Hepatic/biliary/urogenic Flashcards
definition: white bands found on the hands when a hepatic/urogenic disease may be present
leukonychia
What does stool look like when there is a hepatic/urogenic disorder?
light, white
What does urine look like when a patient has rhabdomyolysis?
dark brown and decreased output
What is the referred pain pattern of the liver?
Tspine
R shoulder
R upper trap
definition: Tremor of the wrist when the wrist is extended; sometimes said to resemble a bird flapping its wings
asterixis
(“flapping tremor” or “liver flap”)
definition: Abnormal accumulation of fluid in peritoneal cavity
ascites
How does a person get hepatitis A and E?
Transmitted primarily by fecal-oral route
–> Contaminated water/food
How does a person get hepatitis B, C, D, and G?
Transmitted primarily by blood borne pathogens
–> Blood/body fluids from an infected person
What are the stages of viral hepatitis?
Initial/preicteric (1-3 weeks)
Icteric (2-4 weeks)
Recovery (3-4 months)
What is seen in the initial/preicteric stage of viral hepatitis?
vague GI/body s/s (weeks 1-3)
What is seen in the icteric stage of viral hepatitis?
Jaundice (weeks 2-4)
What is seen in the recovery stage of viral hepatitis?
fatigue (3-4 months)
s/s:
- Blood and body fluids (including sexual intercourse through mucus membranes)
- malaise
- RUQ tenderness
- Jaundice
- Dark urine
- Fever
hepatitis B
What population is hepatitis B commonly found in?
20-45 y/o (but can be present at any age)
What is the prognosis of hepatitis B?
> 90% recover
(true/false) Some with hepatitis B may have a chronic condition
true
What is the treatment for hepatitis B?
no Tx
What is hepatitis C primarily caused by?
Drug abuse
What are risk factors for hepatitis C?
- Organ transplant (includes ligament recon)
- Blood transfusion
- Tattoos
- Unprotected sex
- Long-term kidney dialysis
What is the treatment for hepatitis C?
No cure, but medications in some cases can suppress the virus for a long period of time
definition: Chronic hepatic disease ~ destruction of liver cells; replaced by fibrous bands
cirrhosis
What are the results of cirrhosis?
- Scarring impairs blood/lymph flow
- Decreased liver function
What is the most common cause of cirrhosis?
alcohol abuse
definition: Fatty inflammation of the liver
Nonalcoholic fatty liver disease (NAFLD)
What conditions are nonalcoholic fatty liver disease commonly associated with?
diabetes and obesity
(true/false) Liver cancer is primarily METs
true
Why? since it filters blood from the GI tract
Liver cancer is known as a site of metastasis from what other organs?
esophagus, lung, breast
What are the s/s of liver cancer?
- jaundice
- overall muscular weakness
- mid-back/epigastric pain
definition: ~ the yellow breakdown product of normal “heme” (iron) catabolism from hemaglobin; excreted in bile, and its levels are elevated in certain diseases
bilirubin
What is a prefix for gallbladder issues?
Chol/chole
What is the 5th leading cause of hospitalization?
gallstones/cholelithiasis
What is cholelithiasis?
gallstones
What is the cause of cholelithiasis/gallstones?
changes in bile
What are the types of gallstones?
- cholestrol stones (most common)
- Pigment stones
When do s/s of cholelithiasis/gallstones occur?
if gallstones leave the gallbladder & cause obstruction elsewhere
–> Biliary colic, Cholecystitis, or Cholangitis
What are risk factors with cholelithiasis?
- Increases w/ age
- Women > men (under 60 yo)
- increased estrogen, family hx of gallstones
- Obesity, diabetes, high cholesterol diet
What is biliary colic?
pain in the neck of the gallbladder (cystic duct)
Where is cholecystitis found?
cystic duct
Where is cholangitis found?
common bile duct
definition: Blockage or impaction of gallstones in the cystic duct
cholecystitis
What are the s/s of cholecystitis?
- N/V within 1-3 hours after eating
- fever
Where is pain referral of cholecystitis?
- 10th-12th R rib (anterior) [acute]
- R shoulder/ mid scap
- RUQ & Epigastrium (more right sided)
(true/false) Gallbladder cancer is not associated with gallstones
FALSE
What are the risk factors for gallbladder cancer?
- Gallstones
- Obesity
- Reproductive abnormalities
- Chronic gallbladder infections
What causes red urine color?
- blood
- medications
- ingestion of dyes
What are the causes of brown/dark urine?
- hepatic/biliary obstructive disease
- acute exertional rhabdomyolysis
(true/false) decreased urine output is can be seen with DM
FALSE (increased output)
What is urethral discharge in men commonly associated with?
infection such as UTIs and STDs
What are causes of Erectile dysfunction?
- Neuro conditions (SCI, HNP)
- Post-surgical (radical prostate, bladder, colon)
- DM
- Medication (side effects)
- Psychogenic disorders
When is a menstrual cycle considered as abnormal?
Abnormal if < 21 days or >36 days since last period
definition: painful menstruation; may be abnormal
dysmenorrhea
Blood flow during a period > ___ days is considered as abnormal
> 7 days
What can cause obstruction in the upper urinary tract?
kidney, ureter tumor, stone
Upper urinary tract infections is most commonly from a ___ problem.
renal
Lower urinary tract infections is most commonly from a ___ problem.
bladder, urethra, prostate
What are s/s of Upper urinary tract inflammation/infection?
- Unilateral costovertebral tenderness, flank pain
- Ipsilateral shoulder pain
- Constitutional sxs (fever/chills)
- Nocturia; hematuria; pyuria (pus)
definition: infection of the kidney
pylonephritis
What are possible causes of pyelonephritis?
From infection of the ascending urinary tract
- Blood-borne pathogens
- Obstruction (benign prostatic hyperplasia or kidney stones)
definition: bladder infection/inflammation
cystitis
definition: urethra infection/inflammation
urethritis
What is the common cause of urethritis?
gonorrhea
s/s:
- increased frequency, urgency w/ dysuria, nocturia
- hematuria; pyuria (pus), bacteriuria
- LBP, pelvic pain, lower abdominal pain
cystitis
s/s
- Acute, spasmodic, radiating pain OR mild, dull flank pain OR low back pain
- Hyperesthesias (T10-L1 dermatomes)
- Constitutional sxs (fever/chills/nausea/vomiting)
- Urge to frequently urinate; hematuria; abd mm spasm
upper urinary tract obstruction
definition: Hard masses of salts that precipitate from urine when it becomes supersaturated w/ a particular substances (aka Kidney Stones)
nephrolithesis
What are the s/s of pyelonephritis and nephrolithesis?
chills/fever, N/V
What is the most common population that presents with nephrolithesis?
White males
What is the reoccurrence rate of nephrolithesis?
50%
What are common conditions caused by lower urinary tract obstruction?
- bladder cancer
- enlargement of the prostate
What is the second leading cause of male death in the USA?
prostate cancer
What population is BPH commonly found in?
men > 50 y/o
BPH commonly affects what mechanism?
urination
Prostatitis is commonly associated with what syndrome?
pelvic pain syndrome
Prostatitis affects 10% of adult males __-__ y/o
40-70 y/o
What are common conditions of upper urinary tract obstructions?
- kidney stone
- urethral stone
What are common conditions of upper urinary tract inflammation/infection?
Pyelonephritis, glomerulonephritis (acute/chronic)
overactive bladder is an involuntary contraction of the _____ muscle
detrusor muscle
definition: Incontinence that is a combination of stress and urge incontinence.
mixed
definition: overdistention of the bladder; bladder cannot empty completely
overflow incontinence
Who commonly has renal cancer?
Males who smoke, are obese, have HTN, and/or have a PMH of CA
Who commonly has bladder cancer?
White men > 40 y/o who use tobacco and/or have chemical exposure
