Liver, Pancrease, Gallbladder Flashcards
what type of necrosis occurs in acute pancreatitis?
liquifactive hemorrhagic necrosis of the pancrease
fat necrosis of perpancreatic fat
what are the clinical features of acute pancreatitis?
epigastric abd pain
nausea and vomit
periumbilical and flank haemorrhage (CULLEN’S AND GREY TURNERS SIGNS)
inc serim lipase
hypocalcemia
what are the complications ass with acute pancreatitis?
shock
pancreatic pseudocyst
pancreatic abcess( due to E.COLI)
DIC
ARDS
What are the causes of acute pancreatitis?
alc
gallstones
mumps
trauma
hypercalcemia (act the enzymes)
hyperlipidemia
scorpion sting
rupture of post duodenal ulcer
sulfa drugs,diabetes,6MP
ERCP
What histological changes to pancrease occurs in acute and chronic pancreatitis?
in acute;
inflammation and hemorrhage of the pancrease
in chronic;
fibrosis of paranchyma ,mostly due to recurrent acute pan
what causes chronic pancreatitis?
alc
cystic fibrosii (in children)
what are the clinical features of chronic pancreatitis?
epigastric abd pain
pancreatic insufficiency
dystrophic calcification
sec diabetes mellitus
inc risk of Ca
where does pancreatic Ca originates from?
an adenocarcinoma arising from the pancreatic ducts
what are the 2 main causes of panc Ca?
smoking
chr pancreatitis
what are the clinical features of panc Ca?
epigastric abd pain
secondary diabetes mellitus( when tumor in the body or tail of pancrease)
obstructive jaundic( when tumor in the body)
pancreatitis
migratory thrombophlebitis
what is another name for migratory thrombophlebitis?
Trousseau syndrome
( swelling ,erythema, tenderness in the extremities)
what’s the serum tumor marker for pancreatic Ca
CA 19-9
what is the name of procedure for en bloc removal o carcinoma pancrease?
whipple procedure
what is whipple procedure
removal of;
head n neck of pancrease
proximal duodenum
gallbladder
what’s courvoisier sign?
physical exm finding for pancreatic Ca
enlarged painless gallbladder with jaundice
when does billiary atresia occur
first 2 months of life
what are the presentations for billiary atresia?
jaundice
cirrhosis
what are the two types of gallstones?
cholesterol stones(yellow, RADIOLUCENT)
bilirubin stones(pigmented, RADIOPAQUE)
What are the risk factors for cholesterol gallstones?
age in 40a
estrogen
multiple pregnancies( in preg both estrogen and proges inc, so estrogen inc chl syntheisi and proges dec gallbldr emptying)
oral contracepties
clofibrate
Americans
Crohns disease
cirrhosis
what are the risk factors for bilirubin gallstones?
extravascular hemolysis
biliarry tract infection
which organisms are involved in billiary tract infection?
ascaris lumbricoides
clonorchis sinensis
what re the symptoms of gallstones?
gallstone are usually ASYMPTOMATIC, however many complications can occur;
biliary colic
acute and chronic cholecystitis
ascending cholangitis
gallstones illeus
gallbladder cancer
where and why dose the billiary colic occurs?
its a RUQ Pain
it occurs due to gallbladder contracting against a STONE lodged in the cysic duct
how does acute cholecystitis occurs?
stone lodged in cystic duct
RUQ pain often radiating to the right scapula
