Hepatic/biliary/urogenic

Question 1

definition: white bands found on the hands when a hepatic/urogenic disease may be present

Answer 1

leukonychia

Question 2

What does stool look like when there is a hepatic/urogenic disorder?

Answer 2

light, white

Question 3

What does urine look like when a patient has rhabdomyolysis?

Answer 3

dark brown and decreased output

Question 4

What is the referred pain pattern of the liver?

Answer 4

Tspine
R shoulder
R upper trap

Question 5

definition: Tremor of the wrist when the wrist is extended; sometimes said to resemble a bird flapping its wings

Answer 5

asterixis

(“flapping tremor” or “liver flap”)

Question 6

definition: Abnormal accumulation of fluid in peritoneal cavity

Answer 6

ascites

Question 7

How does a person get hepatitis A and E?

Answer 7

Transmitted primarily by fecal-oral route
–> Contaminated water/food

Question 8

How does a person get hepatitis B, C, D, and G?

Answer 8

Transmitted primarily by blood borne pathogens
–> Blood/body fluids from an infected person

Question 9

What are the stages of viral hepatitis?

Answer 9

Initial/preicteric (1-3 weeks)
Icteric (2-4 weeks)
Recovery (3-4 months)

Question 10

What is seen in the initial/preicteric stage of viral hepatitis?

Answer 10

vague GI/body s/s (weeks 1-3)

Question 11

What is seen in the icteric stage of viral hepatitis?

Answer 11

Jaundice (weeks 2-4)

Question 12

What is seen in the recovery stage of viral hepatitis?

Answer 12

fatigue (3-4 months)

Question 13

s/s:
- Blood and body fluids (including sexual intercourse through mucus membranes)
- malaise
- RUQ tenderness
- Jaundice
- Dark urine
- Fever

Answer 13

hepatitis B

Question 14

What population is hepatitis B commonly found in?

Answer 14

20-45 y/o (but can be present at any age)

Question 15

What is the prognosis of hepatitis B?

Answer 15

> 90% recover

Question 16

(true/false) Some with hepatitis B may have a chronic condition

Answer 16

true

Question 17

What is the treatment for hepatitis B?

Answer 17

no Tx

Question 18

What is hepatitis C primarily caused by?

Answer 18

Drug abuse

Question 19

What are risk factors for hepatitis C?

Answer 19

• Organ transplant (includes ligament recon)
• Blood transfusion
• Tattoos
• Unprotected sex
• Long-term kidney dialysis

Question 20

What is the treatment for hepatitis C?

Answer 20

No cure, but medications in some cases can suppress the virus for a long period of time

Question 21

definition: Chronic hepatic disease ~ destruction of liver cells; replaced by fibrous bands

Answer 21

cirrhosis

Question 22

What are the results of cirrhosis?

Answer 22

• Scarring impairs blood/lymph flow
• Decreased liver function

Question 23

What is the most common cause of cirrhosis?

Answer 23

alcohol abuse

Question 24

definition: Fatty inflammation of the liver

Answer 24

Nonalcoholic fatty liver disease (NAFLD)

Question 25

What conditions are nonalcoholic fatty liver disease commonly associated with?

Answer 25

diabetes and obesity

Question 26

(true/false) Liver cancer is primarily METs

Answer 26

true Why? since it filters blood from the GI tract

Question 27

Liver cancer is known as a site of metastasis from what other organs?

Answer 27

esophagus, lung, breast

Question 28

What are the s/s of liver cancer?

Answer 28

- jaundice - overall muscular weakness - mid-back/epigastric pain

Question 29

definition: ~ the yellow breakdown product of normal “heme” (iron) catabolism from hemaglobin; excreted in bile, and its levels are elevated in certain diseases

Answer 29

bilirubin

Question 30

What is a prefix for gallbladder issues?

Answer 30

Chol/chole

Question 31

What is the 5th leading cause of hospitalization?

Answer 31

gallstones/cholelithiasis

Question 32

What is cholelithiasis?

Answer 32

gallstones

Question 33

What is the cause of cholelithiasis/gallstones?

Answer 33

changes in bile

Question 34

What are the types of gallstones?

Answer 34

1. cholestrol stones (most common) 2. Pigment stones

Question 35

When do s/s of cholelithiasis/gallstones occur?

Answer 35

if gallstones leave the gallbladder & cause obstruction elsewhere --> Biliary colic, Cholecystitis, or Cholangitis

Question 36

What are risk factors with cholelithiasis?

Answer 36

- Increases w/ age - Women > men (under 60 yo) - increased estrogen, family hx of gallstones - Obesity, diabetes, high cholesterol diet

Question 37

What is biliary colic?

Answer 37

pain in the neck of the gallbladder (cystic duct)

Question 38

Where is cholecystitis found?

Answer 38

cystic duct

Question 39

Where is cholangitis found?

Answer 39

common bile duct

Question 40

definition: Blockage or impaction of gallstones in the cystic duct

Answer 40

cholecystitis

Question 41

What are the s/s of cholecystitis?

Answer 41

- N/V within 1-3 hours after eating - fever

Question 42

Where is pain referral of cholecystitis?

Answer 42

- 10th-12th R rib (anterior) [acute] - R shoulder/ mid scap - RUQ & Epigastrium (more right sided)

Question 43

(true/false) Gallbladder cancer is not associated with gallstones

Answer 43

FALSE

Question 44

What are the risk factors for gallbladder cancer?

Answer 44

- Gallstones - Obesity - Reproductive abnormalities - Chronic gallbladder infections

Question 45

What causes red urine color?

Answer 45

- blood - medications - ingestion of dyes

Question 46

What are the causes of brown/dark urine?

Answer 46

- hepatic/biliary obstructive disease - acute exertional rhabdomyolysis

Question 47

(true/false) decreased urine output is can be seen with DM

Answer 47

FALSE (increased output)

Question 48

What is urethral discharge in men commonly associated with?

Answer 48

infection such as UTIs and STDs

Question 49

What are causes of Erectile dysfunction?

Answer 49

- Neuro conditions (SCI, HNP) - Post-surgical (radical prostate, bladder, colon) - DM - Medication (side effects) - Psychogenic disorders

Question 50

When is a menstrual cycle considered as abnormal?

Answer 50

Abnormal if < 21 days or >36 days since last period

Question 51

definition: painful menstruation; may be abnormal

Answer 51

dysmenorrhea

Question 52

Blood flow during a period > ___ days is considered as abnormal

Answer 52

> 7 days

Question 53

What can cause obstruction in the upper urinary tract?

Answer 53

kidney, ureter tumor, stone

Question 54

Upper urinary tract infections is most commonly from a ___ problem.

Answer 54

renal

Question 55

Lower urinary tract infections is most commonly from a ___ problem.

Answer 55

bladder, urethra, prostate

Question 56

What are s/s of Upper urinary tract inflammation/infection?

Answer 56

- Unilateral costovertebral tenderness, flank pain - Ipsilateral shoulder pain - Constitutional sxs (fever/chills) - Nocturia; hematuria; pyuria (pus)

Question 57

definition: infection of the kidney

Answer 57

pylonephritis

Question 58

What are possible causes of pyelonephritis?

Answer 58

From infection of the ascending urinary tract - Blood-borne pathogens - Obstruction (benign prostatic hyperplasia or kidney stones)

Question 59

definition: bladder infection/inflammation

Answer 59

cystitis

Question 60

definition: urethra infection/inflammation

Answer 60

urethritis

Question 61

What is the common cause of urethritis?

Answer 61

gonorrhea

Question 62

s/s: - increased frequency, urgency w/ dysuria, nocturia - hematuria; pyuria (pus), bacteriuria - LBP, pelvic pain, lower abdominal pain

Answer 62

cystitis

Question 63

s/s - Acute, spasmodic, radiating pain OR mild, dull flank pain OR low back pain - Hyperesthesias (T10-L1 dermatomes) - Constitutional sxs (fever/chills/nausea/vomiting) - Urge to frequently urinate; hematuria; abd mm spasm

Answer 63

upper urinary tract obstruction

Question 64

definition: Hard masses of salts that precipitate from urine when it becomes supersaturated w/ a particular substances (aka Kidney Stones)

Answer 64

nephrolithesis

Question 65

What are the s/s of pyelonephritis and nephrolithesis?

Answer 65

chills/fever, N/V

Question 66

What is the most common population that presents with nephrolithesis?

Answer 66

White males

Question 67

What is the reoccurrence rate of nephrolithesis?

Answer 67

50%

Question 68

What are common conditions caused by lower urinary tract obstruction?

Answer 68

- bladder cancer - enlargement of the prostate

Question 69

What is the second leading cause of male death in the USA?

Answer 69

prostate cancer

Question 70

What population is BPH commonly found in?

Answer 70

men > 50 y/o

Question 71

BPH commonly affects what mechanism?

Answer 71

urination

Question 72

Prostatitis is commonly associated with what syndrome?

Answer 72

pelvic pain syndrome

Question 73

Prostatitis affects 10% of adult males __-__ y/o

Answer 73

40-70 y/o

Question 74

What are common conditions of upper urinary tract obstructions?

Answer 74

- kidney stone - urethral stone

Question 75

What are common conditions of upper urinary tract inflammation/infection?

Answer 75

Pyelonephritis, glomerulonephritis (acute/chronic)

Question 76

overactive bladder is an involuntary contraction of the _____ muscle

Answer 76

detrusor muscle

Question 77

definition: Incontinence that is a combination of stress and urge incontinence.

Answer 77

mixed

Question 78

definition: overdistention of the bladder; bladder cannot empty completely

Answer 78

overflow incontinence

Question 79

Who commonly has renal cancer?

Answer 79

Males who smoke, are obese, have HTN, and/or have a PMH of CA

Question 80

Who commonly has bladder cancer?

Answer 80

White men > 40 y/o who use tobacco and/or have chemical exposure