Hepatobiliary 2 Flashcards

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1
Q

acute (hemorrhagic) pancreatitis

A
  • disease of exocrine pancreas
  • occurs after large meal or excess alcohol consumption
  • 35-60% have gallstones
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2
Q

prognosis of acute pancreatitis

A
  • most recover completely (5% mortality)

- rare severe chemical peritonitis and shock may lead to ARDS

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3
Q

Where is 60% of carcinoma of the pancreas?

A

head of pancreas

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4
Q

courvoisier law

A

painless enlargement of gallbladder w/ jaundice likely due to pancreatic head carcinoma (not stone in common bile duct)

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5
Q

Trousseau sign

A
  • complication of pancreas carcinoma
  • migratory thromboplebitis
  • 10% of patients
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6
Q

Diabetes Mellitus Type I names

A
  • Insulin Dependent
  • IDDM
  • Juvenile
  • Ketosis prone
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7
Q

Diabetes Mellitus Type 1

A

5-10% of cases

  • failure of insulin synthesis
  • depletion of Beta Cells
  • Abrupt onset
  • carb intolerance
  • hyperglycemia
  • ketoacidosis
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8
Q

Diabetes Mellitus Type 2

A

non-insulin-dependent
NIDDM
adult onset
ketosis resistant

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9
Q

Diabetes Mellitus type 2

A
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
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10
Q

Diabetes Type 2 and insulin

A
  • 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)
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11
Q

Which type of diabetes has hyperglycemia more often?

A

Diabetes type 2 has hyperglycemia 5x more often

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12
Q

Which diabetes is ketoacidosis unusual?

A

Diabetes Type 2 (Stress or surgery)

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13
Q

Predisposing factors of both diabetes

A
obesity
pregnancy
trauma
infections
stress
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14
Q

clinical features of both diabetes

A
polydypsia
polyuria
polyphagia
weight loss
muscle weakness
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15
Q

late complications of diabetes

A

cardiovascular atherosclerosis and arteriosclerosis (more severe and extensive than non-diabetics of the same age + gender)

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16
Q

In diabetes, athersclerosis + arteriosclerosis involve microvasculature of what 3 organs?

A

brain, heart, kidney

17
Q

Late complications of diabetes after atherosclerosis + arteriosclerosis

A

stroke
myocardial infarction
gangrene of extremities, especially toes
nephron ischemia

18
Q

What is the most common cause of end stage renal disease? **

A

DIABETES

19
Q

Bacterial + Fungal infections

A
  • late complication of diabetes
  • poor blood supply due to vasculature disease
  • phagocytosis + bacterial activity of neutrophils impaired
20
Q

Late complication of diabetes of the skin, mucosal, bone, UTI

A

follicular infections, boils, candidiasis, cellulitis, erysipelas

21
Q

pneumonia, klebsiella pneumonia, sinus mucormycosis, pseudomonas aeruginosa, chronic osteomyelitis

A

Late complication of diabetes of the skin, mucosal, bone, UTI

22
Q

acute pyelonephritis + recurrent lower UTI

A

Late complication of diabetes of the skin, mucosal, bone, UTI

23
Q

Kimmelstiel Wilson Syndrome

A

intercapillary, nodular glomerulosclerosis w/ hypertension + edema lead to proteinuria
-onset 20 yrs post diabetes

24
Q

long term complications of diabetes

A

1 cerebrovascular disease
2 diabetetic retinopathy, cataracts glaucoma
3 ischemic heart disease
4 diabetic nephropathy

25
Q
1 severe atherosclerosis
2 peripheral neuropathy w/ trophic ulceration
3 necrobiosis lipoidica
4 skin infections
5 ischemia of lower limbs (gangrene)
A

long term complications of diabetes

26
Q

Oral manifestations of diabetes usually associated with which type of diabetes?

A

diabetes type 1

27
Q

Sialadenosis (enlargement of parotid)

A

Oral manifestations of BOTH types of diabetes

28
Q

more prone to these oral infections during diabetes

A
  • bacterial (gingivitis +periodontitis)

- fungal (candidiasis, asperigillosis + mucormycosis)

29
Q

impaired wound healing during in oral cavity during diabetes

A
  • more likely to have advanced periodontal disease

- more likely to have complications after surgery (tooth extraction)

30
Q

enlargement of erythema of gingiva + some xerostomia are oral manifestation in what disease?

A

diabetes

31
Q

marasmus (withering)

A
  • severe malnutrition or emanciation resulting from inadequate calorie intake (esp young children)
  • failure to thrive, loss of subcutaneous fat, muscle wasting
  • no edema
32
Q

kwashiorker

A
  • Ghanaese for “red boy”

- inadequate protein intake despite adequate calorie intake

33
Q

iron deficiency anemia

A
  • hypocromic microcytic anemia

- atrophy of tongue and gastric mucosa