s

A

anorexia
malabsorption of fats/proteins
dull constant ab pain (LUQ or epigastric)

31
Q

chronic pancreatitis tx

A

eliminate alcohol/smoking
low-fat diet
oral enzyme replacement
insulin

32
Q

pancreatic cysts

A

previous damage to pancreas

benign (pseudocysts/serious cystadenomas) vs malignant (potentially mucinous)

33
Q

pancreatic cysts s/s

A 
usually asymptomatic
pain (epigastric radiating to back)
nausea
vomiting
jaundice
ab fullness
34
Q

pancreatic cysts tx

A

benign: monitoring
malignant: surgery

35
Q

pancreatic cancer

A

spreads quickly
invades lymphatic system
lack of well-defined pancreatic capsule

36
Q

pancreatic cancer RF

A 
smoking
obesity
diet
diabetes
chronic pancreatitis
genetic predisposition
37
Q

pancreatic cancer s/s

A

symptoms are slow

late: portal vein hypertension, ascites, hepatomegaly, splenomegaly, esophageal varices

38
Q

pancreatic cancer tx

A

surgery
chemotherapy
radiation

39
Q

common liver disorder s/s

A

vague ab pain
indigestion
hepatomegaly
advanced: jaundice, ascites

40
Q

Liver cancer

A

5th most common

poor survival rate world wide (2nd most common cause of death for men)

41
Q

liver cancer RF

A 
cirrhosis
hemochromatosis
hep b or c
excess alcohol 
excess coffee
obesity
oral contraceptive use
42
Q

liver cancer patho

A

immune cells: inflammation > deregulation of liver cell proliferation
insulin related: insulin resistance > cytokines > hepatic steatosis & inflammation
gene malfunction: malfunction limits ability to manage toxins & carcinogens

43
Q

liver cancer s/s

A 
weakness
weight loss
bloating
jaundice
disturbances in clotting factors/hormones
increase alk-phos, GGT, AST, ALT
44
Q

liver cancer tx

A

surgery
radiofrequency ablation
cryotherapy
percutaneous ablation

45
Q

cirrhosis and causes

A 
late stage scarring of liver
alcohol (most common)
chronic viral hepatitis
chronic obstruction of bile ducts
genetic disease (wilson disease, hemochromatosis, glycogen storage disease, autoimmune hepatitis)
46
Q

acute liver damage

A

alcoholic hepatitis

47
Q

chronic liver damage

A

cirrhosis
steatosis
steatohepatitis
fibrosis

48
Q

causes of liver disease

A

cellular damage
inflammation
obstruction

49
Q

alcohol and the liver

A

progressive deterioration of liver cells

50
Q

accumulation of fat in liver

A

early: steatosis
progressive: cirrhosis
hepatocytes replaced by scar tissue
liver metabolic fx are impaired
secondary conditions: portal htn, splenomegaly, systemic effects

51
Q

contributing factors to severity of alcohol induced liver damage

A 
patter of drinking (amount/number of years)
immunity
hmoral disorders
genetic biochemical makeup
overall nutrition, diet, health
52
Q

splenomegaly progression

A 
steatosis (usually asymptomatic ^ AST,ALT)
> hepatomegaly 
> RUQ ab discomfort
> nausea
> esophageal varices
53
Q

ascites progression

A 
portal hypertension (may lead to gen edema)
>dyspnea r/t ascites & portal htn
> weakness
>anorexia/weight loss
>asterixis
54
Q

abnormal liver function tests

A 
rplonged prothrombin time 
bruising bleeding
jaundice
gynecomastia
spider angioma
caput medusa
55
Q

early s/s of alcohol induced cirrhosis

A

increased serum amnoia
restlessness
agitation
progressive impairment in judgement

56
Q

alcohol induced cirrhosis tx

A 
abstinence (most important)
improving overall health/nutrition
liver transplant (only if pt maintains sobriety)
prevention/tx of complications (bleeding/esophageal varices/swollen rectal veins/ascites)

Pathophysiology and Pharmacology 2 (27 decks)

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