Gastrointestinal

Question 1

The four hepatic enzymes ALkaline phosphate, GGT, ALT, and AST are specific to what?

Answer 1

Alkaline phosphatase
GGT = biliary flow

AST/ALT= heptocytes

Question 2

Why don’t late liver failure patients develop ammonia elevations?

Answer 2

Because they often are not eating and you must eat to develop high ammonia levels

Question 3

A patient is continuously vomiting. What would his ABG show?

Answer 3

Metabolic alkalosis

You lose acid when you vomit

Question 4

If a patient has chronic diarrhea you would expect an ABG to show what?

Answer 4

Metabolic acidosis

You lose base through diarrhea

Question 5

If pancreatic enzymes get activated within the pancreas what occurs?

Answer 5

If amylase, lipase, and trypsin are activated within the pancreas then acute pancreatitis can occur or “auto digestion”

Question 6

What are some causes of acute pancreatitis?

Answer 6

Alcoholism, biliary stones, trauma, shock, infection

Question 7

What are Cullen and grey turner signs? What do they tell you?

Answer 7

Cullen sign is a bluish discoloration around the umbilical region

Grey turner is a bluish discoloration around the flank

They are a concern for necrotizing pancreatitis

Question 8

A patient presents with elevated liver enzymes, jaundice, increases amylase and lipase, hypokalemia, hypokalemia, and hypomagnesemia, increased glucose, N/V/D and a distended abdomen. What are you expecting?

Answer 8

Acute pancreatitis
Or
Splenic rupture

Question 9

Why does hemorrhagic pancreatitis go undiagnosed often?

Answer 9

The drop in H/H is masked by the dehydration from N/V

Question 10

What is Kehrs sign?

Answer 10

Shoulder pain in left shoulder

Often a sign of splenic rupture

Question 11

Normal intraabsominal pressure is what?

Answer 11

0-5 = normal
>12 = hypertension
>25 = fatal