FA GIT I Flashcards
(199 cards)
1
Q
Cover picture on back of slide and identify numbered structures.
A
- Duodenum (2nd, 3rd, 4th parts)
2
Q
Adrenal Glands and Rectum not shown.
A
http://o.quizlet.com/i/HoAUgibDaM5T55flmVzuZw.jpg
3
Q
What structure does it contain? Fetal Derivative?
A
Connects Liver to Anterior Abdominal Wall
4
Q
Contains Ligamentum Teres and is a derivative of the fetal umbical vein.
A
http://o.quizlet.com/i/ecu59KdPrB51HUQ4jF6XJQ.jpg
5
Q
Hepatoduodenal Ligament? What does it contain? Connects what? Compressed in what situation?
A
Liver to duodenum, contains portal triad- hepatic artery, portal vein, common bile duct.
6
Q
Connects greater and lesser sacs.
A
http://o.quizlet.com/i/ecu59KdPrB51HUQ4jF6XJQ.jpg
7
Q
Gastrohepatic Ligament? Contains? Separates? Can be cut during?
A
Liver to lesser curvature of stomach, contains gastric arteries.
8
Q
May be cut during surgery to access lesser sac
A
http://o.quizlet.com/i/ecu59KdPrB51HUQ4jF6XJQ.jpg
9
Q
Gastrocolic ligament Connects? Contains?
A
Greater curvature and transverse colon.
10
Q
Contains Gastroepiploic arteries. Part of the greater omentum
A
http://o.quizlet.com/i/ecu59KdPrB51HUQ4jF6XJQ.jpg
11
Q
Gastrosplenic connects? contains? Separates?
A
Gastrosplenic connects greater curvature and spleen.
12
Q
Contains short gastrics, Separates left greater and lesser sacs.
A
http://o.quizlet.com/i/ecu59KdPrB51HUQ4jF6XJQ.jpg
13
Q
Splenorenal connects? Contains?
A
Spleen to posterior abdominal wall,
14
Q
Contains Splenic Artery and Vein
A
http://o.quizlet.com/i/ecu59KdPrB51HUQ4jF6XJQ.jpg
15
Q
What are the layers of the gut wall from inside to outside?
A
- Mucosa- contains epithelium (absorption), lamina propria (support), muscularis mucosa (motility)
16
Q
- Serosa/ Adventitia
A
http://o.quizlet.com/i/UNh32x3Pez415yR6m95LTA.jpg
17
Q
What is the role of the mesentery
A
Fixes position of intestinal loops and anchors intestine to retroperitoneum
18
Q
What are the is the frequency of basal electric rhythms (slow waves) in the stomach?
A
3 waves/ min
19
Q
What are the is the frequency of basal electric rhythms (slow waves) in the Duodenum?
A
12 waves/min
20
Q
What are the is the frequency of basal electric rhythms (slow waves) in the Ileum?
A
8-9 waves/ min
21
Q
Describe muscle distribution in esophagus
A
Upper 1/3 is striated, Middle 1/3 is striated and smooth, Lower 1/3 is smooth
22
Q
Esophagus Histology?
A
Nonkeratinized stratified squamous epithelium
23
Q
Stomach contains?
A
Gastric Glands
24
Q
Duodenum contains?
A
Villi and Microvilli which increase absorptive surface area, Brunner’s glands of submucosa and Crypts of lieberkuhn
25
Jujunum contains?
Largest number of goblet cells in small intestine, Plica circulares and crypts of lieberkuhn
26
Ileum contains?
Peyer's patches (lamina propria, submucosa), plicae circulares (proximal ileum), and crypts of lieberkuhn
27
Colon contains?
Crypts but no villi
28
Name the branches of the abdominal aorta
T12- Celiac
29
Canned Soup Really Good in Bowls
http://o.quizlet.com/i/lcrlbqNAnBy-GyneUVTAjQ.jpg
30
What does the left common iliac artery branch into
Left internal iliac artery and Left external iliac artery.
31
Foregut- Artery, Parasympathetic Innervation, Vertebral Level and Structures supplied
Artery- Celiac
32
Midgut- Artery, Parasympathetic Innervation, Vertebral Level and Structures supplied
Artery- SMA
33
Which area supplied is considered a watershed region.
Artery- IMA
34
What are the branches of the celiac trunk?
Common hepatic, splenic, left gastric- These constitute the main blood supply of the stomach.
35
What are the branches of the common hepatic artery?
RPG
36
What does the superior gastroduodenal split into?
Superior Pancreatoduodenal and Right Gastroepipoloic
37
What does the hepatic artery proper split into?
Left Hepatic and Right Hepatic with Cystic branching off the right hepatic.
38
What does the splenic artery branch into?
Some People Like Sayings
39
What does the left gastric lead into?
Esophageal Artery
40
Short Anastomoses exist between what arteries off the celiac trunk?
Left and Right Gastroepiploics
41
What artery has poor anastomosis if the splenic artery is blocked?
Short Gastrics
42
If the abdominal aorta is blocked? what arterial anastomoses (origin) compensate?
Superior Rectal (IMA) to Middle Rectal (Internal Iliac)
43
What are some portosystemic anastomoses? What can be seen with portal hypertension
Esophageal vein connecting to left gastric vein. Can lead to Esophageal varices.
44
Varices of gut, butt, and caput (medusae) are commonly seen with portal hypertension.
http://o.quizlet.com/i/YlC_49wpaHM8ZloMb0bFew.jpg
45
What is a treatment for portal hypertension?
Insert a transjugular intrahepatic portosystemic shunt between the portal vein and hepatic vein percutaneously relieves potal hypertension by shunting blood to the systemic circulation.
46
Significance of pectinate line?
Formed where hindgut meets ectoderm.
47
What type of hemorrhoids can you see above pectinate line? Type of cancer? Derivation? Arterial Supply? Venous Drainage. What type of innervation?
Internal Hemorrhoids
48
What type of hemorrhoids can you see below the pectinate line? Type of cancer? Derivation? Arterial Supply? Venous Drainage. What type of innervation?
External Hemorrhoids
49
Describe organization of structures near femoral region
Lateral to Medial: Femoral Nerve, Artery, Vein, Empty Space, Lymphatics
50
What makes up the femoral triangle?
Femoral Nerve, Artery, and Vein make up the triangle.
51
Triangle contains sartorious, adductor longus, and inguinal ligament.
http://o.quizlet.com/i/F1SRi778foWe4SnxV3GERQ.jpg
52
What does the femoral sheath contain? Where is it located?
Fascial tube 3-4 cm below inguinal ligament. Contains femoral vein, artery and canal (deep inguinal ligaments), but not femoral nerve.
53
How does blood drain from the central vein of the liver?
To the Hepatic Veins to the inferior vena cavae to the systemic circulation.
54
What can tumors that arise in the head of the pancreas (near the duodenum cause)?
Obstruction of the common bile duct
55
What can gallstones that reach the common channel at ampulsa cause?
Can block both bile and pancreatic ducts.
56
Describe the anatomy of the biliary structures (Liver, Gallbladder, and Pancreas). Talk about the how the ducts emerge from these structures. What name refers to the lumen of the duct?
Right Hepatic and Left hepatic duct make common hepatic duct which combines with the cystic duct to make the common bile duct which combines with the pancreatic duct at the sphincter of oddi (around the duct).
57
The Ampulla of vater refers to the lumen of the duct.
http://o.quizlet.com/i/5ryDVBNvoi83AyYAgfHELA.jpg
58
What is a hernia?
A protrusion of peritoneum through an opening, usually a site of weakness.
59
What is a diaphragmatic hernia? Can occur as a result of what? Most commonly?
Abdominal structures enter the thorax, may occur in infants as a result of defective development of pleuroperitoneal membrane.
60
What is a paraesophageal hernia?
GE junction is normal. Cardia moves into thorax.
61
What is a femoral hernia? Leading cause of?
Protrudes below inguinal ligament through femoral canal below and lateral to pubic tubercle. More common in women.
62
What is a direct inguinal hernia? Usually in what population? Goes through what? Covered by what?
Protrudes through the inguinal (Hesselbach's) triangle. Bulges directly through abdominal wall medial to inferior epigastric artery.
63
What is an indirect inguinal hernia? Usually in what population? Goes through? Covered by?
Goes through the internal (deep) inguinal ring, external (superficial) inguinal ring, and into the scrotum. Enters internal inguinal ring lateral to inferior epigastric artery.
64
What is Hesselbach's triangle
Area between Inferior epigastric artery, lateral border of rectus abdominus, and inguinal ligament
65
What is a way to remember direct vs indirect hernias?
MD'S don't Lie.
66
Name the structures that the inguinal canal passes through as it starts from the transversalis fascia?
Passes through transversus abdominus, Internal Oblique, and External Oblique, and Inguinal Ligament
67
What structures are located between the parietal peritoneum and the transversalis fascia
The Inferior epigastric artery, medial umbical ligament, median umbilical ligament
68
What structures makle up the spermatic cord?
External spermatic fascia, Cremasteric muscle and fascia, and Internal Spermatic Fascia
69
Increased in what disease? What amino acids are potent stimulators
Source- G Cells (Antrum of the Stomach)
70
Cholecystokinin Source, Action, Regulation.
Source- I cells (Duodenum, Jejunum)
71
How does this hormone allow pancreatic enzymes to function
Source: S cells (duodenum)
72
Used to treat?
Source: D cells (panreatic islets, GI mucosa)
73
which is used more rapidly an Oral glucose load a glucose load given by IV?
Source: K Cells (Duodenum, Jejunum)
74
VIPoma?
Source: Parastympathetic ganglia in sphincters, gallbladders, and small intestine
75
Loss is implicated in what disease?
Decreased smooth muscle relaxation, including lower esophageal sphincter
76
Motilin Source, Action, Regulation
Small intestine, Promotes Migrating motor complexes, Increased in fasting state
77
Lost in? Associated with
Source: P/D1 cells (Stomach)
78
Intrinsic Factors Source, Action?
Parietal Cells of Stomach
79
Gastrinoma?
Source: Parietal Cells (Stomach)
80
Pepsin Source, Action, Regulation, Notes
Source: Chief Cells of Stomach
81
Trapped where?
Source: Mucosal cells (stomach, duodenum, salivary glands, pancreas), and Brunner's glands (duodenum)
82
Three parts of the stomach from highest to lowest?
Fundus, Body, Antrum
83
What cells are located in the body?
Parietal Cells and Chief Cells
84
What Cells are located in the Antrum
Mucous Cells and G cells
85
What cells are located in hte pancreas
D cells which release somatostatin
86
What cells are located in the duodenum?
I cells (CCK), S cells (Secretion), and K Cells (GIP)
87
How does vagus nerve affect secretion
Activates G cells to release gastrin or can activate parietal cells to release HCL.
88
How does gastrin primarily increase acid secretion?
Primarily through its effect on ECL cells leading to histamine release rather than through its direct effect on parietal cells.
89
Brunner's Glands location and purpose. Hypertrophy seen in what disease?
Located in duodenal submucosa (the only GI submucosal glands)
90
Parotid, submandibular, and Sublingual. Which one is most mucinous? Which one is most serous?
Parotid is most serous, Submandibular, submaxillary, and sublingual (most mucinous) are mucinous
91
What is salivary secretion stimulated by?
Stimulated by both sympathetic (T1-T3 superior cervical ganglion) and parasympathetic (facial, glossopharyngeal nerve) activity.
92
What nerve runs through the parotid gland?
CN VII, can be damaged during surgery.
93
How can flow rate affect salivary secretions?
Low flow rate- hypotonic (more time to reabsorb Na and Cl)
94
What are some functions of salivary secretions?
A-amylase- ptyalin begins starch digestion, inactivated by low pH on reaching stomach
95
What are things that activate the gastric parietal cell and through what G protein coupled receptor?
Ach, Gastrin-> Gq
96
Alkaline tide?
In gastric parietal cell, HCO3- leaves the cell in exchange for Cl- going in the cell.
97
What is the role of trypsinogen? How is it activated? What does it activate?
A-amylase- starch digestion, secreted in active form
98
Explain carbohydrate absorption. What transported do different carbohydrates go through?
Only monosacharrides (glucose, galactose, and fructose) are absorbed by enterocytes.
99
Where is iron absorbed?
Absorbed as Fe2+ in duodenum.
100
Where is folate absorbed?
Absorbed in Jejunum
101
where is b12 absorbed?
Absorbed in ileum along with bile acids.
102
What are Peyer's patches? Where are they found? What cells do they contain?
Unencapsulated lymphoid tissue found in lamina propria and submucosa of small intestine. contain specialized M cells that take up antigen.
103
What happens when b cells are stimulated in germinal centers of Peyer's patches?
B cells stimulated in germinal centers of peyer's patches differentiate into IgA secreting plasma cells, which ultimately reside in lamina propria.
104
Needed for?
Composed of bile salts (bile acids conjugated to glycine or taurine, making them water soluble),phospholipids, cholesterol, bilirubin, water, and ions.
105
What is bilirubin?
Product of heme metabolism. removed from blood by liver and conjugated with glucuronate and excreted in bile.
106
Direct bilirubin?
Conjugated with glucuronic acid, water soluble
107
Indirect bilirubin
Unconjugated, water insoluble
108
Explain how heme is broken down.. to Urobilinogen
Macrophages break down RBCs into Heme into unconjugated bilirubin.
109
Urobilinogen Pathways
80% goes to be excreted in feces as stercobilin, which gives characteristic color of stool.
110
What are the types of salivary gland tumors? Malignant or benign?
generally benign and occur in parotid gland.
111
Achalasia, Increased risk of? Secondary causes of achalasia?
Failure of relaxation of lower esophageal sphincter (LES) due to loss of myenteric (Auerbach's plexus).
112
Gastroesophageal Reflux Disease
Commonly presents as heartburn and regurgitation upon lying down. May also present with nocturnal cough and dyspnea.
113
Esophageal Varices
Painless bleeding of submucosal veins in lower 1/3 of esophagus
114
Mallory-Weis
Painful mucosal lacerations at gastroesophageal junction due to severe vomiting. Leads to hematemesis. Usually found in alcoholics and bulimics
115
Boerhaave syndrome
Transmural espophageal rupture due to violent retching. "Been-heaving syndrome"
116
Esophageal Strictures Associated with?
Associated with lye ingestion and acid reflux.
117
Esophagitis Associated with?
Associated with reflux, infection (HSV-1, CMV, Candida), or chemical ingestion
118
Plummer-Vinson Syndrome
Triad of dysphagia (due to esophageal webs), glossitis, iron deficiency anemia
119
What happens in Barrett's esophagus?
Glandular metaplasia that leads to replacement of nonkeratinizes stratified squamous epithelium with intestinal (columnar) epithelium in the distal esophagus. due to chronic acid reflex (GERD)
120
What type of cancer is more common worldwide? what is is more common in the US? Location?
Progressive Dysplasia-> (solids-> Liquids-> weight loss)
121
Name some malabsorption syndromes
Celiac Sprue, Tropical Sprue, Whipples Disease, Disaccharidase Deficiency, Pancreatic Insufficiency, Abetalipoproteinemia
122
Increased risk of?
Autoantibodies to tissue transglutaminase and gluten (gliaden) in wheat and other grains. Proximal Small Bowel, Leads to steatorhea. Associated with people of northern European descent. Tissue transglutaminase serum levels used for screening., blunting of villi and lymphocytes in the lamina proproa.
123
What happens in Tropical Sprue? What part of GI does it affect:
Probably infectious, responds to antibiotics. similar to celiac sprue, but can affect entire small bowel.
124
Whipple's Disease? Infected by? Signs and symptoms? Most commonly in?
Infection with tropheryma whippelii (gram positive); PAS-positive macrophages in intestinal lamina propria, mesenteric nodes.
125
Disaccharidase deficiency, when can this occur? what is most common type? What type of diarrhea?
Most common is lactase deficiency-> milk intolerance. Normal-appearing villi. Osmotic Diarrhea. Since lactase is located at tips of intestinal villi, self-limited lactase deficiency can occur following injury (viral diarrhea)
126
Pancreatic Insufficiency Causes? What can it cause?
Due to cystic fibrosis, obstructing cancer, and chronic pancreatitis. Causes malabsorption of fat and fat-soluble vitamins (Vitamines A, D, E, K)
127
Presents in early childhood as what?
Decreased synthesis of Apo B-> inability to generate chylomicrons-> decreased secretion of cholesterol, VLDL into bloodstream which leads to fat accumulation in enterocytes.
128
Acute Gastritis (erosive)- what happens and what causes it? Common among?
Disruption of mucosal barrier which leads to inflammation. Can be caused by stress, NSAIDS (Decreased PGE which leads to decreased gastroc mucosa production), alcohol, uremia, burns, and brain injury.
129
What happens in Curling's ulcer
Burns->Decreased plasma volume-> sloughing of gastric mucosa
130
What happens in Cushings Ulcer?
Brain injury which leads to Increased vagal stimulation which leads to increased ACH which leads to increased H+ production.
131
What are the the types of chronic gastritis (nonerosive) and part of the stomach do they affect?
Type A (fundus/body)
132
Type A Chronic Gastritis- Associated with?
(Fundus, Body) Autoimmune disorder characterized by autoantibodies to parietal cells, pernicious anemia, and achlorhydria. Associated with other autoimmune disorders.
133
Type B Chronic Gastritis? Caused by? Increased risk of?
Most common type. Caused by H. pylori infection. Increased risk of MALT Lymphoma.
134
What happens in Menetrier's Disease?
Gastric hypertrophy with protein loss, parietal cell atrophy, and increased mucous cells. Precancerous. Rugae of stomach are so hypertrophied that they look like brain gyri.
135
Stomach cancer- Almost always? Associated with? Common features? Whats it caused when diffuse?
Almost always adenocarcinoma. Early aggressive local spread and node/liver mets.
136
virchow's node, Krukenberg's tumor, and Sister Mary joseph's nodules possible
http://o.quizlet.com/i/nF84RzGjfC2bqwypsBsQyA.jpg
137
Virchow's node
involvement of left supraclavicular node by mets from stomach
138
Krukenberg's Tumor
Bilateral mets to ovaries. Abundant mets to ovaries. Abundant mucus, signet ring cells.
139
Sister Mary joseph's nodule
subcutaneous periumbilical metastasis.
140
Gastric Ulcer, pain greater with meals? Percent Infection with certain organism?
Pain can be greater with meals and leads to weight loss.
141
How do margins look like? Potential complications
Pain decreases with meals- weight gains. Almost 100% have h. pylori infection. Due to increased gastric acid secretion (zollinger-elinson syndrome) or decreased mucosal protection. Hypertrophy of Brunner's glands.
142
Irritable Bowel Syndrome, How do you treat?
Recurrent abdominal pain with 2 or more of the following: Pain improves with defecation, changes in stool frequency, change in appearance of food.
143
Differential?
All age groups, most common indication for emergent abdominal surgery in children. Initial diffuse periumbilical pain which localizes pain at McBurney's pint (2/3 the distance from iliac crest to umbilicus). Nausea, fever, may perforate-> which can perforate leading to peritonitis.
144
Diverticulum? Most often where? Most often false or true?
Blind pouch protruding from the alimentary tract that communicates with the lumen of the gut. Most diverticula (esophagus, stomach, duodenum, colon) are acquired and are termed "false" in that they lack or have an attenuated muscularis externa. Most often in the sigmoid colon
145
What is the difference between a "True Diverticulum" and a "False Diverticulum" Where do false diverticulum most often occur?
True Diverticulum- all 3 layers of wall layers outpouch.
146
What signs/ symptoms do you see?
Many Diverticula. Common in 50% of people greater than 60. Caused by increased intraluminal pressure and focal weakness in colonic wall. Associated with low-fiber diets. Most often in sigmoid colon.
147
Diverticulitis- What is it? How do you treat? May Cause
Inflammation of diverticula classically causing left lower quadrant pain, fever, leukocytosis.
148
Zenker's Diverticulum
False diverticulum. Herniation of mucosal tissue at junction of pharynx and esophagus. Presenting symptoms: halitosis (due to trapped food particles), dysphagia, and obstruction.
149
Meckel's Diverticulum, Can cause? Contrast with? what are the Five 2's
Persistence of the vitelline duct or yolk stalk. May contain ectopic acid-secreting gastric mucosa and/or pancreatic tissue.
150
What is an intussusception? If occurs in adults? If occurs in children? Which one does it occur more in?
Telescoping of 1 bowel segment into distal segment which can compromise blood supply. Unusual in adults (associated with intraluminal mass or tumor). Majority of cases occur in children (usually idiopathic; may be viral (adenovirus). Abdominal emergency in early childhood.
151
Volvulus/
Twisting of portion of bowel around its mesentery which can lead to obstruction and infarction. May occur at cecum and sigmoid colon, where there is redundant mesentery. Usually in elderly.
152
Hirschsprung's disease? due to? Presents as? Risk increases?
Congenital megaocolon characterized by lack of ganglion cells/ enteric nervous plexuses( Auerbach's and Meissner's plexuses) in segment on intestinal biopsy. Due to failure of neural crest cell migration.
153
Duodenal Atresia, Associated with?
Causes early bilious vomiting with proximal stomach distention ("double bubble") due to failure of recanalization of small bowel. Associated with Down's syndrome.
154
Meconium Ileus
In cystic fibrosis, meconium plug obstructs intestine preventing stool passage at birth.
155
Necrotizing Enterocolitis
Necrosis of intestinal mucosa and possible perforation. Colon is usually involved, but can involve entire GI tract. In neonates, more common in premies (decreased immunity)
156
Ischemic Colitis
Reduction in intestinal blood causes ischemia. Pain seen after eating -> weight loss. commonly occurs at splenic flexure and distal colon. Typically affects elderly
157
Adhesion
Acute bowel obstruction, commonly from a recent surgery. Can have well-demarcated necrotic zones.
158
angiodysplasia
Tortuous dilation of vessels-> bleeding. Most often found in cecum, terminal ileum, and ascending colon. More common in older patients. Confirmed by angiography.
159
Colonic Polyps
Masses protruding into gut lumen-> sawtooth appearance. 90% are non-neoplastic. Often rectosigmoid.
160
What are the types of colonic polyps?
Hyperplastic, Juvenile, and Peutz Jeghers
161
Hyperplastic Polyps
Most common non-neoplastic polyp in colon (> 50% found in rectosigmoid colon)
162
Juvenile polyps. What is single polyp found?
Mostly sporadic lesions in children < 5 years of age. 80% in rectum. If single, no malignant potential.
163
Peutz-Jeghers
Single Polyps are not malignant.
164
Colorectal Cancer- What most common cancer? What most deadly cancer in the US. How old are most patients? What percent have a family history
3rd most common cancer, 3rd most deadly in the United States. Most patients are greater than 50 years of age and 25% have a family history.
165
What additional risk factors are there for colon cancer?
IBD, Streptococcus bovis bacteremia, tobacco use, large villous adenomas, juvenile polyposis syndrome, Peutz-Jegher Syndrome
166
What presentation will you see with colorectal cancer (CRC)
Distal colon- obstruction, colick pain
167
How can you diagnosis colorectal cancer?
Iron deficiency anemia in older males. Screen patients greater than 50 years of age with stool occult blood test and colonoscpy.
168
What are the types of colorectal cancer?
Familial Adenomatous Polyposis, Gardner's Syndrome, Turcot's Syndrome, and Hereditary Nonpolyposis colorectal cancer (HNPCC/Lynch Syndrome)
169
Familial Adenomatous Polyposis
Autosomal dominant mutation of APC gene on chromosome 5Q. Two-hit hypothesis. 100% progress to colorectal cancer. Thousands of polyps. Pancolonic. Always involves rectum.
170
Gardner's Syndrome
FAP+ osseous and soft tissue tumors, retinal hyperplasia
171
Turcot's Syndrome
FAP+ malignant CNS tumor. TURcot= TURban.
172
Hereditary Nonpolyposis Colorectal Cancer (HNPCC/ Lynch Syndrome)
Autosomal dominant mutation of DNA mismatch repair genes. 80% progress to CRC. Proximal colon is always involved.
173
What are two molecular pathways that lead to Colorectal cancer? What percentages?
1. Microsatellite instability pathway (15%): DNA mismatch repair gene mutations-> sporadic and HNPCC syndrome. Mutations accumulate, but no defined morphologic correlatess.
174
2. APC/ Catenin pathway (chromosomal instability) pathway: 85%
http://o.quizlet.com/i/vpwJO7XL5lu5Wdnx627JwA.jpg
175
Describe pathway that leads from normal colon to adenocarcinoma
Normal Colon-> Loss of APC Gene, Decreased intercellular adhesion and increased proliferation-> Colon at Risk-> K-ras mutation (unregulated intracellular signal transduction)-> Adenoma-> loss of p53 mutation (increased tumorigenesis)-> carcinoma
176
What happens if tumor is localized to GI System? What if its not?
Tumor of neuro-endocrine cells. Constitute 50% of small bowel tumors. Most common sites are the appendix, illeum, and rectum. Most commmonly malignant in the small intestine.
177
What are some effects of portal hypertension
Esophageal varices-> hematemesis, Melena
178
Hemorrhoids
http://o.quizlet.com/i/U6M4zYSXcQvOTasj_WLQTA.jpg
179
What are some effects of liver cell failure?
Coma, scleral icterus, Fetor hepaticus (breath smells like a freshly opened corpse), spider nevi, gynecomastia, jaundice, testicular atrophy, liver flap= asteriis (course hand tremor)
180
Bleeding tendency (decreased prothrombin and clotting factors),Anemia, and Ankle Edema
http://o.quizlet.com/i/U6M4zYSXcQvOTasj_WLQTA.jpg
181
Micronodular Cirrhosis
Nodules < 3mm, uniform size. Due to metabolic insult (alcohol, hemochromatosis, wilsons)
182
Macronodular cirrhosis
Nodules >3 mm, varied size. Usually due to significant liver injury leading to hepatic necrosis (postinfecious or drug-induced hepatitis), Increased risk of heptaocelluar carcinoma.
183
How can Aminotransferases be used diagnostically?
Viral hepatitis (ALT> AST)
184
How can GGT (gamma-glutamyl transpeptidase) be used diagnostically?
Various liver diseases, with increase in heavy alcohol consumption
185
How can alkaline phosphatase be used diagnostically
Obstructive liver disease (hepatocellular carcinoma), Bone disease, bile duct disease
186
How can amylase be used diagnostically?
Acute pancreatitis, Mumps
187
How can lipase be used diagnostically?
Acute Pancreatitis
188
How can ceruloplasmin be used diagnostically?
Wilson's Disease
189
What happens in Reye's Syndrome
Rare, often fatal childhood hepatoencephalopathy.
190
Hepatic Steatosis
Short-term change with moderate alcohol intake. Macrovesicular fatty change that may be reversible with alcohol cessation.
191
Alcoholic hepatitis
Requires sustained, long-term consumption. Swollen and necrotic hepatocytes with neutrophilic infiltration. Mallory bodies (intracytoplasmic eosinophilic inclusions) aer present
192
Alcoholic Cirrhosis
Final and irreversible form. Micronodular, irregularly shrunken liver with hobnail appearance. Sclerosis around central vein (zone III). Has manifestations of chronic liver disease (jaundice, hypoalbuminemia)
193
Nutmeg liver
Due to backup of blood into the liver. Commonly causes by right sided heart failure and BUDD-CHIARI syndrome. The liver appears mottled like a nutmeg. If the condition persists, centrilobar congestion and necrosis can result in cardiac cirrhosis.
194
Hepatocellular Carcinoma/ Hepatoma
Most common primary malignant tumor of the liver in adults. Increased incidence is associated with hepatitis B and C, Wilson's Disease, alcoholic cirrhosis, and carcinogens (aflatoxin in peanuts).
195
Budd-Chiari Syndrome
Occlusion of IVC of hepatic veins with centrilobar congestion and necrosis, leading to congestive liver disease (hepatomegaly, ascites, abdominal apin, and eventual liver failure).
196
A1-Antitrypsin Deficiency
Misfolded gene product protein accumulates in hepatocellular ER. Decreased elastic tissue in lungs -> panacinar emphysema.
197
What is a cause of physiologic neonatal jaundice. How do you treat it?
At birth, imaature UDP-glucuronyl transferase-> unconjugated hyperbilirubinemia-> jaundice/kernicterus
198
What are the types of jaundice? What will you see in each case regarding types of billirubin, urine billirubin levels, and urine urobilinogen levels.
Hepatocellular Jaundice- Conjugated/ Unconjugated Hyperbilirubinemia, Increase Urine Bilirubin, and Normal to Decreased urine urobilinogin.
199
Wilson's Disease (Hepatolenticular Degeneration). Signs? Treatment? How is it passed?
Inadequate hepatic copper excretion and failure of copper to enter circulation as ceruloplasmin. Leads to copper accumulation, especially in liver, brain, cornea, kidneys, and joints..
