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Exam 2 Flashcards

1
Q

Complications for chronic pancreatitis

A

Diabetes mellitus
Pancreatic cancer
Calcification of pancreas
Multiple cysts

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2
Q

Spreads through contaminated food and water, often causes an acute and self-limiting infection, but (unlike hep A) causes severe intralobular necrosis, acut cholangitis, does not cause chronic hepatitis

A

HEV
+ssRNA
Infectious hepatitis

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3
Q

IgG indicates

A

Chronic case

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4
Q

Hepatic rub, bruit, and abdominal venous hum would suggest that a patient with cirrhosis had developed a

A

Hepatoma

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5
Q

Management of acute cholecystitis

A

Cholecystectomy

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6
Q

Metastases to the liver results from

A

Specific venous blood flow from GI tract to v.porta which brings the blood to the liver for detoxification

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7
Q

Sickle cell anemia

A

RBC abnormal chemical structure - sickle shape

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8
Q

Large amount of meal or fat meal can trigger the pain

A

Acute cholecystitis

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9
Q

Pathogenesis of acute cholecystitis

A

Etiological agents
Decrease gallbladder motility
Delay of bile evacuation
Increase of pressure inside gallbladder, increase of bile concentration, activation of opportunistic bacteria (e.g. E. Coli)
Inflammation of gallbladder wall
Edema of gallbladder wall
Compromising of blood flow and lymphatic drainage in gallbladder wall and surrounding tissue
Ischemia and necrosis of gallbladder wall and surrounding tissue

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10
Q

Treatment pancreatitis

A

Only medical treatment

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11
Q

ERCP

A

Endoscopic retrograde cholangiopancreatography

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12
Q

Signs and symptoms acute pancreatitis

A

Sudden acute, severe pain in upper abdomen, lasts from short time to days, and resolves itself

Pain worsens after food eating

Pain may reach to across the back, level T8-L1 (band-like pain)

Pain could radiate to umbilical, both flanks, left shoulder

Pain worse when lying flat on back

Pain decreases with sitting and flexion forward

Pain is always accompanied by high BP and tachycardia

Positive cullen’s sign

Nausea

Vomiting

Fever

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13
Q

Right shoulder radiation

A

Gallbladder

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14
Q

Indicates inflammation of the gallbladder wall due to bile duct obstruction

A

Elevated ALP

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15
Q

There are three types of blood test for evaluation of patients with hepatitis

A

Liver enzymes aka aminotransferases
Anti-viral antibodies and viral genetic materials
Serum proteins

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16
Q

AST
ALT
GGT
Inc with _____

Bile duct obstruction only ALP increased

A

ALP

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17
Q

Complications cholelithiasis

A 
Gallbladder gangrene
Acute cholecystitis
Chronic cholecystitis
Perforation or rupture of gallbladder
Cholangitis
Acute pancreatitis
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18
Q

Etiology liver cancer

A 
Chronic infectious hepatitis B, C, D
Liver cirrhosis
Aflatoxins
Wilson’s disease
Hemochromatosis
Non-alcoholic fatty liver diseases
Estrogen and anabolic steroids
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19
Q

Cancer that originates from liver cells

A

Primary liver cancer

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20
Q

Cirrhosis signs and symtpoms

A 
Ankle swelling 
jaundice
Palmar erythema
Nail changes and clubbing of fingers
Easy bruising
Abnormal bleeding
Confusion or problems thinking
Hepatic encephalopathy
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21
Q

Most frequent liver cancer, which originates from hepatocytes

A

Hepatocellular carcinoma aka hepatoma

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22
Q

Spreads through blood, body fluids, sexual contacts, tattoos, mothre to child by breast feeding

A

HBV
+dsDNA
Serum hepatitis

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23
Q

Incubation period Hepatitis A

A

28 days (range 15-50 days)

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24
Q

Formation and migration of stones inside the biliary tree or common bile duct

A

Choledocholithiasis

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25
Q

Diagnosis pancreatitis

A 
Blood amylase and lipase high
Urine amylase significantly increased
Blood glucose inc
US
CT
MRI
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26
Q

Formation of stones in the gallbladder

A

Cholelithiasis aka gallstone disease

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27
Q

Tests for bilirubin

A

Considerable increase of blood total and conjugated (direct) bilirubin
Finding of bilirubin in the urine (which results in dark brown color of the urine, like dark beer)
Increased concentration of urobilirubinogen in the urine

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28
Q

Cholesterol long time between meals

A

Only eat 1 or 2 times a day

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29
Q

Both cullen’s and grey-turner’s signs can predict

A

Acute pancreatitis

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30
Q

Usually the clinical manifestations of pancreatic cancer come to the clinical attention in ____stage of the disease

A

Terminal

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31
Q

Acute cystitis easy pathogenesis

A

Quiescent
Stone blocks cystic duct. Chemical and bacterial inflammation
Stone drops back into gallbladder in 7 days or so
Resolution in 2 months or so

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32
Q

Acute pancreatitis when the ____ or ___ is obstructed

A

Hepatopancreatic duct

Pancreatic duct

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33
Q

Complications cholecystitis

A

Perforation or rupture of gallbladder
Ascending cholangitis
Local abscess
Peritonitis

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34
Q

Diagnosis pancreatic cancer

A

Blood CA-19-9
CT
Endoscopic ultrasound (EUS)
Endoscopic ultrasound with endoscopic needle biopsy

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35
Q

Signs and symptoms typical for acute hepatitis in overt stage

A 
Hepatomegaly
Abdominal discomfort and pain
Jaundice - yellowing of the skin and eyes (icterus)
Lymphadenopathy
Dark colored urine
White stool
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36
Q

Cooleys or mediterranean anemia

A

Thallassemia major

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37
Q

Predisposing factors pancreatic cancer

A 
Chronic pancreatitis
Smoking
Family history
Age over 60
Diet with high amount red meat, soft drinks
Obestiy
Partial gastrectomy as treatment of obesity
H. Pylori infection
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38
Q

Treatment cirrhosis

A

Liver cirrhosis is an irreversible disease and the treatment usualy focuses on preventing of its progression and complications

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39
Q

Hypoalbuminemia and increased prothrombin time are the most specific tests for

A

Liver destruction

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40
Q

For determination of biochemical activity of the organ and cancer stage

A

PET-CT (positron-emission tomography-computer tomography)

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41
Q

Risk factors for cholesterol gallstones

A 
Decreased gallbladder motility with bile stasis
Obesity
Family history (genetic predisposition)
Rapid weight loss
Long intervals between meals
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42
Q

Murphy’s sign is positive in cholelithiasis only when

A

It complicated with cholecystitis

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43
Q

Tumor marker frequently elevated in pancreatic or liver cancer

A

CA-19-9

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44
Q

Spherocytosis

A

Small eccinocytes, present with dec amount of lip

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45
Q

MRI is used for diagnosis of stones at

A

Any level of bile tree and gallbladder

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46
Q

Acute pancreatitis

A

Reversible disease, if does NOT turn into chronic pancreatitis

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47
Q

Presence of paget’s disease with osteoblastic activity, or metastatic prostate cancer

A

High ALP

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48
Q

Complications cholelithiasis

A

Acute cholecystitis when cystic duct is obstructed

Chronic cholecystitis when long-term presence of gallstones leads to fibrosis of gallbladder wall with further its calcification

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49
Q

Beta-cell tumor generally benign is characterized by overproduction of insulin, which can result in hypoglycemia

A

Insulinoma

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50
Q

Calculous cholecystitis

A

When stones in the gallbladder are formed

90%

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51
Q

Zollinger-Ellison syndrome causes multiple

A

Peptic ulceration not only in stomach and duodenum but also in jejunum

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52
Q

Etiology of acalculous cholecystitis

A 
Critical illness (HIV, diabetes mellitus, myocardial infarction)
Major surgery or severe trauma/burns
Sepsis
Long-term total parenteral nutrition
Prolonged fasting
Salmonella infection
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53
Q

Don’t forget that liver cirrhosis is the major cause of

A

Esophageal varicies

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54
Q

Virus etiology hepatitis aside from Hep a, b, etc.

A

Cytomagalovirus
Epstein-Barr virus
Yellow fever virus
Ebola virus and Marburg virus

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55
Q

Blood tests diagnosis cholelithiasis

A

Inc WBC
Inc common bilirubin content
Inc alkaline phosphatase

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56
Q

Signs and symptoms of hepatitis depend on the

A

Form of hepatitis (acute or chronic) and its etiological factor

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57
Q

Incubation period Hepatitis B

A

90 days (range 30-150 days)

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58
Q

Autoimmune diseases etiology hepatitis

A

Sjogren’s sydnrome

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59
Q

Increased alfa-fetoprotein

A

Is normal for infants before 1 year old

Aften 1year it decreases and is low during the entire life

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60
Q

Alkaline phosphatase (ALP) is an enzyme presenting in all tissues of the body, but is particularly concentrated in

A 
Liver
Bile duct
Kidneys
Bones
Placenta
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61
Q

Recommendations by chiropractor for hepatitis

A

Rest to minimize energy demands
Avoid alochol and other hepatotoxic drugs (tylenol)
Small amount, high-calorie meal

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62
Q

Pain in upper abdomen that typically radiates to the back when carcinoma located in the body or tail of the pancreas

A

Pancreatic cancer

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63
Q

Acute gastritis and duodenitis
Internal bleeding with development of hypovolemic shock
Lung problems (enzymes may affect lung tissue causing it’s inflammation)

A

Acute pancreatitis

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64
Q

Superficial edema and bruising in the subcutaneous fatty tissue around the umbilicus

A

Acute peritonitis positive cullen’s sign

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65
Q

Metastases to the liver

A

Major sources of metastases to the liver are the ones from the GI tract organs

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66
Q

Cirrhosis etiology alcoholism

A

Alocholic steatosis

Non-alcoholic steatohepatitis

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67
Q

2 forms of cholecystitis

A

Calculous

Acalcolous

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68
Q

Most common causes chronic hepatitis, cirrhosis, liver cancer

A

Hepatitis C

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69
Q

Most common type of pancreatic cancer

A

Adenocarcinoma - 95%

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70
Q

Only small stones are the ___ dangerous

A

More

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71
Q

The ____ the calculi, the less likely they are to enter the cystic or common ducts to produce obstruction

A

Larger

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72
Q

Cholesterol gallstones genetic

A

Predominantly young spanish population

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73
Q

Signs and symptoms of chronic cholecystitis

A 
First symptoms are bitter taste adn taste of metal in mouth in the morning
Abdominal discomfort after meals
Complaints of gas accumulation
Nausea
Chronic diarrhea
Presence of skin xanthomas
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74
Q

Poisons produced by the plant mold aspergillus, that grows on wheat, rice, corn, and peanuts

A

Aflatoxins

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75
Q

Usually blood test liver panel is abnormal with liver cancer because a patiente had

A

A previous liver disease

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76
Q

Etiology for chronic pancreatitis

A

Alcoholism
Cystic fibrosis
Pseudocysts
Idiopathic

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77
Q

Pain when pressuring between edges of Right SCM muscle

A

Georgievskiy-Myussi’s sign

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78
Q

Xanthomas represent

A

Focal accumulation of cholesterol

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79
Q

Most common cause of toxic hepatitis

A

Alcohol

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80
Q

ALT is normally most concentrated within ____ and in ____

A

Liver cells

Heart muscle cells, kidneys, pancreas

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81
Q

Irreversible disease characterized by atrophy, fibrosis, and calcification of pancreatic parenchyma

A

Chronic pancreatitis

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82
Q

Unexplained thrombophelbitis (Trousseau sign) of superficial veins anywhere in the body, portal vein or deep veins of the extremities

A

Pancreatic cancer

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83
Q

Represents the dilation of periumbilical collateral veins and is an important sign of portal hypertension

A

Caput medusae

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84
Q

Treatment pancreatic cancer

A

Surgery
Radiation therapy
Chemotherapy

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85
Q

Chronic hepatitis usually results from ___ form of hepatitis but sometimes develops insidiously, with ____ initial clinical manifestations

A

Acute
Non-sepcific

Weakness
Fatigue

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86
Q

Incubation period Hepatitis D

A

60-90 days (range 30-180 days)

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87
Q

Parasites hepatitis etiology

A

Echinococcus
Toxocara
Schistosoma

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88
Q

3 types of gallstones

A

Cholesterol stones
Pigment stones
Mixed stones

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89
Q

Primary liver cancer

A

When the tumor originates from liver cells

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90
Q

Serum proteins diagnosis hepatitis

A

IgM
IgG
Hypoalbuminemia
Increased prothrombin time

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91
Q

Obesity etiology hepatitis

A

Non-alcoholic steatosis

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92
Q

Protozoa etiology hepatitis

A

Toxoplasma

Leishmania

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93
Q

Accumulation of fat in the hepatocytes, may results altered fat metabolism in the liver and increase synthesis of fatty acids and triglycerides. Enlargement of the liver is accompanied by symptoms that may include anorexia, nausea and jaundice. At this point the fatty changes are generally reversible if alochol consumption ceases

A

Alocholic steatosis - fatty liver

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94
Q

The most aggressive form, with high mortality rate, cannot exist without B virus, spreads through the blood, typical for IV drug users and hemophilia patients

A

HDV
-ssRNA
Serum delta hepatitis

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95
Q

Causes chronic hepatitis, can cause cirrhosis and cancer

A

Hepatitis B

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96
Q

IgM

A

Indicates acute case

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97
Q

Tenderness when hand taps the end of right costal arch

A

Ortner’s sign

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98
Q

AST is presented not only in the liver but also in

A 
Skeletal muscles
Heart muscle
Brain
Lungs
Pancreas

Can be released from these tissues in the case of their destruction

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99
Q

Classification of primary liver cancer

A

Hepatocellular carcinoma
Cholangiocarcinoma
Angiosarcoma

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100
Q

Risk factors for calculous cholecystitis

A 
Female
Obesity
Rapid weight loss
Pregnancy
Increasing age
Ethnic groups (hispanic, scandinavian)
Drugs (esp hormonal therapy in women)
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101
Q

Alpha-1-antitrypsin deficiency

A

Abnormal accumulation of the protein within liver cells

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102
Q

More sensitive for diagnosis of porcelain gallbladder characterized by calcification of gallbladder wall, developing usually in cholelithiasis complicated by ____

A

Describing cholelithiasis

Chronic cholecystitis

103
Q

Signs and symptoms in choledocholithiasis

A

Acute constant pain in upper part of abdomen
Obstructive jaundice
Murphy’s sign negative
Charcot triad

104
Q

Pain worse when lying flat on bakc

A

Acute pancreatitis

105
Q

An eosinophilic cytoplasmic inclusion, alocholic hyaline, found in liver cells

A

Mallory bodies

106
Q

Long-term presence og gallstones

A

Silent stones

107
Q

Initial manifestations of hepatitis may start and get better quickly = ______ or cause long-term disease = _____

A

Typical for acute hepatitis

Chronic hepatitis

108
Q

Charcot triad

A

Indicates ascending cholangitis

Severe right upper quadrant pain
Jaundice
Fever

109
Q

Treatment hepatitis

A

Medical, depends on the cause

110
Q

Arises in the duodenum, pancreas, and peripancreatic soft tissue

A

Sollinger-Ellison syndrome

111
Q

The most common type of pancreatic cancer is adenocarcinoma arising from the ___ component, from the cells that line the ducts of the pancreas

A

Exocrine

112
Q

Aspartate aminotransferase (AST) aka serum glutamic oxaloacetic tranaminase (SGOT) is

A

Intracellular enzymes

113
Q

AST blood concentration is significantly increased in

A

Acute toxic hepatitis
Acute viral hepatitis
Alcoholic liver disease

114
Q

The major danger of gallstones is their ability

A

To move to the bile ducts resulting in duct obstruction

115
Q

Diagnosis cirrhosis imaging

A

CT of abdomen
MRI of abdomen
Upper endoscopy for esophageal varicies
Ultrasound of the abdomen

116
Q

CT-scan is used for diagnosis of _____ stones

Aka ____

A

Distal common bile duct stones

Porcelain gallbladder

117
Q

Normal gallbladder wall vs inflamed

A

1 inch

2 inches

118
Q

Cirrhosis etiology

A 
Alocholism
Chronic hepatitis B, C, D, F
Autoimmune hepatitis
Some medicines (corticosteroids)
Genetic diseases (genetic hemochromatosis, Wilson’s disease)
119
Q

Signs and symptoms of acute cholecystitis

A

Acute pain in right upper abdomen that is severe and constant, may last for days

Pain is increased with breathing

Pain radiates to right shoulder, or right scapula, or right mid back (T8-9 level)

Changing position and passing gas do NOT relieve pain
Large amount of meal or fat meal can trigger the pain
Pain occurs several hours after eating and awakens the pt during the night
Fever and chills
Nausea nad vomiting
Vomiting does NOT relieve pain (unlike peptic ulcer)

120
Q

Ischemic hepatitis (shock liver) most often associated with

A

Heart failure
Shock
Sepsis

121
Q

Gastrinoma

A

Zollinger-Ellison syndrome

122
Q

Alanine aminotransferase (ALT) aka serum glutamic pyruvic tranaminase (SGPT) is

A

Intracellular enzymes

123
Q

Pathogenesis of chronic cholecystitis

A

Occurs after repetitive mild exacerbations of acute cholecystitis and is characterized by mucosal atrophy and fibrosis of gallbladder wall

124
Q

Toxic hepatitis could be caused by

A

Medications (tylenol, birth control pills, Lipitor, etc)
Mushroom poison
Alcohol

125
Q

Metastases from the liver

A

To local veins and then to lungs

Advanced cases are characterized by metastases to the bone (including spine) and brain

126
Q

Acalcolous cholecystitis

A

Without formation of stones

10%

127
Q

When cholelithiasis becomes symptomatic the following signs and symptoms develop

A 
Murphy’s sign?
Tachycardia
Nausea, vomiting (vomiting does NOT relieve pain)
Increased production of gas
Fat intolerance
128
Q

As liver function worsens, symptoms may include

A

Ascites

Ascites with caput medusae

129
Q

In acute cholecystitis vomiting ____ relive the pain

A

Does not

130
Q

Differential diagnosis for chronic cholecystitis

A

Peptic ulcer
Hiatal hernia
Colitis
Chronic pancreatitis

131
Q

Gold standard for diagnosis of cirrhosis is

A

Liver biopsy

132
Q

Decreased gallbladder motility - mixed gallstones

A

Severe trauma (e.g. car accidents)
Severe burns
Paralysis

133
Q

X-ray in cholelithiasis

A

15% sensitivity for radioopaque stones (pigment and mixed stones)

134
Q

Spreads through sexual contacts and hemotransfusions, cross the placenta

A

HCV
+ssRNA
Serum non-A, non-B hepatitis

135
Q

Cholelithiasis signs and symptoms - gallstone attack

A

Sudden acute pain in right upper quadrant lasts 30 minutes to several hours, until gallbladder relaxes
Pain radiates to back, between blades, right shoulder, behind sternum
Change of posture, defecation do NOT relieve pain

136
Q

Risk factors for mixed gallstones - what part of ilium

A

Distal portion

137
Q

This is a new discovered hepatitis virus, spreads by blood and sexual contact.

Does not appear to replicate primarily in the liver, its characteristics are in the process of study

A

HGV

GB virus C

138
Q

Phrenic nerve sign

A

Georgievskiy-Myussi’s sign

139
Q

More sensitive than ultrasound in diagnosis of pericholecystitic inflammation

A

CT-scan

140
Q

Signs and symptoms of liver cancer

Clinical manifestations appear only in the late stages, and worsen with a progression of the disease

A

Loss of weight
Loss of appetite
Upper abdominal discomfort and pain

141
Q

Liver size can be ___ in cirrhosis

A

Normal
Enlarged
Shrunken

142
Q

Incubation period Hepatitis E

A

40 days (range 14-60 days)

143
Q

Comlpications hepatitis

A 
Liver cirrhosis (hep b,c,d,f, toxic, autoimmune, genetic)
Hepatic failure
Hepatocellular carcinoma (hepatoma)
144
Q

Zollinger-Ellison syndrome diagnosis

A

Blood testing to detect inc gastrin levels
Upper GI endoscopy
Imaging tests to look for gastrinoma
Measurement of stomach acid - gastric pH less than 2.0; large gastric volume greater than 140mL

145
Q

Thalassemia

A

Absence of globulin or alpha or 2beta

Physical or morphological structure

146
Q

Diagnosis liver cancer

A 
Blood test
US
CT
MRI
Liver biopsy
PET-CT
147
Q

Gastric pH less than 2.0

Large gastric volume >140mL

A

ZES (Zollinger-Ellison syndrome)

148
Q

Gamma-glutamyltransferase (GGT) is found predominately in the ___ but also is present in the cell membrance of other tissues (e.g. kidneys, heart, brain)

A

Hepatobiliary cell membrances

149
Q

Bacteria cause hepatitis

A

Staphylococci and streptococci - toxic shock syndromes
Leptospira (gram-negative spirochete)
Listeria (gram positive, non spore-forming rods)

150
Q

Radioopaque stones

A

Pigment and mixed stones

151
Q

Diagnosis cirrhosis

A

CBC - thrombocytopenia, leukopenia, neutropenia
Inc prothrombin time
Hypoalbuminemia
Aminotrasferases - AST, ALT, GGT elevated; AST usually > ALT, GGT typically much higher in alcoholic cirrhosis
ALP elevated
Bilirubin elevated

152
Q

Increased prothrombin tmie indicates the

A

Decreased production of clotting factors

153
Q

Risk factors for pigement gallstones

A

Young population
Hemolytic conditions (sickle cell anemia, hereditary spherocytosis, thalassemia)
Liver cirrhosis
Intraductal stasis (choledochole cyst, postsurgical biliary stricture)

154
Q

Zollinger-Ellison syndrome can mmetastasize to ____leading to a significantly short life

A

The liver

155
Q

Blood tests for acute cholecystitis

A

Elevated WBC
Elevated alkaline phosphatase
Elevated C-reactive protein

156
Q

In men signs and symptoms cirrhosis

A

Impotence
Hypogonadism (shrinking of the testicles)
Gynecomastia (breast swelling)

157
Q

ALT blood elevation is significantly increased in case of

A

Acute hepatocyte destruction or severe kidneys, pancreas damage

158
Q

Cirrhosis etiology

A

Alocholism is major etiological factor

159
Q

GGT blood concentration is significantly increased in liver diseases associated with

A

Hepatocyte necrosis
Cirrhosis
Alcoholic liver disease

160
Q

Pain decreases with sitting and flexion forward (unlike to pain in ___ and ____)

A

Acute pancreatitis

Cholelithiasis

Acute cholecystitis

161
Q

Spreads through fecal contamination of food and water, causes an acute and self-limiting infection, does NOT cause chronic hepatitis

A

HAV (hepatitis A)
+ssRNA
Infectious hepatitis

162
Q

One of the real treatment options today is

A

Liver transplantation

163
Q

Signs and symptoms liver cirrhosis

A

There may be no symptoms or symptoms may come on slowly, depending on how well the liver is working

164
Q

Etiology hepatitis

A 
Viral
Toxic
Bacteria
Protozoa
Parasites
Fungi
Autoimmune diseases
Obesity
Genetic
Ischemic hepatitis
165
Q

Risk factors for mixed gallstones

A

Crohn’s disease
Partial removal of ilium
Decreased gallbladder motility

166
Q

Originates from the blood vessel cells in the liver

A

Angiosarcoma aka hemangioendothelioma

167
Q

Most liver transplant recipients recieve immunosuppressive drugs (corticosteroids) for

A

Prevention of the graft rejeciton

168
Q

Tumor markers found only in primary liver cancers as well as in other cancers and certain other disorders

A

Carbohydrate antigen 19-9 (CA19-9)
Carcinoembryonic antigen (CEA)
Cancer antigen 125 (CA125)

169
Q

Anti-viral antibodies and viral genetic materials

A

Anti-HAV (for Hep A)
Anti-HBV (for Hep B)
Anti-HCV (for HEp C)

170
Q

Decreased gallbladder motility with bile stasis

A

Age over 40
Female
Some drugs (statins, estrogen therapy)
Multiple pregnancies

171
Q

Hepatitis exists in 2 forms

A

Acute - less than 6 months

Chronic - more than 6 months

172
Q

Specific for cholecystitis but is non-sensitive especially in geriatric patients

A

Murphy’s sign

173
Q

Pancreatitis blood amylase and lipase are ____ than normal variations

Which is better indicator

A

4-6 times hight

Lipase

174
Q

Use for differential diagnosis between acute and chronic cholecystitis

A

HBS - hepatobiliary scintigraphy

175
Q

Fungi etiology hepatitis

A

Aspergillus
Histoplasma capsulatum
Candida

176
Q

Pain occurs several hours after eating and awakens pt at night

A

Acute cholecystitis

177
Q

Lateral clinical manifestations of cirrhosis

A 
Jaundice
Esophageal varicies
Ascites
Hepatomegaly
Splenomegaly
Hemorrhoids
Edema
Peripheral neuropathy
Changes in mental responsiveness and memory
Spider angiomas. Face, neck, shoulders
Anemia
Thrombocytopenia
Coagulation disorders
Collateral veins visible on abdominal wall
Palmar erythema
Sexual characteristics
Changes
Gynecomastia
Hirsuitism
178
Q

Initial manifestations of acute hepatitis for first 2-4 days are NON-specific and characterized by flu-like signs and symptoms

A 
Fever
Malaise
Joint aches
Headache
Nausea, vomiting
Diarrhea
179
Q

Managment of chronic cholecystitis

A

Diet modification
Antibiotics
Restriction of physical activity

180
Q

The first symptoms of cholecystitis

A

Bitter taste and taste of metal in mouth in the mornings

181
Q

Hemochromatosis

A

Iron accumulate in multiple body sites, including the liver

182
Q

Pulmonary embolism because the pancreatic cancer produces

A

Blood clotting chemicals

183
Q

Splenomegaly is often found regardless of

A

Liver size

184
Q

Cholelithiasis diagnosis

A 
Blood tests
US
CT
MRI
ERCP
X-ray
185
Q

Ankle swelling (non-pitting, non-pedal edema) due to

A

Hypoalbuinemia

186
Q

Cholangitis when the common bile duct is obstructed before jointing the

A

Pancreatic duct

187
Q

Gold standard examination for diagnosis of gallbaldder stones and stones in the cystic duct is

A

Ultrasound examination

188
Q

Occupies 3rd position in frequency among the most common cancer mortality

A

Liver cancer

189
Q

Treatment cholelithiasis

A

Just medical treatment including surgery

190
Q

Fibrosis of gallbladder wall with further calcification

A

Porcelain gallbladder

191
Q

A consequence of chronic liver diseases characterized by replacement of liver tissue by scarring tissue leading to loss of liver function

A

Liver cirrhosis

192
Q

Jaundice develops when pancreatic cancer is located in

A

The head of the pancreas

193
Q

Treatment recommendations by chiropractor cirrhosis

A

Avoiding alcohol consumption
Eating healthy diet that is low in salt
Vitamin and nutritional supplements

194
Q

Cholesterol stones

A

Radiolucent

80%

195
Q

Liver enzymes

A 
Aspartate aminotransferase (AST)
Alanine aminotransferase (ALT)
Gamma glutamyltransferase (GGT)
196
Q

Complications for acute pancreatitsi

A 
Pancreonecrosis
Pancreatic abscess
Acute gastritis and duodenitis
Internal bleeding with development of hypovolemic shock
Lung problems
197
Q

Causes chronic hepatitis, cirrhosis, liver cancer

A

Hepatitis D

198
Q

Tumor markers blood test most important is increased

A

Alfa-fetoprotein

199
Q

Tumor originates from the bile duct cells

A

Cholangiocarcinoma

200
Q

Blood tests for chronic cholecystitis

A

Frequently shows normal values

201
Q

Inflammation of the pancreas when certain enzymes that normally do not become active until they reach the small intestine, become active in the pancreas digesting this gland itself

A

Pancreatitis

202
Q

Non-specific signs and symptoms pancreatic cancer

A 
Clinical depression - sometimes presenting before caner is diagnosed
Unexplained weight loss
Anorexia
Nausea, vomiting
Steatorrhea
203
Q

Murphy’s sign is negative with the stone in the

A

Bile duct - choledocholithiasis

204
Q

Radiologic exam can be used for differential diagnosis between

A

Gallbladder

Kidney stones

205
Q

Autoimmune, parasites, protozoa, obesity, genetic, ischemic etiological agents usually result in

A

Progression to chronic hepatitis

206
Q

Increased neutrophils for acute

A

Cholecystitis

207
Q

Metastases pancreatic cancer

A
  1. To regional lymphatic nodes
  2. Liver
  3. Lungs and pleura
208
Q

High ALP can show

A 
Liver disease
Bile duct obstruction
Presence of paget’s disease with osteoblastic activity
Presence of pregnancy
Presence of celiac disease
209
Q

Xanthomas result from

A

Cholestasis and/or hyperlipidemia

210
Q

Complications cirrhosis

A

Bleeding disorders
Esophageal varicies
Hepatocellular carcinoma
Hepatic encephalopathy

211
Q

Etiology for acute pancreatitis

A 
Alcohol use
Gallstones
Trauma of the abdomen
Viral infections (mumps)
Pseudocysts
Medications (corticosteroids, estrogen, statins)
212
Q

Anit-viral antibodies and viral genetic materials can be helpful in diagnosis of both

A

Acute and chronic viral hepatitis

213
Q

Spreads through blood transfusion or oral fecal route

Causes chronic hepatitis

A

HFV

Serum, mutated B-virus

214
Q

Diagnosis cholelithiasis

A

Blood tests are infomative in the cases of exacerbation

215
Q

Cancer that begins in another area of the body (colon, breast, stomach) and then spreads to the liver

A

Secondary (metastatic)

216
Q

Hypoalbuminemia indicates

A

A decreased function of hepatocytes

217
Q

Measures of liver homeostasis

High concentrations develop as a result of destruction or inflammation not only in the liver, but in other tissues as well

A

Liver enzymes aka aminotransferases

218
Q

Malignant neoplasm originating from transformed cells of the pancreas

A

Pancreatic cancer

219
Q

Left shoulder radiation

A

Heart

Pancreas

220
Q

This pain is ALWAYS accompanied by high blood pressure and tachycardia

A

Acute pancreatitis

221
Q

Perforation or rupture of gallbladder with development of

A

Bile peritonitis and high level of mortality

222
Q

Characterized by overproduction of gastrin which stimulates extreme HCl secretion

A

Zollinger-Ellison syndrome

223
Q

Incubation period Hepatitis C

A

50 days (range 15-160 days)

224
Q

Types of pancreatitis

A

Acute

Chronic

225
Q

The enzyme ____ plays teh most important role in pancreatitis process

A

Trypsin

226
Q

Pigment stones

A

Contain bilirubin and calcium

Radioopaque

227
Q

Liver cancer - forms

A

Primary

Secondary - metastatic

228
Q

On lateral lumbar x-ray film

Gallstones are located :

Kidney stones :

A

In front of lumbar spine

Overlap L2 or locate posterior to it

229
Q

Changing position and passing gas do NOT relieve pain

A

Acute cholecystitis

230
Q

Signs and symptoms liver cancer

A 
Nausea, vomiting
General weakness, fatigue
Jaundice with skin itching
Hepatosplenomegaly
Sudden ascites
Back pain
231
Q

Early symptoms liver cirrhosis

A

Fatigue and loss of energy
Poor appetite and weight loss
Nausea and upper abodminal discomfort
Small, red, spider-like blood vessels on the skin (telangiectasia, spider angioma)

232
Q

Early pancreatic cancer often does not cause symptoms or symptoms are _____

A

Silent disease

Non-specific

233
Q

Differential diagnosis for acute cholecystitis

A

Acute peptic ulcer
Perforated peptic ulcer
Acute pancreatitis
Ureteral colic

234
Q

Viral, bacterial, fungal, and toxic etiological agents usually result in

A

Acute hepatitis until further progression to chronic hepatitis EXCEPT

HAV and HEV

235
Q

Signs and symptoms pancreatic cancer

A

Painless jaundice, may be associated with itching

236
Q

Signs and symptoms typical for all forms and etiologies of hepatitis in overt stage

A

Weight loss
Easy bruising
Encephalopathy
Hepatosplenomegaly

237
Q

Inflammation of the gallbladder wall

A

Cholecystitis

238
Q

During the physical exam the ___ can be found with liver cancer

It develops because hepatocarcinoma has a lot of blood vessels with turbulent blood flow

A

Hepatic bruit

239
Q

Treatment liver cancer

A

Cryotherapy in early stage
Chemoembolisation
Radiotherapy
Liver transplantation

240
Q

Diagnosis hepatitis

A 
Tests for bilirubin
Liver enzymes
Anti-viral antibodies and viral genetic materials
Serum proteins
Ultrasound
Liver biopsy
241
Q

Increased sensitivity below the right scapula (also due to phrenic nerve irritation)

A

Boas’ sign

242
Q

Inflammation of the liver with change of its function

A

Hepatitis

243
Q

The gallstones may be present for ____ before symptoms develop, and ___ of patients remain asymptomatic throughout their lives

A

Decades

70-80%

244
Q

Brusing of the flank, which may be indicative of pancreatic necrosis with retro peritoneal or intraabdominal bleeding

A

Acute pancreatitis positive Grey-Turner’s sign

Ecchymosis of the flanks

245
Q

Genetic causes of hepatitis

A

Alpha-1-antitrypsin deficiency
Hemochromatosis
Wilson disease
Glycogen storage disorders

246
Q

The signs and symptoms of pancreatic cancer depend on

A

Size, location, and tissue type of tumor

247
Q

Wilson disease

A

Copper accumulate in the liver and brain

248
Q

Cholecystitis divides into

A

Acute

Chronic

249
Q

Endocrine pancreatic tumors

A

Insulinoma

Zollinger-ellison syndrome

250
Q

Diagnosis cholecystitis

A 
Ortner’s sign
Georgievskiy-Myussi’s sign
Murphy’s sign
Boas’ sign
Blood tests
US
MRI
CT
HBS
251
Q

Signs and symptoms for chronic pancreatitis

A 
Acute pain is NOT resolved itself
Nausea
Severe vomiting
Fatty stool
Signs of diabetes mellitus: thirst, polyuria
Weight loss
Pain increases after eating and drinking

Change of position does NOT relive the pain

Band-like pain

252
Q

Increased alfa-fetoprotein is found not only in primary liver cancer but also in

A

Cancer of testicles and ovaries

Metastatic cancer to the liver

253
Q

Acute pain is NOT resolved itself

Pain increases after eating and drinking

Change in position does NOT relieve the pain

Band-like pain

A

Chronic pancreatitis

GE (5 decks)

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