GIT

Question 1

Complication of ulcers

Answer 1

perforation haemorrhages penetration pyloric stenosis malignancy

Question 2

Differences between gastric ulcers and duodenal

Answer 2

gastic:
older people
equally distributed
pathohenseis is usually due to increased attack
tends to be associated with cancer and not the case in duodenal
tend to be skinny

dusoenal:
pathogenesis is usally due to decreased defence 
more males
common in smokers
tend to be fat

Question 3

symptoms of ulcers

Answer 3

pain in epigastric area
hematemesis- coffee grounds
meleana

Question 4

what can affect the defence

Answer 4

smoking, stress, drugs like NSAIDS and corticosteroieds

Question 5

chronic gastritis ABC

Answer 5

A- autoimmune associated with megoblastic anemia
B- bacteria , h.pyloir
C- chemical type, we call in reactive gastritis like in the case of kidney failure you have levels of urea which affects the stomach

Question 6

how do we metabolise alcolhol?

Answer 6

1. alcohol dh - most common - converts it to acetaldehyde ( very toxic worse than alcohol)
2. catalase
3. p450 - for large amounts consumed

Question 7

b12 deficiency symptoms

Answer 7

hunters glossitis

cns disorders due funicular myelosis ataxia, loss of proprioception, parethesia

Question 8

function of prostaglandins

Answer 8

they have a protective role on the stomach especially E2, and medications like NSAIDS inhibit the cox pathway leaving more vulnerable to ulcers

Question 9

examples of post pre hepatic portal hypertension

Answer 9

pre- portal vein thrombosis
hepatic - cirrorhis, hepatitis
post- budd chiari syndrome and constrictive pericarditis which intereferes with venous return

Question 10

the different diseases associated with bilirubin

Answer 10

gilbert 3 - getting the br into the hepatocyte
gilbert 2 - the 2 proteins needed to transport it to the microsome
gilbert 1- deficiency in smaller enxyme

kriggs najar 1 -deficiency in major enzyme - total
kriggs najar 2 - parital

dubin johnson + rotores- problem with excretion out of the liver

Question 11

3 routes of urobilinogen

Answer 11

1. eneterohepatic
2. kidneys
3. stercobolin

Question 12

which type of br will be found in urine and why

Answer 12

conjugated br as its water soluable

Question 13

hepatorenal synsrome

Answer 13

always due to the liver damage usally cirrohosis

Question 14

porto caval anastomoses

Answer 14

1. hemoroids
2. lower oesaphaguse
3. umbilical veins

Question 15

problem with cirrhoris

Answer 15

the regenerationatory capacity of the liver has been exceeded replacement of functional liver with non fucntional. now also the structure which is very important is being affected which also affects fucntion

Question 16

metabolism of alcohol

Answer 16

3 ways - all produce acetaldehyde (very toxic)

1. alcholol dh - common
2. catalase- small fraction
3. cytochrome p450 - large amounts

Question 17

effects of alcohol

Answer 17

hypoglycemic effect due to induction of insulin and also it uses up a lot of energy for its metabolis which is why it triggeres hunger

effects ETC so less ATP which is a problem as you need energy to metabolise it

Question 18

biliary cirrhoris

Answer 18

a build up of bile in the liver due to obstruction so it backflows into the liver increasing pressure in the liver and setroying the bile channels within the liver

Question 19

mechanism of a fatty liver

Answer 19

1. too much fat for the liver to metabolise

2. liver is damaged so it cant metabolise it

Question 20

pancreatitis signs

Answer 20

cullens sign - umbilicus
grey turners sign - retroperitoneal
hyperglcemia - damage of the islets
hypoalbumineam - increased permeability of the capillaries
SHOCK - decreased perfusion due to hemorrrgaes and also hypovelemia due to massive inflammtion
hypoactive bowel signs
abdominal distenetion

Question 21

diagnosis for pancreatitis and treatment

Answer 21

increase enzyme of which lipas is more specific
hypoalbumneia
inflammatory markers like crp
leukocyte counts

no food - reduce secretions
iv fluids to increase blood volume and pressure

Question 22

complications of pancrwatiits

Answer 22

fatty necrosis
shock
abscess
fluid acumulation around the pancrease

Question 23

Which hepatitis virus is associated with cancer

Answer 23

hep B and hep C - liver cancer and non hodgskin lympha

Question 24

Which type of hepatitis is related to HIV

Answer 24

hep c and b , some people with hep will have co infection with hiv but more so in the case of c

Question 25

types of viruse

Answer 25

hep b is the only dna

Question 26

Why do people with liver disease develop alkalosis

Answer 26

Failure of urea cycle
RAAS
respiratory alkalosis

Question 27

What is the effect of alkalosis on the bohr shift

Answer 27

shifts to the left hold strongly to 02 —-hypoxia

Question 28

spider Navy

Answer 28

Occurs when you have a lot of oestrogen in your system because of the fact of the liver cannot biotransform

Question 29

hyperammonia theory

Answer 29

decreased energy in the brain

Question 30

if br can not enter the hepatocyte

Answer 30

heaptic unconjugted

Question 31

main mechanism for the development of ascites

and second

Answer 31

portal hypertension

raas