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Differential Dx > Hepatic/biliary/urogenic > Flashcards

Hepatic/biliary/urogenic Flashcards

1
Q

definition: white bands found on the hands when a hepatic/urogenic disease may be present

A

leukonychia

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2
Q

What does stool look like when there is a hepatic/urogenic disorder?

A

light, white

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3
Q

What does urine look like when a patient has rhabdomyolysis?

A

dark brown and decreased output

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4
Q

What is the referred pain pattern of the liver?

A

Tspine
R shoulder
R upper trap

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5
Q

definition: Tremor of the wrist when the wrist is extended; sometimes said to resemble a bird flapping its wings

A

asterixis

(“flapping tremor” or “liver flap”)

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6
Q

definition: Abnormal accumulation of fluid in peritoneal cavity

A

ascites

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7
Q

How does a person get hepatitis A and E?

A

Transmitted primarily by fecal-oral route
–> Contaminated water/food

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8
Q

How does a person get hepatitis B, C, D, and G?

A

Transmitted primarily by blood borne pathogens
–> Blood/body fluids from an infected person

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9
Q

What are the stages of viral hepatitis?

A

Initial/preicteric (1-3 weeks)
Icteric (2-4 weeks)
Recovery (3-4 months)

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10
Q

What is seen in the initial/preicteric stage of viral hepatitis?

A

vague GI/body s/s (weeks 1-3)

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11
Q

What is seen in the icteric stage of viral hepatitis?

A

Jaundice (weeks 2-4)

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12
Q

What is seen in the recovery stage of viral hepatitis?

A

fatigue (3-4 months)

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13
Q

s/s:
- Blood and body fluids (including sexual intercourse through mucus membranes)
- malaise
- RUQ tenderness
- Jaundice
- Dark urine
- Fever

A

hepatitis B

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14
Q

What population is hepatitis B commonly found in?

A

20-45 y/o (but can be present at any age)

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15
Q

What is the prognosis of hepatitis B?

A

> 90% recover

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16
Q

(true/false) Some with hepatitis B may have a chronic condition

A

true

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17
Q

What is the treatment for hepatitis B?

A

no Tx

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18
Q

What is hepatitis C primarily caused by?

A

Drug abuse

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19
Q

What are risk factors for hepatitis C?

A
  • Organ transplant (includes ligament recon)
  • Blood transfusion
  • Tattoos
  • Unprotected sex
  • Long-term kidney dialysis
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20
Q

What is the treatment for hepatitis C?

A

No cure, but medications in some cases can suppress the virus for a long period of time

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21
Q

definition: Chronic hepatic disease ~ destruction of liver cells; replaced by fibrous bands

A

cirrhosis

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22
Q

What are the results of cirrhosis?

A
  • Scarring impairs blood/lymph flow
  • Decreased liver function
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23
Q

What is the most common cause of cirrhosis?

A

alcohol abuse

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24
Q

definition: Fatty inflammation of the liver

A

Nonalcoholic fatty liver disease (NAFLD)

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25
Q

What conditions are nonalcoholic fatty liver disease commonly associated with?

A

diabetes and obesity

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26
Q

(true/false) Liver cancer is primarily METs

A

true

Why? since it filters blood from the GI tract

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27
Q

Liver cancer is known as a site of metastasis from what other organs?

A

esophagus, lung, breast

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28
Q

What are the s/s of liver cancer?

A
  • jaundice
  • overall muscular weakness
  • mid-back/epigastric pain
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29
Q

definition: ~ the yellow breakdown product of normal “heme” (iron) catabolism from hemaglobin; excreted in bile, and its levels are elevated in certain diseases

A

bilirubin

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30
Q

What is a prefix for gallbladder issues?

A

Chol/chole

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31
Q

What is the 5th leading cause of hospitalization?

A

gallstones/cholelithiasis

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32
Q

What is cholelithiasis?

A

gallstones

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33
Q

What is the cause of cholelithiasis/gallstones?

A

changes in bile

34
Q

What are the types of gallstones?

A
  1. cholestrol stones (most common)
  2. Pigment stones
35
Q

When do s/s of cholelithiasis/gallstones occur?

A

if gallstones leave the gallbladder & cause obstruction elsewhere

–> Biliary colic, Cholecystitis, or Cholangitis

36
Q

What are risk factors with cholelithiasis?

A
  • Increases w/ age
  • Women > men (under 60 yo)
  • increased estrogen, family hx of gallstones
  • Obesity, diabetes, high cholesterol diet
37
Q

What is biliary colic?

A

pain in the neck of the gallbladder (cystic duct)

38
Q

Where is cholecystitis found?

A

cystic duct

39
Q

Where is cholangitis found?

A

common bile duct

40
Q

definition: Blockage or impaction of gallstones in the cystic duct

A

cholecystitis

41
Q

What are the s/s of cholecystitis?

A
  • N/V within 1-3 hours after eating
  • fever
42
Q

Where is pain referral of cholecystitis?

A
  • 10th-12th R rib (anterior) [acute]
  • R shoulder/ mid scap
  • RUQ & Epigastrium (more right sided)
43
Q

(true/false) Gallbladder cancer is not associated with gallstones

A

FALSE

44
Q

What are the risk factors for gallbladder cancer?

A
  • Gallstones
  • Obesity
  • Reproductive abnormalities
  • Chronic gallbladder infections
45
Q

What causes red urine color?

A
  • blood
  • medications
  • ingestion of dyes
46
Q

What are the causes of brown/dark urine?

A
  • hepatic/biliary obstructive disease
  • acute exertional rhabdomyolysis
47
Q

(true/false) decreased urine output is can be seen with DM

A

FALSE (increased output)

48
Q

What is urethral discharge in men commonly associated with?

A

infection such as UTIs and STDs

49
Q

What are causes of Erectile dysfunction?

A
  • Neuro conditions (SCI, HNP)
  • Post-surgical (radical prostate, bladder, colon)
  • DM
  • Medication (side effects)
  • Psychogenic disorders
50
Q

When is a menstrual cycle considered as abnormal?

A

Abnormal if < 21 days or >36 days since last period

51
Q

definition: painful menstruation; may be abnormal

A

dysmenorrhea

52
Q

Blood flow during a period > ___ days is considered as abnormal

A

> 7 days

53
Q

What can cause obstruction in the upper urinary tract?

A

kidney, ureter tumor, stone

54
Q

Upper urinary tract infections is most commonly from a ___ problem.

A

renal

55
Q

Lower urinary tract infections is most commonly from a ___ problem.

A

bladder, urethra, prostate

56
Q

What are s/s of Upper urinary tract inflammation/infection?

A
  • Unilateral costovertebral tenderness, flank pain
  • Ipsilateral shoulder pain
  • Constitutional sxs (fever/chills)
  • Nocturia; hematuria; pyuria (pus)
57
Q

definition: infection of the kidney

A

pylonephritis

58
Q

What are possible causes of pyelonephritis?

A

From infection of the ascending urinary tract
- Blood-borne pathogens
- Obstruction (benign prostatic hyperplasia or kidney stones)

59
Q

definition: bladder infection/inflammation

A

cystitis

60
Q

definition: urethra infection/inflammation

A

urethritis

61
Q

What is the common cause of urethritis?

A

gonorrhea

62
Q

s/s:
- increased frequency, urgency w/ dysuria, nocturia
- hematuria; pyuria (pus), bacteriuria
- LBP, pelvic pain, lower abdominal pain

A

cystitis

63
Q

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

A

upper urinary tract obstruction

64
Q

definition: Hard masses of salts that precipitate from urine when it becomes supersaturated w/ a particular substances (aka Kidney Stones)

A

nephrolithesis

65
Q

What are the s/s of pyelonephritis and nephrolithesis?

A

chills/fever, N/V

66
Q

What is the most common population that presents with nephrolithesis?

A

White males

67
Q

What is the reoccurrence rate of nephrolithesis?

A

50%

68
Q

What are common conditions caused by lower urinary tract obstruction?

A
  • bladder cancer
  • enlargement of the prostate
69
Q

What is the second leading cause of male death in the USA?

A

prostate cancer

70
Q

What population is BPH commonly found in?

A

men > 50 y/o

71
Q

BPH commonly affects what mechanism?

A

urination

72
Q

Prostatitis is commonly associated with what syndrome?

A

pelvic pain syndrome

73
Q

Prostatitis affects 10% of adult males __-__ y/o

A

40-70 y/o

74
Q

What are common conditions of upper urinary tract obstructions?

A
  • kidney stone
  • urethral stone
75
Q

What are common conditions of upper urinary tract inflammation/infection?

A

Pyelonephritis, glomerulonephritis (acute/chronic)

76
Q

overactive bladder is an involuntary contraction of the _____ muscle

A

detrusor muscle

77
Q

definition: Incontinence that is a combination of stress and urge incontinence.

A

mixed

78
Q

definition: overdistention of the bladder; bladder cannot empty completely

A

overflow incontinence

79
Q

Who commonly has renal cancer?

A

Males who smoke, are obese, have HTN, and/or have a PMH of CA

80
Q

Who commonly has bladder cancer?

A

White men > 40 y/o who use tobacco and/or have chemical exposure

Differential Dx (13 decks)

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