GIT L1-L2 ( general examination and examination of liver ) Flashcards
Complaints of patients with diseases of the
digestive system:
- Abdominal pain
- Gastric dyspepsia (dysphagia, belching,
nausea, vomiting, heartburn, changes in
taste and appetite, dry mouth,
salivation),
- Gastric dyspepsia (dysphagia, belching,
- Intestinal dyspepsia (flatulence of the
abdomen, rumbling, tenesmus, stool
disorders: constipation, diarrhea,
qualitative changes in the stool).
- Intestinal dyspepsia (flatulence of the
explain the Spastic pain
- due to spasm of the smooth
muscles of the
gastrointestinal tract - sharp, paroxysmal with a
clear localization - сauses: gastric colic
(hypersecretion), intestinal
colic, biliary colic
explain the Distension pain
- associated with hypomotor
dyskinesia of smooth
muscles and hollow organ
distension - dull pains, non-intense,
without clear localization - сauses: flatulence,
hyposecretory syndrome
explain the Vascular pain
- associated with a violation of the blood supply to the
abdominal cavity, as a result of this, ischemia and
necrosis develop sudden onset, very intense,
progressive, - сauses: mesenteric thrombosis, embolism, ischemic
disease of the digestive system
explain the Peritoneal pain
- based on tension of the capsule or visceral sheet of
the peritoneum - peritoneal pain occurs gradually or suddenly (with
perforation), increases, intense, accompanied by
tension of the abdominal wall, a symptom of irritation
of the peritoneum, vomiting and fever - сauses: peritonitis due to inflammation of the organs
(appendicitis, acute cholecystitis, acute pancreatitis)
and perforation of the stomach and intestines
explain the Dyspepsia in gastric and intestinalis
–1. Gastric:
* accompanied by pain in the
epigastric region;
* heartburn;
* vomiting;
* change in appetite
* belching;
* nausea;
2. Intestinal:
* accompanied by pain in
different parts of the
abdomen (in the projection
of the small and large
intestine;
* flatulence;
* diarrhea;
* сonstipation;
* tenesmus -painful impulse to
defecate
explain the Vomiting
- The nature of the vomit:
- Admixture of blood, type of “coffee grounds” - a sign of
gastrointestinal bleeding
- Admixture of blood, type of “coffee grounds” - a sign of
- Fecal odor - intestinal obstruction
- Vomiting of acidic contents in the morning - nocturnal
hypersecretion
- Vomiting of acidic contents in the morning - nocturnal
- Vomiting in the morning on an empty stomach with mucus
- chronic gastritis, chronic alcohol intoxication
- Vomiting of food eaten 1-2 days ago, with a putrid odor -
stagnation of food in the stomach with pyloric stenosis
- Vomiting of food eaten 1-2 days ago, with a putrid odor -
explain the Diarrhea
- Enteric:
- stool frequency up to 4-6 times in
1 day; - a large volume of feces with
undigested food residues; - steatorrhea;
- pain in the umbilical region
- Colitis:
- stool frequency up to 10-15 times
in 1 day; - tenesmus (painful urge to
defecate); - small volume of feces;
- admixture of mucus and blood
- Achilic:
- stool frequency up to 4-6 times in 1 day;
- a large volume of dark-colored feces with
remnants of undigested muscle fibers; - putrid smell of feces;
- a feeling of fullness and dull stretching pain in
the epigastrium - Pancreatic:
- stool frequency up to 4-6 times in 1 day;
- a large volume of feces; - steatorrhea;
- putrid smell of feces;
- pain in the upper abdomen
- flatulence;
- weight loss
explain the Constipation
- Spastic constipation:
- paroxysmal spastic pains, clearly
localized, intense in nature; - feces of the “sheep feces” type;
- palpation: spasmodically contracted
and painful sections of the colon - Atonic constipation:
- dull prolonged stretching pain along
the colon; - flatulence;
- palpation: an increase in the size of
the colon, dense feces - Mechanical obstruction:
- progressively worsening condition;
- intoxication;
- pronounced peristalsis (with the
development of peritonitis and intestinal
paresis or;
- pronounced peristalsis (with the
- weakening or complete absence of
peristalsis
- weakening or complete absence of
Admixture of blood in the feces
- bright scarlet blood from the anus in the form of drops or trickles is a
characteristic sign of»_space;hemorrhoidal bleeding; - scarlet blood on the surface of the feces - a symptom of lesions of the»_space; sigmoid and rectum;
- dark red brown blood, evenly mixed with feces, is characteristic of
pathological processes localized in the initial section of the large intestine; - black mushy stools (melena) - a sign of massive bleeding from the esophagus, stomach or small intestine.
THE MAIN RISK FACTORS OF DEVELOPMENT
OF DISEASES OF THE
HEPATOBILIARY SYSTEM
Alcohol consumption
Medication intake
Surgical intervention
Intravenous injections and / or blood
transfusions
Profession (blood contact)
Sex
Family history of liver disease
Drugs that can cause abnormal
liver function
Analgesics - paracetamol, Aspirin
Cardiovascular drugs -
methyldopa,аmiodarone
Antibacterial drugs - macrolides
(erythromycin), - cephalosporins
(cefoperazone)
Psychotropic drugs - phenothiazines
Other - oral contraceptives
Liver function
Synthetic
- synthesis of albumin, coagulation factors,
fibrinogen, cholesterol, complement, binding
proteins for iron, copper, vitamin A
Detoxification / excretion
- products of protein metabolism, steroids,
prostaglandins, drugs, alcohol, bilirubin, urea,
products of bacteria metabolism
Accumulation - Glycogen, lipids, iron,
copper, vitamins A, B12, D, E, K
Excretory - bile secretion
Main complaints of liver
Pain
Dyspeptic complaints
Fever
Itch (pruritus)
Yellowness of the skin
Discoloration of urine and feces
Peripheral signs of long-term liver
damage
Spider veins
Drumsticks
Palmar erythema
Scratches
Hemorrhagic diathesis –petechial eruption
and hemorrhage into the skin (ecchymosis)
