General Flashcards
Nonalcoholic Fatty Liver Disease (NAFLD)
NAFLD includes wide spectrum of disorders including nonalcoholic fatty liver (NAFL) to nonalcoholic steatohepatitis (NASH), fibrosis, and cirrhosis.
NAFLD has become the most common form of liver disease in the U.S. and is the most common morbidity associated with overweight and metabolic syndrome. Can be reversed.
Causes: alcohol, excessive kcalorie intake, obesity, complications of medications, excessive parenteral nutrition, pregnancy, diabetes, inadequate protein intake in malnutrition, infection, malignancy
causes of cirrhosis
Causes: buildup of fibrous connective tissue and fat due to alcohol, hepatitis, biliary disorders, chronic autoimmune disease, metabolic disorders, or chronic use of hepatotoxic drugs, malnutrition
Gall stones (cholelithiasis)
Most cases (75%) are asymptomatic. Symptoms: mild, aching pain in midepigastrium (upper region of abdomen. Pain may radiate up and to the right. Nausea, vomiting, tachycardia and diaphoresis may also be present. Symptoms may be worst after after a high-fat meal Risk factors: multiparous women; pregnancy, estrogen therapy, oral contraceptives; obesity; rapid weight loss, sedentary lifestyles; age; diabetes mellitus
Cholecystitis (inflammation of the gallbladder)
Symptoms: pain/tenderness in upper right side of the abdomen, fever, jaundice, steatorrhea as manifested by flatulence, belching, epigastric heaviness, indigestion, heartburn, chronic upper abdominal pain, and nausea
Treatment: Surgical removal of the gallbladder
Pancreatitis
Signs and symptoms: Upper abdominal pain, Abdominal pain that radiates to your back, Abdominal pain that feels worse after eating, Fever, Rapid pulse, Nausea, Vomiting,Tenderness when touching the abdomen
Diagnosis: elevated serum enzymes (amylase)
Treatment: Patients with Acute Pancreatitis should be screened for nutritional status, as they are at high risk of malnutrition.
Cystic Fibrosis
Cystic fibrosis (CF) is an inherited disorder which increases viscosity of bodily fluids and causes severe damage to the lungs, digestive system and other organs in the body. People with CF can now live in their 30s or 40s, sometimes even 50s.
Atherosclerosis
Chronic inflammatory process in which damage to the arterial wall can lead to coronary artery disease, stroke, and peripheral artery disease. Begins early in life. Associated with Vitamin D deficiency.
Stroke (Cerebrovascular accident) (CVA)
A stroke or cerebrovascular accident (CVA) involves damage to a portion of the brain resulting from loss of blood supply as a result of a blood vessel spasm, clot, or rupture. Inflammation in the neural cells plays a central role in the pathogenesis of the disease. Obesity, heavy or binge drinking, physical inactivity, smoking, and use of cocaine or methamphetamines are lifestyle risks that can be controlled. Other risk factors include hypertension, diabetes mellitus, high cholesterol, atrial fibrillation, heart failure, oral contraceptive or estrogen use, and obstructive sleep apnea. Men have a higher risk than women at a younger age, but women are more likely to die from strokes.Both fish and omega-3 fatty acids seem to prevent thrombotic strokes.
Thrombosis
Blood Clot
Dyslipidemia
When LDL and HDL are unbalanced. May be triggered by Intermittent hypoxemia from obstructive sleep apnea (OSA).
Cardiac Cachexia
Unintentional severe weight loss associated with heart disease
chronic obstructive pulmonary disease (COPD)
collective phrase for chronic bronchitis, asthma, or emphysema. COPD is the second leading cause of disability in the United States
Respiratory distress syndrome (RDS)
Affects newborns, especially premature newborns. RDS usually develops in the first 24 hours after birth.
Symptoms:
Rapid breathing (tachypnea), or stopped breathing (apnea)
Grunting noises, nasal flaring, or pulling of the chest or neck muscles as the infant works to breathe
Pale color (pallor) or blue color (cyanosis)
Acute respiratory failure (ARF)
When a person has acute respiratory failure, the usual exchange between oxygen and carbon dioxide in the lungs does not occur. As a result, enough oxygen cannot reach the heart, brain, or the rest of the body.
This can cause symptoms such as shortness of breath, a bluish tint in the face and lips, and confusion.
Acute respiratory failure has many possible causes. The cause may be acute, including pneumonia, or chronic, such as amyotrophic lateral sclerosis (ALS).
Half of patients with ARF experience malnutrition.
Kidney syndromes:
The key with ____ syndrome is an excess amount of protein in the urine, whereas ___ syndrome is where there is an excess amount of blood in the urine.
NEPHROTIC =PROTEIN
NEPHRITIC = BLOOD
Proteinuria
Proteinuria is the presence of excess proteins in the urine. In healthy persons, urine contains very little protein; an excess is suggestive of illness. Excess protein in the urine often causes the urine to become foamy. Severe proteinurina can cause nephrotic syndrome in which there is worsening swelling of the body. This condition can be a sign of kidney damage.
Causes: In many cases, proteinuria is caused by relatively benign (non-cancerous) or temporary medical conditions.
These include dehydration, inflammation and low blood pressure. Intense exercise or activity, emotional stress, aspirin therapy and exposure to cold can also trigger proteinuria. In addition, a kidney stone in the urinary tract can cause proteinuria.
Occasionally, proteinuria is an early indication of chronic kidney disease, a gradual loss of kidney function that may eventually require dialysis or a kidney transplant.
Other potentially kidney-harming diseases and medical conditions, which can lead to proteinuria, include:
Immune disorders like lupus and Goodpasture’s syndrome
Acute inflammation of the kidney (glomerulonephritis)
Cancer of plasma cells (multiple myeloma)
Intravascular hemolysis, which is the destruction of red blood cells and release of hemoglobin in the bloodstream
Cardiovascular disease
Preeclampsia, the simultaneous development of hypertension and proteinuria in a pregnant woman
Poisoning
Trauma
Kidney cancer
Congestive heart failure
Symptoms:
if proteinuria is advanced, symptoms can include:
More frequent urination
Shortness of breath
Tiredness
Nausea and vomiting
Swelling in the face, belly, feet or ankles
Lack of appetite
Muscle cramping at night
Puffiness around the eyes, especially in the morning
Foamy or bubbly urine
Diagnosis: Urine test
Treatment: Typically ACE inhibitors or ARBs would be recommended due to their known antiproteinuric effects. Additionally, some patients may be on immunosuppressive therapies with corticosteroids, adrenocorticotropic hormone, Tripterygium wilfordii, alkylating agents, mycophenolate mofetil, azathioprine, IVIG, rituximab, eculizumab, cyclosporine, or tacrolimus.
Nephrotic syndrome
Nephrotic syndrome describes a complex of symptoms that can occur after damage to the capillary walls of the glomerulus. Glomerular damage results in increased urinary excretion of protein (proteinuria), which leads to decreased serum levels of albumin (hypoalbuminemia), hyperlipidemia, and edema.
Nephrotic syndrome often results from primary glomerular disease (glomerulonephritis), nephropathy secondary to amyloidosis (accumulation of waxy starchlike glycoprotein), diabetes mellitus, infectious disease, or systemic lupus erythematosus (SLE) a chronic inflammatory disease. In children, there is an association between food sensitivity, altered gut microbiota, and nephrotic syndrome (Uy, et al, 2015).
Treating nephrotic syndrome includes addressing the underlying cause as well as taking steps to reduce high blood pressure, edema, high cholesterol, and infection (NIDDK, 2017). In some children, diminished proteinuria results from eliminating cow’s milk and the use of a gluten-free diet (Uy, et al, 2015).
The syndrome may be treated with corticosteroids, immunosuppressants, and statins. When it is resistant to treatment, the condition may progress to renal failure.
Oliguria
Oliguria is when urine output is lower than expected. It is typically a result of dehydration, a blockage, or medications. Most of the time, oliguria can be treated at home, but in some cases, it can be a symptom of a serious medical condition that requires further testing and treatment. Oliguria is different from anuria, which is when urine output stops completely.
