liver, pancreas, gallbladder Flashcards
1
Q
acute pancreatitis etiology
A
- acute inflammation of the pancreas
- spillage of pancreatic enzymes into surrounding tissue causes auto-digestion and severe pain
- auto-digestion begins when injury to pancreas cells lead to the activation of enzymes called (lipase = fat necrosis, typsin = bleeding)
2
Q
acute pancreatitis causes
A
- women = gallbladder disease
- men = alc use
- mild (edematous) vs severe (necrotizing, gland dysfunction, organ failure)
3
Q
acute pancreatitis manifestations
A
- sudden left upper quadrant pain that radiates to back, abdominal guarding
- eating worsens pain, pain not relieved by vomitting
- jaundice, cyanosis, fever, hypotension
- crackles in lungs
- absent bowel sounds or diminshed
- flank brusing or brusining around umbilicus
- pseudocysts or pancreatic absesses (infected pseudocyts may form)
- systemic = hypocalcemia, hypotension
- all enzyme lab levels will be up
4
Q
interprofessional care
A
- focus on managing pain and hydration
- if pt goes into shock, administer plasma volume expanders like dextran or albumin
- treat infection w antibitoics
- NPO and NG suction, may need enteral nutrition
5
Q
cholelithiasis
A
= stones in gallbladder
- cause unknown but has to do w cholesterol and bile salts balance (bile becomes supersaturated with cholesterol)
- can stay in gallbladder or migrate, possibly causing pain or obstruction (clay colored stool, jaundice, fever, intolerance for fatty foods)
6
Q
cholecystitis
A
= inflammation of gallbladder
- most common cause = cholilitiasis
- inflammation without stones is common in old people, ill ppl, immobile ppl or fasting ppl
- when stones are moving, steady and excruciating pain in RUQ occurring 3-6 hr after fatty meal and when ppt lies down
- abdominal rigidity
- liver labs increased
7
Q
hepatitis = inflammation of liver
A
- often caused by virus
- can be acute or chronic
8
Q
hep a
A
- vaccine
- fecal oral route (crowded locations, poor hygiene, contaminated food and water)
- mild to acute liver failure
- flu like symptoms and jaundice
9
Q
hep b
A
- vaccine
- travels thru blood (sex, iv drug use, perinataly)
- can be acute or chronic
- incubation is 115 days and person is infectious for life
10
Q
hep C
A
- spread thru IV drug use, sex, perinatally, and drug infusions before 1992
- associated with HIV
- 15- 20 yr delay in liver damage
- most chronic cases
11
Q
hep d
A
- needs hep b to infect
- RNA
12
Q
hep e
A
- occurs mostly in developing countries
- transmitted via fecal oral route via contaminated water
13
Q
acute liver infection
A
- liver cells targeted, large number of hepatocytes destroyed
- can interfere w bile production, coagulation, blood glucose, detoxifying of drugs
- manifestations = clay colored stool, dark urine, jaundice, flu like symptoms, RUQ tenderness
14
Q
chronic liver infection
A
- hep c mostly
- increased risk for liver dysfunction, liver CA, portal HTN
- manifestations = ALT and AST levels increased, ascites, edema, hepatic encephalopathy, increased bilirubin, spider angiomas
- acute phase (1-6 months) = max infectivity, flu like symptoms with reduced taste smell, find food and cigs to be repugnant (can be icteric or with jaundice and dark urine and clay colored stool)
- convalescent phase = begins when jaundice is disappearing, can last from weeks to months (major issues are fragility and malaise, inflammation of spleen and liver persists)
15
Q
jaundice
A
- occurs from a change in bilirubin or blood flow
- urine will appear darker and stools may be clay colored
1) hemolytic = blood transfusion reaction
2) hepatocellular = cirrohosis, hep, liver cancer
3) obstructive = cirrohsis, hep, liver cancer, bile duct obstruction, pancreas cancer
