Exam 2 part 2 Flashcards
What are the symptoms of acute vs chronic pancreatitis?
- Acute
- Abdominal pain, distension, N/V
- Great distress, profuse sweating, uncontrollable pain, syncope, rapidly developing shock
- Sudden onset and occurs in pt w/history of gallstones or alcoholism
- Chronic
- Pain, exocrine pancreatic insuffiency (protein malabsorption)
- Endocrine insuffiency - 70% have signs of diabetes, slow but steady destruction of islets of langerhans
- Mild elevations or serum amylase and lipase
- Alcohol abuse, epigastric pain, weight loss, bulky/fatty stools, numerous pancreatic calcifications
What happens to pancreatic tissue when there is blockage of biliary tract? (pathogenesis of acute hemorrhagic pancreatitis)
- Answer: Auto-digestion
- Tissue damage due to pancreatic digestive enzyme buildup (activation of Trypsinogen)
What are 80% of acute pancreatitis caused by?
- Gallstones and alcohol
What condition would you find Mallory bodies in?
- Seen in alcoholic hepatitis (micronodular cirrhosis)
How does alcohol affect liver function?
- Doesn’t allow for peripheral FA’s to enter
- Doesn’t allow for triglycerides to be broken down
- High caloric content (leads to fatty liver - doesn’t allow for beta oxidation)
- Alcholic hepatitis can be fatal
Match the following characteristics to the different hepatitis diseases:
- Benign - fecal/oral vector - picornavirus (like polio, cocksackie)
- Co-infection with Hep B
- DNA - (everything else is RNA)
- One used to be cause post-transfusion/non-A, non-B
- 20% of infected pregnant women develop heptaic necrosis
- Hep A
- Hep D
- Hep B
- Hep C
- Hep E
Which serologic test antibody would detect Hep B during the window period?
(Window period - where you have antigen present - but not enough anitbody reaction)
- Order HBcAb (core antigen) - HBsAg and HbsAb will be negative during window period)
- 3 phases of infection - incubation period, acute infection, and convalescent/recovery phase
- What is osteoporosis?
- Who is most likely to get it?
- What is pathophysiology?
- Loss of bone matrix
- Long bones and vertebral most commonly affected
- For women it’s related to decrease in estrogen levels, causes decrease in bone mass, etiology of osteoporosis is more hormonal thatn any other
- Changes in articular cartilage
- Prevalence and severity increases with age
What bone is most likely affected by fracture in osteoporosis? (in old age and postmenopausal women)
Weight bearing joints: hipts, kneew, and cervical spine
Which joint disease (osteoarthritis or gout) causes destruction of articular cartilage with underlying bone cysts/spurs?
Osteoarthritis
Within osteoarthritis - what are the definitions of:
- Eburnation?
- Fibrillation?
- Sclerosis of subchondral plate due to continued pressure
- Fibrillation - formation of vertical clefts, which shed cartilage into subchondral bone
What are the features of osteoarthritis througout the body?
- When affects the toe, causes bunion
- Affects cervical and lumbar vertebral bodies and hands
- Bouchards vs Heberden’s nodules
- Bone cysts - fill up with synovial fluid
- Osteophytes - bone spurs
What are the definitions of pedagra and tophi?
- Pedagra - foot seizure - the first symptom that occurs in Gout at big toe (tarsometatarsal joint)
- Tophi - encapsulated urate crystals surrounded by macrophages, lymphocytes and giant cells
- Can deposit in organs like the kidneys
What is the pathophysiology of gout?
- 95% male, family history, unknown cause, but genetic and environmental factors
- Hyperuricemia - uric acid crystal deposits in joints, subcutaneous tissue and kidneys
- Big toe (most common area)
- Alcohol exacerbates gout
Which environmental factors predispose development of lupus?
- Young black adults - 10x women over men - familial
- Malfunction of CD4+ T-cells, leading to polycolonal B-cell activation (autoimmune)
