unit 3 stuff Flashcards
5 functions of the endocrine system
- splits reproductive and CNS of the fetus
- Stimulates sequential growth/development during puberty
- Coordination of reproductive systems
- Maintenance internal environment
- activated in emergencies
what is the main center in the brain for endocrine + autonomic nervous systems
hypothalamus
how does the hypothalamus control endocrine
by neural and hormonal pathways
what type of feedback system is the endocrine system controlled by
negative feedback systems
adrenocorticotropic hormone (ACTH) target
adrenal cortex
what 2 hormones are produced by the posterior pituitary gland
antidiuretic hormone
oxytocin
basic action of growth hormone (somatotropin)
Stimulates growth and cell reproduction, releases insulin-like growth factor 1 from liver, retention of nitrogen to promote protein anabolism
basic action of thyroid-stimulating hormone
Promotes secretory activity (T3 and T4)
basic action of adrenocorticotropic hormone (ACTH)
Stimulates secretory activity synthesis of corticosteroids
basic action of antidiuretic hormone (ADH)
Reabsorption of water retention in kidneys
vasoconstriction
release ACTH in anterior pituitary
how is adipose tissue an endocrine gland
secretes hormones
what are 2 main causes of endocrine system dysfunctions
inflammation
tumor growth (hypothalamus, pituitary gland, etc)
ectopic hormone production
hormone production of cancer cells that causes paraneoplastic syndrome
neuroendocrine theory of aging
cells are programmed to function for a given amount of time
clinical symptoms of endocrine/metabolic diseases
fatigue
muscle weakness
muscle/bone pain
what autoimmune disorder can be an underlying sign of endocrine disease
rheumatoid arthritis
what is a symptom of carpal tunnel syndrome that indicates an endocrine disorder rather than an overuse issue
CTS presents BILATERALLY
what hormone and gland causes acromegaly
growth hormone
anterior pituitary gland
what are the 3 hormones produced by the thyroid
thyroxine (t4)
triiodothyronine (t3)
calcitonin
what thyroid hormone(s) regulate the metabolic rate of the body and increase protein synthesis
T3 and T4
what regulates the thyroid
hypothalamus
pituitary
hyperthyroidism symptoms
heat intolerance
weight loss
sweating
tremors
palpitations
graves disease is caused by
hyperthyroidism
autoimmune condition that increases T4 production
graves disease
thyroid storm
acute episode of thyroid over-activity
what autoantibody circulates in people with graves disease
TSI
(they react against thyroglobulin)
hypothyroidism symptoms
slowing of metabolism, heart, GI tract, and neurological functioning
cold intolerance
anemia
what is type II hypothyroidism
the failure of the pituitary gland to synthesize and release adequate amounts of TSH
(the hormone that stimulates the thyroid)
what is myxedema and what is it a symptom of
nonpitting, boggy edema around the eyes, hands, and feet
it is a symptom of hypothyroidism
TSH levels are always ____ in primary hypothyroidism
Elevated
T4 levels are always ___ in primary hypothyroidism
decreased
what are the main goals of hypothyroid treatment
correct thyroid hormone deficiency
reverse symptoms
prevent further cardiac/arterial damage
what does PTH regulate
calcium and phosphorus metabolism
where are the parathyroid glands located
posterior surface of each thyroid gland lobe
basic action of parathyroid hormone
calcium and phosphorus metabolism
calcification of bone
what does the parathyroid hormone target
bone
kidney
intestinal tract
hypoparathyroidism symptoms
decreased bone resorption
depressed serum calcium levels
elevated serum phosphate levels
t/f: PTH is regulated by the pituitary and the hypothalamus
FALSE: PTH maintains normal blood calcium levels by increasing bone resorption and GI absorption, NOT BY PITUITARY OR HYPOTHALAMUS
what disease could cause calcifications in the eyes and basal ganglia
hypoparathyroidism
tetany
neuromuscular irritability that causes involuntary muscle contractions
what are the 2 parts to the adrenal gland
outer cortex
inner medulla
the outer cortex secretes what 3 hormones
mineralocorticoids
glucocorticoids
androgens
what are mineralocorticoids what do they do
steroid hormones that regulate fluid and mineral balance
what are glucocorticoids and what do they do
steroid hormones responsible for controlling the glucose metabolism
what hormones does the medulla produce
epinephrine and norepinephrine
epinephrine + norepinephine’s basic action
fight or flight
increased HR
vasoconstriction
increased BP
increased blood glucose
ACTH production
addison disease can be caused by (2)
- decreased production of cortisol
- aldosterone deficiency
what are some clinical symptoms of addison disease (cortisol deficiency)
weak/fatigued
hypotensive
anorexic/weight loss
nausea
less resistance to stress
hypoglycemia
in addisons disease, the drop in cortisol results in a failure to inhibit….
anterior pituitary secretion of ACTH
(results in a bronze/tan appearance)
what are some clinical symptoms of addison disease (aldosterone deficiency)
fluid/electrolyte imbalances
sodium excretion
dehydration
hypotension
decreased heart size
what is the hallmark of Addison disease
decreased serum cortisol levels
what do PTs need to watch out for in patients with addison disease
not to overstress the body
dizziness, nausea, tremors
is primary or secondary adrenal insufficiency more common
secondary is more common
how can secondary adrenal insufficiency develop (3)
- steroid therapy
- opportunistic infections due to HIV
- removal of the pituitary or hypopituitarism
what hormone is responsible for the symptoms of secondary adrenal disease
cortisol ONLY
cushing syndrome cause
excess of cortisol in the body from either
1. hyperfunction
2. corticosteroid medication
what hormone responds to stress and is anti-inflammatory
cortisol
cortisol has a key role in ____ metabolism
glucose
cushing disease cause
hypercortisolism due to oversecretion of ACTH from the pituitary (usually tumor on anterior pituitary gland)
pseudo-cushing syndrome cause
depression, alcoholism, estrogen therapy, or eating disorders cause cushing syndrome-like symptoms
clinical symptoms of cushing syndrome
hyperglycemia
hypertension
proximal muscle wasting
osteoporosis
conn syndrome cause
adrenal lesion results in hypersecretion of aldosterone
what does an excess of aldosterone do in the kidneys
enhances sodium reabsorption
adipokines
proteins released by adipocytes after being induced by neurotransmitters and glucose
(basically the protein hormone fat produces in the body)
adipokines act as ____ hormones locally but as ____ hormones in the bloodstream
autocrine
endocrine
what is the function of adipokines
regulating appetite
energy expenditure
insulin sensitivity
lipid uptake
brown fat is important for
thermoregulation
white fat is responsible for
storage of triglycerols to provide long-term energy storage
fat accumulation in the lower body is called _____ and results in what kind of body shape
subcutaneous fat
pear-shaped
fat accumulation in the abdominal region is called _____ and results in what kind of body shape
visceral fat
apple shape
what 2 anthropometric measures are more predictive of visceral fat than BMI
waist circumference and waist-to-height ratios
bariatrics
branch of medicine concerned with the management of obesity
normal range BMI
18.5-24.9
obese BMI
> or = to 30
overweight BMI for kids is in what percentile
85-94th percentile
islets constitute for __% to __% of the pancreas
1% to 2%
what cells produce and secrete insulin
beta cells
type 1 diabetes mellitus
insulin-dependent
type 2 diabetes mellitus
insulin resistant
is type I or type II diabetes more common
type II
is type I or type II diabetes autoimmune
type I
diabesity
obesity-dependent diabetes in childhood
when does gestational diabetes occur
24-28 weeks of gestation
what % of pregnancies are accompanies with gestational diabetes
0.08
A1C % in prediabetes
5.7-6.4%
fasting blood sugar test levels in prediabetes
100-125 mg/dL
glucose tolerance test levels in prediabetes
140-199 mg/dL
what does A1C measure
the percent of blood sugar attached to hemoglobin
__% of the adult population in Texas have diabetes and __% have prediabetes
12.4%
34%
what causes type I diabetes
autoimmune destruction of beta cells in the pancreas, which results in a lack of insulin
3 steps to diabetes
- insulin resistance
- hyperglycemia
- beta cell dysfunction
polyuria
excessive urination
polydipsia
excessive thirst
polyphagia
excessive hunger
5 main complications with type 2 diabetes
blindness
kidney failure
heart disease
stroke
loss of toes, feet, or legs
macrovascular complications in type 2 diabetes
affecting arteries that supply heart, brain, and lower extremities
microvascular complications in type 2 diabetes
retina
renal glomerulus
peripheral nerve
hypoglycemia symptoms
shallow breathing
tachycardia
shaky/hungry/dizzy
hyperglycemia symptoms
dry
weak
fruity breath
thirst
which type of diabetes is diabetic ketoacidosis (DKA) mostly found in
type I
the triad of diabetic ketoacidosis (DKA)
- hyperglycemia
- acidosis
- ketosis
what are the ABC levels to be controlled when treating type II diabetes (and the values)
A1C = less than 7%
BP = less than 130/80
cholesterol = less than 100 LDL, more than 50 HDL, less than 150 triglycerides
what type of insulin does not have a peak response
long-acting insulin
type II diabetes raises a person’s risk of dying from heart disease by ___ to ____x
2-3x
__% of myocardial infarctions and ___% of strokes are attributable to diabetes
50%
75%
what are the 3 distinct families of endogenous opioid peptides
endorphins
enkephalins
dynorphins
what are common side effects of Mu receptor activation
sedation and respiratory depression
antagonists don’t produce ____
analgesia
antagonists are primarily used to treat….
opioid overdoses
addiction
what is the primary agent used to treat opioid overdose
naloxone
strong agonists are used to treat…
severe pain
morphine is an example of
strong agonist
mild-to-moderate agonists are used to treat….
moderate pain
codeine, hydrocodone and oxycodone are what type of agonsit
mild-to-moderate
mixed agonist-antagonists strength
less risk of side effects with Mu receptors
mixed agonist-antagonist weaknesses
may produce psychotropic effects
maximal analgesic effect may not be as strong
spinal effects/mechanism of opioids
inhibits both presynaptic and postsynaptic membranes of pain-mediating synapses by “trapping” neurotransmitters
(basically is able to stop neurons from communicating to each other that there is pain)
opioid receptors are linked via _________ to signaling pathways
G proteins
supraspinal effects/mechanism of opioids
opioids bind to the midbrain’s gray matter (PAG) and sends signals down a pathway to the pain sight to slow the pain signals
(basically decreases pain by stopping the pain signals to the brain)
increased activity of descending pathways travel through the ventromedial medulla (VMM) to reach the ______
dorsal horn of the spinal cord
neurons in descending pathways release _____ and _____ onto _______ to inhibit pain impulses to the brain
serotonin
norepinephrine
dorsal horn synapses
orthostatic hypotension
when you get up too fast and get dizzy
2 mechanisms of opioid tolerance
- receptor down-regulation
- loss of communication between opioid receptors and G proteins
when do withdrawal symptoms become evident, when is the peak, and how long do they last for?
evident: 6-10 hours
peak: day 2-3
last for: 5 days
some symptoms of physical dependence to pain medicine include
body aches
diarrhea
fever
insomnia
irritability
stomach cramps
vomiting/nausea
opioid-induced hyperalgesia
failure to respond to opioids
could increase pain sensitivity
methadone function
offers milder withdrawal symptoms
peripheral effects/mechanism of opioids
the exogenous opioids assist the endogenous peptides in stopping the transmission of pain
2 types of corticosteroids
- glucocorticoids (cortisol)
- mineralocorticoids (aldosterone)
what corticosteroid affects carbohydrate and protein metabolism
glucocorticoids (cortisol)
what corticosteroid regulates electrolyte and water metabolism
mineralocorticoids (aldosterone)
glucocorticoids __(increase/decrease)___ blood glucose and liver glycogen
increase
glucocorticoids act on macrophages, lymphocytes, and endothelial cells to inhibit the expression of __________
inflammatory proteins (cytokines)
how do glucocorticoids reduce inflammation
- inhibits inflammatory proteins (cytokines)
- reduces lymphocytes and eosinophils
- inhibits adhesion molecules so leukocytes can’t promote inflammation
- reduces vascular permeability by suppressing histamine and kinins
in order to reduce vascular permeability, ____ and ___ must be produced (think endogenous)
histamine and kinins
what are the main functions of glucocorticoid medications
decrease inflammation
immunosuppression
replacement for adrenal insufficiency
the main adverse symptom of prolonged corticosteroids in the ENDOCRINE system
hyperglycemia
the main adverse symptom of prolonged corticosteroids in the CARDIOVASCULAR system
fluid retention/edema
the main adverse symptoms of prolonged corticosteroids in the IMMUNE system
increase risk of infections
activates latent viruses
masks infection
the main adverse symptoms of prolonged corticosteroids in the MUSCULOSKELETAL system
osteoporosis
bone fractures
the main adverse symptoms of prolonged corticosteroids in the GASTROINTESTINAL system
peptic ulcers
GI bleeding
gastritis
nausea
the main adverse symptoms of prolonged corticosteroids in the NERVOUS system
insomnia
mood changes
prazole
proton pump inhibitor
helps with gastric ulcers
idine
histamine H2-receptor blockers
helps with gastric ulcers
amide
oral antidiabetics (sulfonylurea group)
helps with type 2 diabetes (antidiabetics)
dronate
bisphosphonates
helps with osteoporosis
what is the first step of the eicosanoid biosynthesis and then what are the 2 pathway options
arachidonic acid is released then either goes the LOX or COX pathway
prostaglandin
a group of lipid-like compounds that are produced by all living cells (except RBCs)
leukotriene
pro-inflammatory and mediates airway inflammation
increased PGE2 causes
inflammation
how do eicosanoids promote fever
altering thermo-regulatory set-point
dysmenorrhea
painful cramps that accompany menstruation
eicosanoids cause
pain
fever
dysmenorrhea
thrombus formation
inflammation
how do eicosanoids cause thrombus formation
TXA2 causes platelet aggregations that result in the blood clot formations
what do aspirin and other NSAIDs inhibit
Cyclooxygenase (COX)
what does it mean to say that aspirin is a nonselective inhibitor? Why is this a bad thing?
it means that aspirin inhibits COX1 and COX2
This is bad because COX1 helps platelet function and gastric protection
COX1 function
gastric protection
platelet function
COX2 function
pain
fever
bone formation
what is aspirin good at preventing
pain/inflammation
fever
vascular disorders
cancer prevention
what is the primary NSAID used in treating fever in adults
aspirin
2 main adverse effects of aspirin-like drugs
- gastrointestinal problems
- cardiovascular problems
aspirin is linked to causing _______ in children
reye syndrome
benefit of COX-2 selective drugs
because COX1 is untouched, the chance of gastric irritation is much lower
what does NSAID stand for
Nonsteroidal anti-inflammatory drugs
which COX drug (1 or 2) may increase the risk of serious cardiovascular events like heart attack/stroke
COX-2
is acetaminophen an NSAID drug? why or why not?
no because it lacks anti-inflammatory and anti-coagulant properties
what is the main contraindication to taking acetaminophen
people who have pre-existing liver disease (or are alcohol abusers)
acetaminophen is filtered through the liver and can be especially toxic in these individuals
contents of the upper GI tract
mouth
esophagus
stomach
duodenum
contents of lower GI tract
small intestine
large intestine
what is the small intestine’s job
digestion and absorption of nutrients
what is the large intestine’s job
absorbs water and electrolytes
stores waste products of digestion until elimination
enteric nervous system
the “second brain” in the gut
the gut immune system has ____% to ___% of the body’s immune cells
70% to 80%
what are the 3 most common GI problems in older adults
constipation
incontinence
diverticular disease
hiatal hernia
esophageal hiatus of the diaphragm becomes enlarged which causes the stomach to poke through into the thoracic cavity
(basically stomach squeezes into thoracic cavity)
are sliding hernias or rolling hernias more common
sliding hernias
____% of people over 60 have hiatal hernias
0.6
what is the main symptom of having a hiatal hernia
Reflux –> causes heart burn
what structure is most involved in heart burn
incompetence of the lower esophageal sphincter (LES)
valsalva maneuver
breath technique that increases intraabdominal pressure
(think about bracing abs when lifting)
post-prandial heartburn
heart burn shortly after eating (typically 30-60 mins)
what is GERD
backflow of gastric contents into the esophagus (reflux) typically due to the esophageal sphincter being open
foods that increase GERD incidence
____% to ___% of adults have GERD
10% to 20%
what are the 2 main causes of GERD
- decreased pressure of the lower esophageal sphincter
- gastric contents near junction (typically from increased intraabdominal pressure)
3 barriers in healthy people that prevent GERD
- anatomic barriers in tact
- mechanisms that clear stomach acid from esophagus
- maintaining stomach acidity & volume
3 extra-esophageal manifestations of GERD
asthma
cough
laryngitis
what are the 2 recommended sleeping positions for patients with GERD
supine
left side-lying
what is peptic ulcer disease
a break in the lining of the stomach or duodenum of 5mm or more
what are the 2 most common ways of developing peptic ulcer disease
- NSAID medications
- H. pylori bacterial infection
what are the main symptoms of a peptic ulcer
epigastric pain
burning, gnawing, cramping near xiphoid or radiating to the back
4 main complications of peptic ulcers
- bleeding
- perforation
- penetration
- gastric outlet obstruction
Crohn disease
chronic inflammatory disorder that can affect any segment of the intestinal tract (most commonly ileum and/or colon)
ulcerative colitis
chronic inflammatory disorder of the mucosa of the colon and rectum
age at onset of crohn disease vs ulcerative colitis
crohn:10-30 years
ulc: 10-40 years
family history of crohn disease vs ulcerative colitis
20-25% (c)
20% (u)
granulomas, thickened bowel wall, fissures, and narrowed lumen are common in _______ (crohn or ulcerative)
crohn disease
inflammation of just the mucosal layer is involved is most common in _______ (crohn or ulcerative)
ulcerative
location of lesions mostly on rectum and left colon are common in _______ (crohn or ulcerative)
ulcerative
where does an abdominal mass form in crohn disease
right lower quadrant
does growth retartation occur in crohn disease or ulcerative colitis
crohn disease
does crohn disease or ulcerative colitis typically have bloody stools
ulcerative colitis
does crohn disease or ulcerative colitis commonly have a cancer association
ulcerative colitis
diverticulosis
the presence of out pouching in the wall of the colon or small intestine
diverticulitis
inflammation/infection of the diverticula
diverticular disease is asymptomatic in ___% of affected people
0.8
in complicated diverticular disease, what develops with the bladder
fistula
what exercises should be avoided in patients with diverticular disease
increased intraabdominal pressure
risk factors of diverticular disease
constipation
physical inactivity
eating red meat
obesity
smoking
pneumaturia
air in the urine
fecaluria
urine in the stool
what referred pain can be present in diverticular disease
back pain
referred hip/thigh pain
what age and what gender is most susceptible to appendicitis
15-19
males
1/3 appendicitis cases are caused by
an obstruction that prevents normal drainage
what structure of the appendix is primarily obstructed
lumen
where will the pain be for appendicitis
lower right quadrant with tenderness
40-50% of appendicitis cases are atypical because
the position of the tip of the appendix
symptoms of appendicitis
abdominal pain
nausea/vomiting
low-grade fever
Referred pain:
thigh
groin
pelvic
hip
rectal fissure
ulceration/tear of the lining in the anal canal
what part of the anal canal is typically torn in a rectal fissure
posterior wall
how do hemorrhoids typically develop
through anything that increases intraabdominal pressure
5 system functions of the liver
digestive
endocrine
excretory
hematologic
immune
where is albumin produced
Liver
the liver converts and excretes…
bilirubin
what makes the pancreas an exocrine gland?
digestion!
it releases digestive enzymes and pancreatic juices to help the GI system
what makes the pancreas an endocrine gland?
glucagon and insulin secretion for metabolism
what is the function of the gallbladder
reservoir for bile
releases bile in duodenum in response to food
what does bile do
alkalinizes the intestinal contents and plays arole in emulsification, absorption, and digestion of fat
dark urine and light stools occur in association with…
jaundice
3 indications of hepatic issues
skin changes
spider angiomas
palmar erythema (warm palms)
jaundice can be diagnosed when _________ levels increase
serum bilirubin
why is stool normally brown?
bile and bilirubin
what does light-colored stool and tea/cola colored urine indicate
bilirubin goes to urinary system rather than digestive system
hepatic encephalopathy (or portosystemic encephalopathy)
reversible neuro-psychological symptoms caused by liver failure and metabolic buildup of toxins
asterixis
inability to maintain wrist extension with forward flexion of the upper extremity
musculoskeletal symptoms with liver disease
thoracic pain between scaps, right shoulder, right upper traps, right interscap, right subscap
hepatic osteodystrophy
abnormal development of bone associated with liver malfunction
due to skin changes in liver disease, individuals are more susceptible to ________
pressure ulcers
coagulopathy
easy bruising and bleeding under the skin or into joints in response to the slightest taumas
liver __(increases/decreases)__ size, weight, and blood flow with age
decreases
lipophilic
strong affinity for lipids
why does the decrease of albumin production impact how drug dosages are given
drugs typically bind to albumin
what is the livers role in the immune system response
it produces proteins associated with acute inflammatory reactions
5 severe complications that result from liver damage/nonfunctioning
- jaundice
- cirrhosis
- portal hypertension
- hepatic encephalopathy
- ascites
characteristics of jaundice (icterus)
yellow discoloration of the skin/eyes
urine turns dark
stool turns light
4 common causes of jaundice
- increase bilirubin production
- decreased uptake in bilirubin metabolism
- hepatocyte dysfunction
- impaired bile flow
cirrhosis
fibrosis and nodular regeneration of the liver from chronic inflammation
jaundice of newborns is caused by
a decreased uptake in bilirubin metabolism
portal hypertension
higher portal vein pressure (entry) than inferior vena cava pressure (exit)
what usually causes portal hypertension
cirrhosis
Lab findings in cirrhosis
decreased albumin
- increased prothrombin time (longer to form blood clots)
- anemia
- increased alanine aminotransferase, lactate dehydrogenase
clinical presentations of cirrhosis
Hepatomegaly
Spider angiomata
Splenomegaly
GI bleeding
Edema
Jaundice
Portal hypertension
Ascites
decreased plasma proteins results in what 2 symptoms
ascites and edema
what happens to the body when metabolism of proteins, carbs, and fats occurs
the body becomes hypoglycemic
3 direct symptoms of liver inflammation
pain, fever, GI symptoms
Ascites
abnormal accumulation of fluid within the peritoneal cavity
what is the most common cause of ascites
liver cirrhosis (85%)
spontaneous bacterial peritonitis
infection of ascitic fluid in the setting of portal hypertension
an increase of urobilinogen is an indication of
liver necrosis
a DECREASE in bilirubin metabolism, bile in GI tract, vitamin K absorption is an indication of
liver necrosis
what does a decreased hormone metabolism result in and what are the symptoms
increased androgens and estrogens in the body
spider angiomas
palmar erythema
loss of body hair
what is hepatitis
acute or chronic inflammation of the liver
what can cause hepatitis
virus (main)
chemical/drug/alcohol abuse
how long must a person have hepatitis for it to be considered CHRONIC
6 months
what liver disease can chronic hepatitis lead to
cirrhosis
what is the most common cause of acute liver failure
acetaminophen hepatotoxicity (50% of cases)
fulminant hepatic failure
acute liver failure that is rare but can be fatal
t/f: viral hepatitis can be easily spread even if symptoms are not present
t
how is hepatitis A transmitted
fecal-oral route
(consuming contaminated water/food)
what two types of viral hepatitis are transmitted through the fecal-oral route
Hepatitis A and E
hepatitis A results ONLY this type of infection
acute infection
____ occurs in 90% of heavy drinkers
alcoholic steatosis (fatty liver)
how is hepatitis B transmitted
sexually transmitted disease
(percutaneous or mucosal contact)
how long can HBV survive on environmental surfaces
1 week
how is hepatitis C developed
injection drug use
what form of hepatitis is uncommon in the US
hepatitis D
how is hepatitis D transmitted
it is a coinfection or superinfection of hepatitis B
(it needs hep b to replicate)
what causes oxidative stress to the hepatocytes in the liver
metabolizing alcohol
how does the liver respond to inflammation and injury
by forming scars (fibroids)
nonalcoholic fatty liver disease (NAFLD) causes
related to diabetes and insulin resistance
genetic, environmental, and inflammatory factors
what quadrant is the pancreas located
left upper quadrant (near stomach)
what is the pancreas’s dual function
secrete insulin/glucagon
acts as endocrine gland
2/3rds of acute pancreatitis involve what
gallstones and chronic alcohol consumption
what type of pancreatitis makes up 80% of cases
interstitial pancreatitis
what type of pancreatitis makes up 20% of cases
necrotizing pancreatitis
is necrotizing pancreatitis or interstitial pancreatitis more severe
necrotizing pancreatitis
moderately severe acute pancreatitis is related to
the gallbladder
chronic pancreatitis
the development of irreversible changes in the pancreas secondary to chronic inflammation
what are the 3 risk factors of chronic pancreatitis
chronic alcohol consumption
smoking
genetic predisposition
the pancreas is able to work until more than __% of pancreatic function is lost
0.9
what is the 3rd leading cause of cancer mortality in the US
pancreatic cancer
what cancer has the lowest 5-year survival rate after diagnosis
pancreatic cancer
95% of pancreatic cancers are _____.
Where is it located in the pancreas?
adenocarcinomas
head of pancreas
what disease can increase the risk of developing pancreatic cancer
type II diabetes
(glucose tolerance)
what are the 3 main clinical manifestations of pancreatic cancer
abdominal pain
weight loss
jaundice
t/f: tumors in the head of the pancreas are 2x as likely to metastasize to peritoneum than in the body or tail
false
the body/tail tumors are 2x more likely to metastasize
chole-
pertaining to bile
cholang-
pertaining to bile ducts
cholangiography
radiographic study of bile ducts
cholangitis
inflammation of bile duct
cholecyst-
pertaining to gallbladder
cholecystectomy
removal of gallbladder
cholecystitis
inflammation of gallbladder
cholecystostomy
incision and drainage of gallbladder
choledocho-
pertaining to common bile duct
choledocholithiasis
stones in common bile duct
choledochostomy
exploration of common bile duct
cholelith-
gallstones
cholelithiasis
presence of gallstones
cholescintigraphy
radionuclide imaging of biliary system
cholestasis
stoppage or suppression of bile flow
lith-
stone
what are gallstones made of
75% cholesterol
25% bilirubin salts (pigment stones)
cholelithiasis happens more in men or women
women
what does it mean to be litho-genic
to be more prone to stone formation
what causes cholelithiasis
changes in composition of bile salts, bilirubin, and cholesterol due to supersaturation
2 main complications of cholelithiasis
- cholecystitis (inflammation of gallbladder)
- cholangitis (inflammation of bile duct)
charcot triad
pain
fever
jaundice
peynolds pentad
pain
fever
jaundice
hypotension
mental confusion
___ may be the only presenting sign of acute cholangitis in the elderly
hypotension
acute cholangitis
obstruction and stasis of bile from choledocholithiasis (stones in common bile duct), biliary strictures, or malignancies
how long does acute cholecystitis abdominal pain last for
greater than 6 hours
3 lab values that increase with liver disease
ALT
AST
LDH
2 lab values that decrease with liver disease
BSP
oversecretion of adrenocoricotropic hormone (ACTH) by a pituitary tumor leads to which disease
cushing disease
what is the main extra–esophageal manifestations of gastroesophogeal reflux disease
cough
alcohol is a precipitating cause of
diabetic ketoacidosis
delta cells produce
somatostatin
what fraction of people have PREdiabetes
1/3
the liver is the major site of production proteins that are associated with…
acute inflammatory responses
cholelithiasis, viral hepatitis, and hemolysis all have what side effect
JAUNDICE
