FINALS: LONGGGG EXAM Flashcards
abnormal growth or tumor located in
the head of the pancreas, which is the part of the
pancreas closest to the small intestine and bile
duct. This mass can be either benign or
malignant (cancerous).
Pancreatic head mass
head of the pancreas to join the pancreatic duct and
empty at the
ampulla of Vater into the duodenum.
most common type of
pancreatic cancer
* It arises from the ductal cells of the
pancreas and is often aggressive.
* It can invade nearby structures
Pancreatic Adenocarcinoma
originate from the
pancreatic islet cells that produce
hormones.
Pancreatic Neuroendocrine Tumors (NETs)
These are fluid-filled sacs or pockets
that may develop in the pancreas.
Pancreatic Cystic Lesions
These are benign tumors that arise from
the ductal epithelium of the pancreas.
Pancreatic Ductal Adenomas
Lymphomas can occasionally involve the
pancreas, presenting as a mass in the
pancreatic head.
Pancreatic Lymphoma
These are non-neoplastic lesions that
mimic the appearance of a tumor on
imaging but are not composed of
abnormal cells.
Pseudotumors
Some masses in the pancreatic head may
have mixed solid and cystic
components, making their classification
more complex.
Solid and Cystic Masses
The amount of serum bilirubin to show the
yellowing skin tone of a patient with jaundice
≥ 2.5mg/dL of Serum Bilirubin
This is before Bilirubin reaches the Liver
* Increased Unconjugated Bilirubin
Prehepatic/Hemolytic
Damaged Hepatocytes
Hepatocellular/Intrahepatic
Impaired flow of bile into intestines
* The blockage causes pressure to
increase in the bile duct causing bile to
leak through the tight junctions between
the hepatocytes
Post Hepatic/Obstructive
Due to the obstruction on the bile
canaliculus, the bile flows backwards to
the tight junctions in between the
hepatocyte and reaches the blood.
Hypercholesterolemia & Xanthomas
→ HALLMARK SIGN of obstructive jaundice
secondary to pancreatic head mass
Painless jaundice
e GOLD STANDARD for diagnosing obstructive
jaundice secondary to a pancreatic mass
Endoscopic Retrograde Cholangiopancreatography
(ERCP)
POST-HEPATIC or OBSTRUCTIVE CAUSE
Direct Bilirubin is HIGHER than indirect
✓ Elevated Alkaline Phosphatase (ALP)
✓ Aspartate transferase = Normal
Also known as “Bilirubin Stones”
* Gray in color
* Pigment stones form from precipitated
unconjugated pigments
Pigment stones
- Result from supersaturated bile with
cholesterol - Yellow in color
Cholesterol stones
Obstruction of bile outflow by
gallstones, leading to:
✓ Chemical reaction
Calculous Cholecystitis
- Acute inflammation without gallstone
obstruction.
Acalculous Cholecystitis
➔ Inner layer
➔ Enable blood to transport oxygen and
nutrients without getting absorbed until it
reaches the right spot.
Tunica Intima
Middle layer
➔ Enable the aorta to meet the body’s
changing blood flow needs.
Tunica Media
Outer layer
➔ Anchors the aorta in place
) Tunica Adventitia
HALLMARK SIGN of AAA
➔ Located in the umbilical region to the left of
midline
Pulsatile mass in the abdomen (Bruit)
What is the first dysfunction that will occur with
regards to our patient’s modifiable and non-modifiable
factors?
➔ Endothelial dysfunction
Tearing in one or more of the layers of
the wall of the aorta
o The most common and most lethal
complication involving the aorta
Aortic dissection
the GOLD STANDARD to diagnose AAA.
➔ This uses an injection of contrast material into
your blood vessels
CT Angiogram/Angiography
Also known as congestive heart failure
* A condition that develops when your heart doesn’t
pump enough blood for your body’s needs
Heart Failure
Left-Sided Heart Failure:
* Symptoms:
Fluid accumulation in the lungs
(pulmonary edema) is a common feature.
Fibrotic lungs, “stiff lungs”
Right-Sided Heart Failure:
Right-Sided Heart Failure:
Manifesst
Fluid retention in the extremities
and organs of the body (peripheral edema) is a
hallmark
Occurs when the left ventricle is unable to
contract strongly enough when the heart
beats.
* Also called heart failure with reduced
ejection fraction (HFrEF)
* Do not have a normal ejection fraction.
TWO TYPES OF LEFT-SIDED HEART FAILURE
1. Systolic failure
TWO TYPES OF LEFT-SIDED HEART FAILURE
1. Diastolic failure
Occurs when the left ventricle cannot relax
properly between heartbeats.
* Also called heart failure with preserved
ejection fraction (HFpEF)
* Normally have a normal ejection
fraction
sound indicates left ventricular failure and is
considered an emergency situation.
s3 heart spund
GOLD standard diagnostic test for heart failure
Elevated NT-proBNP indicates heart failure
NT‐proBNP (N-terminal pro–B-type natriuretic peptide)
If FUROSEMIDE (IV push) is given TOO FAST
* May cause
Tinnitus & Hypotension
If FUROSEMIDE is given TOO MUCH
* May cause
Nephrotoxicity (↑ BUN ↑CREA)
* May cause hypokalemia
DIET for a patient with heart failure
Low salt and low-fat diet, Low fluid intake
* Patients with heart failure should limit sodium
intake to 2 to 3 grams or less per day
* Less than 2 L of fluid per day
A patient with left-sided heart failure is having difficulty
breathing. Which of the following is the most
appropriate nursing intervention?
Assist the patient into High Fowler’s position
