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Pathophys II - Exam 3 > Witwer - GI > Flashcards

Witwer - GI Flashcards

1
Q

fxn’s of liver

A

storage

synthesis

immune

detox/breakdown

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2
Q

storage fxn of liver (2)

A

glucose/glycogen

vitamins/minerals

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3
Q

synthesis fxn of liver (7)

A

bile acids

protein

gluconeogenesis

cholesterol

conjugation of bilirubin

ammonia

angiotensin

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4
Q

immunological fxn of liver

A

kupffer cells in sinusoids

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5
Q

detox/breakdown fxn of liver (3)

A

toxins

hormones

drugs

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6
Q

heme is broken into __,

which is secreted into __

and passed into __

A

bilirubin (watr soluble)

bile

feces

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7
Q

hemolytic anemia and internal hemorrhage cause __ jaundice

A

pre hepatic

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8
Q

liver dysfxn → can’t conjugate bilirubin is __ jaundice

A

hepatic

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9
Q

gallstones in CBD and carcinoma of head of pancreas are __ jaundice

A

post hepatic

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10
Q

3 manifestations of jaundice

A

scleral icterus

bilirubinuria

kernicterus

kernicterus encephelopathy

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11
Q

kernicterus encephelopathy is similar to

A

cerebral palsy

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12
Q

tx for jaundice (2)

A

phytotherapy

exchange transfusion

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13
Q

mc cause of malabsorption syndrome

A

pancreatitis

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14
Q

common cause of malabsorption syndrome in kids

A

CF

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15
Q

malabsorption sx of CF (2)

A

steatorrhea

protein malabsorption

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16
Q

__ absorption is not affected by CF

A

CHO

dt salivary amylase

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17
Q

causes of bile salt/acid deficiency (6)

A

hepatic blockage

bacterial overgrowth → diverticuli

excess binding of bile salt to cholestyramine

terminal ileum dz

small bowel dz

apo48/whipple dz

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18
Q

clinical sx of bile acid deficiency

A

steatorrhea

fat soluble vitamin deficiency

folic acid/b12 deficiency

combined anemia: folic acid/iron

ascites and pitting edema dt hypoproteinemia → decreased oncotic pressure

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19
Q

evaluation of malabsorption (3)

A

test for fat malabsorption

test for pancreatic insufficiency

test for bile acid deficiency

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20
Q

steps in heme breakdown

A

heme → biliverdin → unconjugated bilirubin → conjugated bilirubin → urobilinogen → stercobilin and urobilin

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21
Q

bile contents

A

water

bile salts

bilirubin

fats

inorganic salts

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22
Q

enterohepatic circulation

A

bile from gallbladder → stomach → CBD → duodenum → terminal ileum → hepatic portal vein → liver

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23
Q

95% of bile is reabsorbed by __

5% of bile is lost in __

A

SI

feces

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24
Q

where are bile salts and B12 absorbed and recycled

A

terminal ileum

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25
benign liver tumors (2)
cavernous hemangioma focal nodular hyperplasia
26
mc benign liver tumor
cavernous hemangioma
27
2 clinical manifestations of cirrhosis
hepatic insufficiency portal htn
28
4 sx of hepatic insufficiency
jaundice hyperesterinism bleeding encephalopathy
29
4 sx of portal htn
esophageal varices hemorrhoids ascites splenomegaly
30
85% of hep C presents as
mild acute infxn w. chronic hepatitis
31
20% of hep C manifests as
post necrotic cirrhosis
32
complication of cirrhosis
HCC
33
95% of acute cholecystitis is caused by
gallstones
34
quad of acute cholecystitis
fair fat fertile forty
35
stone location in acute cholecystitis (2)
cystic duct cbd
36
mc infectious cholecystitis pathogen
**e.coli** other: enterococcus, bacteroides fragilis, clostridium
37
acute cholecystitis sx
RUQ pain → radiation to right shoulder localized peritonitis w. rebound tenderness (+) murphy sign neutrophilic leukocytosis
38
gs for cholelithiasis dx
US *more sensitive to stones in gallbladder than cystic duct*
39
mc cause of acute pancreatitis
gallstones
40
sx of acute pancreatitis
f/n/v severe, boring, knife-like pain in midepigastrum, → radiationto back hypovolemic shock hypoxemia dic tetany
41
grey-turner and cullen sign
acute pancreatitis
42
mc cause of chronic pancreatitis
etoh
43
mc cause of chronic pancreatitis in kids
CF
44
clinical presentation of chronic pancreatitis
pancreatic pseudocysts calcifications → saponification scarred shrunken pancreas residual DM residual malabsorption
45
severe pain radiating to back malabsorption → 90% exocrine fxn pancreatic pseudocysts
chronic pancreatitis
46
gold standard for pancreatitis dx
CT
47
mc type of pancreatic ca
adenocarcinoma
48
rf for pancreatic ca
smoking chronic pancreatitis DM high fat diet obesity cirrhosis
49
65% of pancreatic ca is in the
head
50
epigastric pain, wt loss, painless or painful jaundice, clay colored stools, trosseau's sign, migratory thrombophlebitis, virchow node on left, sister mary joseph sign
pancreatic ca
51
gs blood test for pancreatic ca
CA19-9
52
mc causes of hematochezia (2)
hemorrhoids diverticulitis
53
other causes of hematochezia
intussusception IBD UC
54
highest incidence of celiac (3)
infancy 3rd and 7th decades
55
dermatitis, herpetiformis, hashimoto's, biliary cirrhosis, T1DM, turner's
celiac associations
56
clinical signs of celiac
ftt steatorrhea, wt loss, abd distension
57
serologic tests for celiac (2)
total IgA endomysial (EMA) abs of IgA
58
gs dx for celiac
**small bowel bx** → flattened villi, hyperplasti glands
59
banana and rice belly protein deficiency malnutrition
kwashiorkor
60
what causes belly distension in kwashihorkor
low colloid osmotic/oncotic pressure of lymph and blood
61
regional enteritis, chronic granulomatous, transmural, discontinuous skip lesions
crohn dz
62
mc location for crohn's dz
ileocecal and terminal ileum
63
sx of crohn's (5)
bloody diarrhea wt loss fever dpn ftt
64
systemic findings of crohn's
uveitis gallstones polyarthropathy erythema nodosum primary sclerosing angitis
65
complications of crohn's
fistula intestinal strictures → obstruction abd abscesses skip lesions adenocarcinoma stones
66
causes of ischemic bowel dz
arterial thrombosis arterial emboli venous thrombosis generalized hypoperfusion strictures volvulus incarcerated hernia
67
causes of arterial thrombosis
ASCVD vasculitis hypercoaguable states
68
mc cause of arterial emboli
**afib** also endocarditis, ASCVD
69
hypoperfusion can be caused by
shock cardiac failure dehydration
70
decreased blood flow in ischemic bowel dz can be (3)
arterial venous non-occlusive
71
mc type of decreased blood flow causing bowel ischemia
arterial
72
volvulus is decreased __ blood flow
venous
73
non-occlusive causes of decreased blood flow leading to ischemic bowel
hypotn hypovolemic shock vasospasm
74
sx of bowel ischemia
pain out of proportion hematochezia fever tachycardia shock adynamic ileus profound leukocytosis
75
atherosclerotic narrowing of SMA w. severe pain in splenic flexure
mesenteric ischemia
76
sx of mesenteric ischemia
bloody diarrhea wt loss → dt fear of eating
77
types of dead bowel dz 2/2 to infarction
transmural mural and mucosal
78
full thickness hemorrhagic infarction 2/2 to SMA thrombosis
transmural dead bowel dz
79
mural/mucosal dead bowel dz is 2/2 to
hypoperfusion
80
colicky abd pain bilious vomiting currant jelly stool sausage shaped mass in RUQ
intusussception
81
mc location of intussusception
ileum into cecum
82
intusussception pt population
3 mo - 5 yo
83
US findings of intusussception
target sign
84
3 pathogens associated w. bacterial diarrhea mortality in developing countries
e.coli salmonella shigellosis
85
food poisoning pathogens
campylobacter jejuni salmonella e.coli staph strep c.perfingens clostridium botulinum
86
4 viral causes of food poisoning
enterovirs hepatitis norovirus rotavirus
87
most lethal neurotoxin known prevents synaptic transmission → paralysis
clostridum botulinum
88
systemic form of salmonellosis
typhoid fever
89
fever w. bradycardia, rose spot rash, encephalitis, fever/malaise, internal hemorrhage
typhoid fever
90
tx for typhoid fever
cholecystectomy
91
bacillary dystentery is caused by
shigellosis
92
severe inflammatory change in bowel, drastic dehydration, rectal bleeding, reactive arthritis
bacillary dysentery
93
severe watery diarrhea, rice water stools, lyte imbalance
cholera
94
tx for cholera
continued eating massive fluid/lyte replacement abx *vaccine available*
95
diarrhea in hospitalized pt w. multiple fx, injuries, etc
clostridium difficile
96
watery diarrhea 10-15/day, tachycardia, dehydration, fever, elevated WBC
c.diff

Pathophys II - Exam 3 (8 decks)

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