Hepatobiliary 2 Flashcards
acute (hemorrhagic) pancreatitis
- disease of exocrine pancreas
- occurs after large meal or excess alcohol consumption
- 35-60% have gallstones
prognosis of acute pancreatitis
- most recover completely (5% mortality)
- rare severe chemical peritonitis and shock may lead to ARDS
Where is 60% of carcinoma of the pancreas?
head of pancreas
courvoisier law
painless enlargement of gallbladder w/ jaundice likely due to pancreatic head carcinoma (not stone in common bile duct)
Trousseau sign
- complication of pancreas carcinoma
- migratory thromboplebitis
- 10% of patients
Diabetes Mellitus Type I names
- Insulin Dependent
- IDDM
- Juvenile
- Ketosis prone
Diabetes Mellitus Type 1
5-10% of cases
- failure of insulin synthesis
- depletion of Beta Cells
- Abrupt onset
- carb intolerance
- hyperglycemia
- ketoacidosis
Diabetes Mellitus Type 2
non-insulin-dependent
NIDDM
adult onset
ketosis resistant
Diabetes Mellitus type 2
90-95% of cases failure to respond to insulin -increased insulin resistance or deranged insulin secretion -most central obesity + onset after 40 -not prone to ketoacidosis
Diabetes Type 2 and insulin
- mild to mod insulin deficiency
- delayed or inadequate insulin secretion may develop
- insulin resistance (impaired ability to react to circulating insulin; decrease in number of cell surface insulin receptors)
Which type of diabetes has hyperglycemia more often?
Diabetes type 2 has hyperglycemia 5x more often
Which diabetes is ketoacidosis unusual?
Diabetes Type 2 (Stress or surgery)
Predisposing factors of both diabetes
obesity pregnancy trauma infections stress
clinical features of both diabetes
polydypsia polyuria polyphagia weight loss muscle weakness
late complications of diabetes
cardiovascular atherosclerosis and arteriosclerosis (more severe and extensive than non-diabetics of the same age + gender)
In diabetes, athersclerosis + arteriosclerosis involve microvasculature of what 3 organs?
brain, heart, kidney
Late complications of diabetes after atherosclerosis + arteriosclerosis
stroke
myocardial infarction
gangrene of extremities, especially toes
nephron ischemia
What is the most common cause of end stage renal disease? **
DIABETES
Bacterial + Fungal infections
- late complication of diabetes
- poor blood supply due to vasculature disease
- phagocytosis + bacterial activity of neutrophils impaired
Late complication of diabetes of the skin, mucosal, bone, UTI
follicular infections, boils, candidiasis, cellulitis, erysipelas
pneumonia, klebsiella pneumonia, sinus mucormycosis, pseudomonas aeruginosa, chronic osteomyelitis
Late complication of diabetes of the skin, mucosal, bone, UTI
acute pyelonephritis + recurrent lower UTI
Late complication of diabetes of the skin, mucosal, bone, UTI
Kimmelstiel Wilson Syndrome
intercapillary, nodular glomerulosclerosis w/ hypertension + edema lead to proteinuria
-onset 20 yrs post diabetes
long term complications of diabetes
1 cerebrovascular disease
2 diabetetic retinopathy, cataracts glaucoma
3 ischemic heart disease
4 diabetic nephropathy
1 severe atherosclerosis 2 peripheral neuropathy w/ trophic ulceration 3 necrobiosis lipoidica 4 skin infections 5 ischemia of lower limbs (gangrene)
long term complications of diabetes
Oral manifestations of diabetes usually associated with which type of diabetes?
diabetes type 1
Sialadenosis (enlargement of parotid)
Oral manifestations of BOTH types of diabetes
more prone to these oral infections during diabetes
- bacterial (gingivitis +periodontitis)
- fungal (candidiasis, asperigillosis + mucormycosis)
impaired wound healing during in oral cavity during diabetes
- more likely to have advanced periodontal disease
- more likely to have complications after surgery (tooth extraction)
enlargement of erythema of gingiva + some xerostomia are oral manifestation in what disease?
diabetes
marasmus (withering)
- severe malnutrition or emanciation resulting from inadequate calorie intake (esp young children)
- failure to thrive, loss of subcutaneous fat, muscle wasting
- no edema
kwashiorker
- Ghanaese for “red boy”
- inadequate protein intake despite adequate calorie intake
iron deficiency anemia
- hypocromic microcytic anemia
- atrophy of tongue and gastric mucosa