GIT Flashcards
Complication of ulcers
perforation haemorrhages penetration pyloric stenosis malignancy
Differences between gastric ulcers and duodenal
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
symptoms of ulcers
pain in epigastric area
hematemesis- coffee grounds
meleana
what can affect the defence
smoking, stress, drugs like NSAIDS and corticosteroieds
chronic gastritis ABC
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
how do we metabolise alcolhol?
- alcohol dh - most common - converts it to acetaldehyde ( very toxic worse than alcohol)
- catalase
- p450 - for large amounts consumed
b12 deficiency symptoms
hunters glossitis
cns disorders due funicular myelosis ataxia, loss of proprioception, parethesia
function of prostaglandins
they have a protective role on the stomach especially E2, and medications like NSAIDS inhibit the cox pathway leaving more vulnerable to ulcers
examples of post pre hepatic portal hypertension
pre- portal vein thrombosis
hepatic - cirrorhis, hepatitis
post- budd chiari syndrome and constrictive pericarditis which intereferes with venous return
the different diseases associated with bilirubin
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
3 routes of urobilinogen
- eneterohepatic
- kidneys
- stercobolin
which type of br will be found in urine and why
conjugated br as its water soluable
hepatorenal synsrome
always due to the liver damage usally cirrohosis
porto caval anastomoses
- hemoroids
- lower oesaphaguse
- umbilical veins
problem with cirrhoris
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
metabolism of alcohol
3 ways - all produce acetaldehyde (very toxic)
- alcholol dh - common
- catalase- small fraction
- cytochrome p450 - large amounts
effects of alcohol
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
biliary cirrhoris
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
mechanism of a fatty liver
- too much fat for the liver to metabolise
2. liver is damaged so it cant metabolise it
pancreatitis signs
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
diagnosis for pancreatitis and treatment
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
complications of pancrwatiits
fatty necrosis
shock
abscess
fluid acumulation around the pancrease
Which hepatitis virus is associated with cancer
hep B and hep C - liver cancer and non hodgskin lympha
Which type of hepatitis is related to HIV
hep c and b , some people with hep will have co infection with hiv but more so in the case of c
types of viruse
hep b is the only dna
Why do people with liver disease develop alkalosis
Failure of urea cycle
RAAS
respiratory alkalosis
What is the effect of alkalosis on the bohr shift
shifts to the left hold strongly to 02 —-hypoxia
spider Navy
Occurs when you have a lot of oestrogen in your system because of the fact of the liver cannot biotransform
hyperammonia theory
decreased energy in the brain
if br can not enter the hepatocyte
heaptic unconjugted
main mechanism for the development of ascites
and second
portal hypertension
raas
