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Internal Medicine Test 3 > hepatic, pancreatic, and biliary systems > Flashcards

hepatic, pancreatic, and biliary systems Flashcards

1
Q

5 system functions of the liver

A

digestive
endocrine
excretory
hematologic
immune

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2
Q

where is albumin produced

A

Liver

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3
Q

the liver converts and excretes…

A

bilirubin

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4
Q

what makes the pancreas an exocrine gland?

A

digestion!
it releases digestive enzymes and pancreatic juices to help the GI system

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5
Q

what makes the pancreas an endocrine gland?

A

glucagon and insulin secretion for metabolism

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6
Q

what is the function of the gallbladder

A

reservoir for bile
releases bile in duodenum in response to food

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7
Q

what does bile do

A

alkalinizes the intestinal contents and plays arole in emulsification, absorption, and digestion of fat

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8
Q

dark urine and light stools occur in association with…

A

jaundice

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9
Q

3 indications of hepatic issues

A

skin changes
spider angiomas
palmar erythema (warm palms)

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10
Q

jaundice can be diagnosed when _________ levels increase

A

serum bilirubin

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11
Q

why is stool normally brown?

A

bile and bilirubin

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12
Q

what does light-colored stool and tea/cola colored urine indicate

A

bilirubin goes to urinary system rather than digestive system

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13
Q

hepatic encephalopathy (or portosystemic encephalopathy)

A

reversible neuro-psychological symptoms caused by liver failure and metabolic buildup of toxins

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14
Q

asterixis

A

inability to maintain wrist extension with forward flexion of the upper extremity

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15
Q

musculoskeletal symptoms with liver disease

A

thoracic pain between scaps, right shoulder, right upper traps, right interscap, right subscap

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16
Q

hepatic osteodystrophy

A

abnormal development of bone associated with liver malfunction

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17
Q

due to skin changes in liver disease, individuals are more susceptible to ________

A

pressure ulcers

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18
Q

coagulopathy

A

easy bruising and bleeding under the skin or into joints in response to the slightest taumas

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19
Q

liver __(increases/decreases)__ size, weight, and blood flow with age

A

decreases

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20
Q

lipophilic

A

strong affinity for lipids

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21
Q

why does the decrease of albumin production impact how drug dosages are given

A

drugs typically bind to albumin

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22
Q

what is the livers role in the immune system response

A

it produces proteins associated with acute inflammatory reactions

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23
Q

5 severe complications that result from liver damage/nonfunctioning

A
  1. jaundice
  2. cirrhosis
  3. portal hypertension
  4. hepatic encephalopathy
  5. ascites
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24
Q

characteristics of jaundice (icterus)

A

yellow discoloration of the skin/eyes
urine turns dark
stool turns light

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25
Q

4 common causes of jaundice

A
  1. increase bilirubin production
  2. decreased uptake in bilirubin metabolism
  3. hepatocyte dysfunction
  4. impaired bile flow
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26
Q

cirrhosis

A

fibrosis and nodular regeneration of the liver from chronic inflammation

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27
Q

jaundice of newborns is caused by

A

a decreased uptake in bilirubin metabolism

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28
Q

portal hypertension

A

higher portal vein pressure (entry) than inferior vena cava pressure (exit)

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29
Q

what usually causes portal hypertension

A

cirrhosis

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30
Q

Lab findings in cirrhosis

A
  • decreased albumin
  • increased prothrombin time (longer to form blood clots)
  • anemia
  • increased alanine aminotransferase, lactate dehydrogenase
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31
Q

clinical presentations of cirrhosis

A

Hepatomegaly
Spider angiomata
Splenomegaly
GI bleeding
Edema
Jaundice
Portal hypertension
Ascites

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32
Q

decreased plasma proteins results in what 2 symptoms

A

ascites and edema

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33
Q

what happens to the body when metabolism of proteins, carbs, and fats occurs

A

the body becomes hypoglycemic

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34
Q

3 direct symptoms of liver inflammation

A

pain, fever, GI symptoms

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35
Q

Ascites

A

abnormal accumulation of fluid within the peritoneal cavity

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36
Q

what is the most common cause of ascites

A

liver cirrhosis (85%)

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37
Q

spontaneous bacterial peritonitis

A

infection of ascitic fluid in the setting of portal hypertension

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38
Q

an increase of urobilinogen is an indication of

A

liver necrosis

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39
Q

a DECREASE in bilirubin metabolism, bile in GI tract, vitamin K absorption is an indication of

A

liver necrosis

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40
Q

what does a decreased hormone metabolism result in and what are the symptoms

A

increased androgens and estrogens in the body

spider angiomas
palmar erythema
loss of body hair

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41
Q

what is hepatitis

A

acute or chronic inflammation of the liver

42
Q

what can cause hepatitis

A

virus (main)
chemical/drug/alcohol abuse

43
Q

how long must a person have hepatitis for it to be considered CHRONIC

A

6 months

44
Q

what liver disease can chronic hepatitis lead to

A

cirrhosis

45
Q

what is the most common cause of acute liver failure

A

acetaminophen hepatotoxicity (50% of cases)

46
Q

fulminant hepatic failure

A

acute liver failure that is rare but can be fatal

47
Q

t/f: viral hepatitis can be easily spread even if symptoms are not present

A

true

48
Q

how is hepatitis A transmitted

A

fecal-oral route
(consuming contaminated water/food)

49
Q

what two types of viral hepatitis are transmitted through the fecal-oral route

A

Hepatitis A and E

50
Q

hepatitis A results ONLY this type of infection

A

acute infection

51
Q

____ occurs in 90% of heavy drinkers

A

alcoholic steatosis (fatty liver)

52
Q

how is hepatitis B transmitted

A

sexually transmitted disease

(percutaneous or mucosal contact)

53
Q

how long can HBV survive on environmental surfaces

A

1 week

54
Q

how is hepatitis C developed

A

injection drug use

55
Q

what form of hepatitis is uncommon in the US

A

hepatitis D

56
Q

how is hepatitis D transmitted

A

it is a coinfection or superinfection of hepatitis B

(it needs hep b to replicate)

57
Q

what causes oxidative stress to the hepatocytes in the liver

A

metabolizing alcohol

58
Q

how does the liver respond to inflammation and injury

A

by forming scars (fibroids)

59
Q

nonalcoholic fatty liver disease (NAFLD) causes

A

related to diabetes and insulin resistance

genetic, environmental, and inflammatory factors

60
Q

what quadrant is the pancreas located

A

left upper quadrant (near stomach)

61
Q

what is the pancreas’s dual function

A

secrete insulin/glucagon
acts as endocrine gland

62
Q

2/3rds of acute pancreatitis involve what

A

gallstones and chronic alcohol consumption

63
Q

what type of pancreatitis makes up 80% of cases

A

interstitial pancreatitis

64
Q

what type of pancreatitis makes up 20% of cases

A

necrotizing pancreatitis

65
Q

is necrotizing pancreatitis or interstitial pancreatitis more severe

A

necrotizing pancreatitis

66
Q

moderately severe acute pancreatitis is related to

A

the gallbladder

67
Q

chronic pancreatitis

A

the development of irreversible changes in the pancreas secondary to chronic inflammation

68
Q

what are the 3 risk factors of chronic pancreatitis

A

chronic alcohol consumption
smoking
genetic predisposition

69
Q

the pancreas is able to work until more than __% of pancreatic function is lost

A

90%

70
Q

what is the 3rd leading cause of cancer mortality in the US

A

pancreatic cancer

71
Q

what cancer has the lowest 5-year survival rate after diagnosis

A

pancreatic cancer

72
Q

95% of pancreatic cancers are _____.
Where is it located in the pancreas?

A

adenocarcinomas
head of pancreas

73
Q

what disease can increase the risk of developing pancreatic cancer

A

type II diabetes

(glucose tolerance)

74
Q

what are the 3 main clinical manifestations of pancreatic cancer

A

abdominal pain
weight loss
jaundice

75
Q

t/f: tumors in the head of the pancreas are 2x as likely to metastasize to peritoneum than in the body or tail

A

false

the body/tail tumors are 2x more likely to metastasize

76
Q

chole-

A

pertaining to bile

77
Q

cholang-

A

pertaining to bile ducts

78
Q

cholangiography

A

radiographic study of bile ducts

79
Q

cholangitis

A

inflammation of bile duct

80
Q

cholecyst-

A

pertaining to gallbladder

81
Q

cholecystectomy

A

removal of gallbladder

82
Q

cholecystitis

A

inflammation of gallbladder

83
Q

cholecystostomy

A

incision and drainage of gallbladder

84
Q

choledocho-

A

pertaining to common bile duct

85
Q

choledocholithiasis

A

stones in common bile duct

86
Q

choledochostomy

A

exploration of common bile duct

87
Q

cholelith-

A

gallstones

88
Q

cholelithiasis

A

presence of gallstones

89
Q

cholescintigraphy

A

radionuclide imaging of biliary system

90
Q

cholestasis

A

stoppage or suppression of bile flow

91
Q

lith-

A

stone

92
Q

what are gallstones made of

A

75% cholesterol
25% bilirubin salts (pigment stones)

93
Q

cholelithiasis happens more in men or women

A

women

94
Q

what does it mean to be litho-genic

A

to be more prone to stone formation

95
Q

what causes cholelithiasis

A

changes in composition of bile salts, bilirubin, and cholesterol due to supersaturation

96
Q

2 main complications of cholelithiasis

A
  1. cholecystitis (inflammation of gallbladder)
  2. cholangitis (inflammation of bile duct)
97
Q

charcot triad

A

pain
fever
jaundice

98
Q

peynolds pentad

A

pain
fever
jaundice
hypotension
mental confusion

99
Q

___ may be the only presenting sign of acute cholangitis in the elderly

A

hypotension

100
Q

acute cholangitis

A

obstruction and stasis of bile from choledocholithiasis (stones in common bile duct), biliary strictures, or malignancies

101
Q

how long does acute cholecystitis abdominal pain last for

A

greater than 6 hours

Internal Medicine Test 3 (5 decks)

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