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Patho > Midterm > Flashcards

Midterm Flashcards

0
Q

What do the superficial epithelial cells do in the stomach?

A

They produce mucus and bicarbonate for acid protection

…die and produce more

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1
Q

What protects the stomach lining from acid?

A

The mucus layer

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2
Q

What do the stomach’s parietal cells do?

A

produce HCl

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3
Q

What do the stomach’s chief cells do?

A

They produce digestive enzymes that break down food for their nutrients

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4
Q

Where is gastrin produced?

What does it do?

A
  • G-cells

- they stimulate the parietal cells to make more HCl

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5
Q

Where is histamine produced in the stomach?

What does it do?

A

The ECL (enterochromaffin-like) cells

When histamine is produced, it stimulates the parietal cells to make more HCl

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6
Q

Name 3 gastric acid producers…

A
  1. Gastrin
  2. Acetylcholine
  3. Histamine
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7
Q

Name 2 gastric acid reducers

A
  1. Prostaglandins

2. Somatostatin

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8
Q

Where is the bicarbonate layer located in the stomach?

A
  • In between the mucus layer and the superficial epithelial layer
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9
Q

What’s the difference between erosion and an ulcer?

A

Erosion is just a superficial injury resulting in decreased mucosal defence

An ulcer is complete erosion through the GI mucus that results in a GI bleed

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10
Q

What 3 things can can peptic ulcer disease (PUD)?

A
  • H. pylori
  • NSAIDS…they inhibit prostaglandin production
  • stress
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11
Q

What’s the difference between a gastric ulcer and a duodenal ulcer?
Which one is more common?

A

gastric = stomach

  • not helped by food
  • pain over wide area under breastbone

duodenal = in the duodenum…more common

  • helped by eating
  • pain under breastbone and umbilicus
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12
Q

What are the virulence factors of H.pylori?

A
  • they colonize the stomach
  • they penetrate the mucus layer (to evade low pH)
  • they cause inflammation and cell death
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13
Q

How does urease help H.pylori?

A

Urease produces ammonia which neutralizes stomach acid and allow the bacteria to travel to the mucus layer

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14
Q

What lifestyle choices can cause ulcers?

How?

A

Alcohol - irritates the stomach lining
Smoking - cause larger ulcers, harder to treat
Cocaine/amphetamine - reduces blood flow to mucus, therefore less bicarbonate

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15
Q

What is the difference between diabetes type l and ll in terms of insulin?

A

type l - complete lack on insulin

type ll - small amounts or insulin resistance

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16
Q

An HbA1C level of ________%, is an indicator of diabetes

A

> 6.5

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17
Q

Are the C-peptide levels high or low in type I diabetes?

Type II?

A

type I - low

type II - normal or high

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18
Q

Which type of diabetes is diabetic ketoacidosis (DKA) more prevalent in?
What are the symptoms?

A

Type I

  • ketones in blood and urine (from fat breakdown)
  • acidosis
  • hyperglycemia
  • frequent urination and thirst
  • abdominal pain
  • hunger
  • deep, rapid breathing
  • fruity breath
  • can be alert, stuperous, comatose
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19
Q

What are the 2 sources of blood supply to the liver?

A

Hepatic artery - O2 blood from general circulation

Hepatic portal vein - dO2 blood from small intestines (contains nutrients)

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20
Q

What vessel drains blood from the liver?

A

The hepatic vein

21
Q

The liver is not vascularized with capillaries. Instead it has blood filled ____________.

A
  • sinusoids
22
Q

What does albumin do?

A
  • regulates fluid balance
23
Q

This pigment is released when RBC’s die and becomes water-soluble
Also causes itching in liver disease patients

A

Bilirubin

24
Q

What does the liver clean/detoxify?

A
  • bacteria
  • alcohol
  • ammonia
  • OTC and Rx drugs
  • other toxins
25
Q

What does the liver store?

A

Glycogen

Iron and other vitamins

26
Q

What are the 5 liver functions?

A
  1. energy metabolism & substrate interconversion
  2. protein synthesis
  3. solubilization, transport and storage
  4. detox and clearance
  5. bile production
27
Q

What is hepatocellular liver disease?

A
  • injury to hepatocytes
  • leads to decrease in synthetic/metabolic functions
  • AST/ALT levels will be high
28
Q

What is cholestatsis liver disease?

A
  • impaired bile formation (hepatocytes)

- impaired bile flow (bile duct)

29
Q

What are the parameters for acute hepatitis?

A

It is acute if it lasts less than 6 months

It is chronic if it lasts longer

30
Q

What are the 7 types of hepatitis?

A
  1. viral (A-E)
  2. alcohol
  3. drug-induced
  4. autoimmune
  5. NAFLD–>NASH
  6. ischemic
  7. giant cell
31
Q

What is the difference between NAFLD and NASH?

A

When NAFLD is severe enough, it leads to inflammation, fibrosis and cirrosis. This is referred to as non-alcoholic steatohepatitis

32
Q

What are the symptoms of liver failure?

A
  • abdominal pain
  • breast development in males
  • dark urine/clay colored stools
  • fatigue
  • low grade fever
  • general itching
  • jaundice
  • loss of appetite
  • nausea and vomiting
  • weight loss
33
Q

______________ is caused by a small RNA virus and results in immunity when the patient recovers.

A

Hepatitis A

34
Q

What virus is

  • asymptomatic/mild symptoms
  • transferred by sex/bodily fluids
  • characterized by hepatocyte death due to the immune response
A

Hepatitis B

35
Q

What are the 2 characteristics of cirrhosis?

A

Liver tissue is replaced by:

  1. Fibrous scar tissue - blocks blood flow
  2. Regenerative nodules - lumps that form from the regenerative process
36
Q

_________________ become activated when the liver is injured.
What do they do?

A
  • Stellate cells

- they produce fibers which cause the liver to become rigid

37
Q

Injury of the liver leads to…

A
  1. activation of stellate cells
  2. accumulation of scar tissue
  3. loss of hepatocyte microvilli
  4. sinusoidal epithelial fenestrae

….all of these eventually lead to complete loss of hepatic function

38
Q

What is the Child-Turcotte-Pugh (CTP) score used for?

A
  • used to determine 1-2 year survival

- rated on a 1-15 point system

39
Q

What is the Model for End-state Liver Disease (MELD) score used for?

A
  • used to determine 3-month survival

- judgement scale for liver transplants

40
Q

What is ascites?

What is it caused by?

A
  • excess fluid in the peritoneal cavity

Caused by:

  • portal hypertension
  • increased pressure in portal vein system
  • fluid that has been forced out of blood vessels
  • the liver’s decreased ability to filter blood
41
Q

What is jaundice?

What is it caused by?

A
  • yellow discoloration of the skin

Caused by:

  • increased levels of bilirubin in the blood and skin
  • damaged liver cells interferes with excretion/uptake of bilirubin
42
Q

What does VacA do?

A
  1. Inflammation/apoptosis
  2. formation of acidic vacuoles in cells
  3. forms pores in epithelial cells
43
Q

What does LPS do?

A
  • recruits immune cells
  • inflammation
  • death of cells
44
Q

How do NSAIDS cause PUD?

A 
They inhibit prostaglandin synthesis
prostaglandins 
- stimulate bicarbonate release
- produce mucus
- stimulate mucosal growth 
- decrease acid production
45
Q

What is Zollinger-Ellison syndrom?

A

A gastrin secreting tumor that can cause ulcers

46
Q

What causes DKA?

A
  • body can’t use glucose for energy
  • breakdown fats instead…this creates ketones which accumulate in blood and urine
  • acidosis
  • hyperglycemia
47
Q

What is the TIMI score used for?

A
  • used for determining risk severity for UA/NSTEMI
0-2 = low risk 
3-4 = moderate risk 
5-7 = high risk
48
Q

What is the math of MAP?

A

MAP = 2/3 diastolic pressure + 1/3 systolic pressure

49
Q

What is the math of BP?

A

BP = TPR x CO

CO = HR x SV

Patho (15 decks)

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