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MED > Internal Med > Flashcards

Internal Med Flashcards

1
Q

What is acute pancreatitis?

A

abnormal activation of digestive enzymes (precursors first) in pancreas.

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2
Q

example of precursor activated in A.Pancreatitis? and what happens?

A

trypsinogen and inflammation, edema, cell death (necrosis or apoptosis)

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3
Q

Pancreatic destructions pathogensis?

A

proteases, inflammatory response and vascular damage causes swelling. Lipases destroy fat around pancreas causing haemorrhagic necrosis

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4
Q

Etiology of A.Pancreatitis

A

gallstones, alcohol drugs, infections (mumps), inflammation of adjacent organs, trauama`

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5
Q

symptoms of A.Pancreatitis

A

pain in epigastgrium (pain in left side)
nausea and vomit
fever
sever weakness
jaundice

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6
Q

physical examination of A.Pancreatits

A

bad general condition, pale and sweaty skin, tongue white, tachycardia and HYPOtension, harsh pain in upper abdomen, liver enlarged and tender

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7
Q

Lab tests for A.Pancreatitis

A

increased WBC, CRP, sedimentation rate
increased alpha-amylase, lipase, blood sugar slightly high, glycosuria
liver enzymes and billirubin increased
creatinine measured

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8
Q

Instrumental tests for A.pancreatitis

A

abdominal ultrasound (edema and fluid in ab cavity)

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9
Q

complications of A pancreatitis

A

peritontis, sepsis, recurrent pancreatitis, renal failure

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10
Q

Chronic pancreatitis pathogenesis

A

fibrous change (pseudocysts) causing impairment of exocrine function and then endocrine

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11
Q

etiology of C pancreatitis

A

acute, alcohol drugs, autoimmune disorder, genetics, metabolic and hormonal disorder, infection of adjacent organs

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12
Q

Symptoms of C pancreatitis

A

exocrine problem = (enzymes) malabsorbtion so diarrohea, smelly stool, heavy abdomen, bloating, fatigue, weak
Endocrine problem (insulin) = diabetes mild, pain in epigastrium and if you have pseudocysts then jaundice

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13
Q

physical exam of C pancreatitis

A

pale dry skin with dec turgor, white tongue, weight loss and edema, +ve Grot, liver enlarged

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14
Q

Lab test of C pancreatitis

A

stool tests for steatorrhoea and creatorrhoea, blood sugar inc, dec protein and albumin, inc liver enzymes

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15
Q

instrumental tests of C pancreatitis

A

abdominal ultrasound (see psuedocysts), secretin stimulation test to see exocrine function

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16
Q

Complications of C pancreatitis

A

pseudocystosis, pancreatic cancer, chronic hepatitis

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17
Q

Pancreatic cancer definition

A

cells in pancreas multiple out of control and form mass

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18
Q

types of pancreatic cancers

A

95% in exocrine and endocrine are called neuroendocrine tumours. Exocrine cancers = adenocarcinoma (ducts that carry away from pancreas), acinar cell carcinoma (acini), cystadenocarcinoma

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19
Q

risk factors of pancreatic cancers

A

age, sex (more women), smoking, obesitiy, diabetes, family, C pancreatitis, diet

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20
Q

Pathogenesis of pacreatic cancers

A

precancerous lesions

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21
Q

Symptoms of pancreatic cancers

A

hard to detect early stages but pain in upper abdomen and back, jaundice and dark urine, weight loss, nausea, stenorrohea, trousseaus syndrome (blood clot in portal blood vessels), wakness, palpable mass

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22
Q

Lab test for pancreatic cancer

A

liver function test to show bile duct obstruction (inc billirubin and enzymes)
CA19-9 tumour marker increased (not specific though :()

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23
Q

Instrumental tests for pancreatic cancers

A

CT (see mass), ERCP (scope in the duct and injected dye) MRI (can see if its pancreatitis or cancer) `

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24
Q

Iron deficiency anaemia definition

A

Lack of iron or inability to be used in erythopoiesis causes decreasing in synthesis of Hb

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25
Q

etiology of iron def anaemia

A

not enough iron diet, dec absorbtion of iron (coeliac disease, diarrhoea), pregnany, blood loss, parasites

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25
Q

etiology of iron def anaemia

A

not enough iron diet, dec absorbtion of iron (coeliac disease),

26
Q

symptoms of anaemia iron

A

fatigue, tiredness, pale skin, headache, weakness, angina, palpitations, SOB, dysphagia, paresthesia

27
Q

physical examination of iron anaemia

A

pale skin, mucosa, ulcers at mouth, changes in nails, tachycardia, systolic murmur, bleeding or the main disease

28
Q

lab test for anaemia iron

A

dec HB, RBC, Ht, low mean corpuscular volume and mean corpuscular HB volume, dec iron, young RBC low, bleeding in stool and primary disease done. increase iron binding capacity as less intake of iron

29
Q

complications of iron anaemia

A

IHD, cardiac or respiratory failure, atherosclerosis

30
Q

Definition of vitamin B12 and folic acid deficiency anaemia

A

lack of it due to impared DNA replication and mitosis of hemopoietic cells as well as neuroepithelial cells

31
Q

etiology of vit b12 and folic acid anaemia

A

absolute (diet) or relative (pregnant) dec intake of vitB12
dec absorbtion of B12 = autoimmune gastritis
chronic diharroea
parasites
lack of pancreatic enzymes
drugs (metformin)

32
Q

symptoms of vit b12 and folic acid anaemia

A

same as iron and burning tongue (hunters glottis) dysphagia, ataxia, psychosis

32
Q

Lab test vit B and folic acid anaemia

A

blood shows dec HB, RBC. MCV and MCHC inc, dec WBC, slightly inc iron and bilirubin (haemolysis), dec of vit b12 and folic acid

33
Q

instrumental test for Vit B12 and folic acid anaemia

A

gastroscopy,

33
Q

instrumental test for Vit B12 and folic acid anaemia

A

gastroscopy, and smear of blood marrow to see large hemopeotics

34
Q

instrumental test for Vit B12 and folic acid anaemia

A

gastroscopy, and smear of blood marrow to see large hemopoietic cells

35
Q

instrumental test for Vit B12 and folic acid anaemia

A

gastroscopy, and smear of blood marrow to see large hemopoietic cells

36
Q

Acute leukaemia definition

A

malignant disease where cell clone from myeloid and lymphoid in bone marrow has fast reproduction and proliferates so normal hemopoeisis supressed and spreads to organs and tissues

37
Q

Classification of acute leukaemia

A

acute myeloid leukaemia and acute lymphoblast leukaemia

37
Q

etiology of acute leukaemia

A

genetic (chromosomal abnormalities), downs syndrome, infections (EBV), radioactivity

38
Q

symptoms of acute leukemia

A

fatigue and exhaustion due to treatment to anaemia and infections with a fever
bleeding in gums, pain in bones and joints, enlarged lymph nodes, loss of appetite and weight loss

39
Q

physical examination of acute leukemia

A

impaired general condition, wax like skin and mucus, leukemids (skin lesion), enlarged lymph nodes and maybe spleen (ALL) or liver and spleen (AML)

40
Q

Lab test of acute leukemia

A

blood: neutropenia, normocytic anaemia, blood smear shows blast cells showing difference enzymes and rods

41
Q

instrumental tests for acute leukemia

A

bone marrow smeal with different staining, abdominal ultrasound, CAT to see spleen and liver enlargement or lymph nodes

41
Q

instrumental tests for acute leukemia

A

bone marrow smeal with different staining, abdominal ultrasound, CAT to see spleen and liver enlargement or lymph nodes

42
Q

complications of acute leukemia

A

infections and sepsis, haemorrage, brain damage?

43
Q

Chronic myeloid leukaemia definition

A

uncontrolled proliferation of myeloid cells and cannot differentiate and suppresses other cell lines in bone marrow

44
Q

etiology of CML (chronic myeloid leukaemia)

A

radiation, toxicity, genetic abnormality (philadelphia chromosome shorter 22 and longer 9) older males are more common

45
Q

pathogenesis of CML

A

uncontrolled proliferation of myeloid cell branch to supress erythropoesis (anaemia) and then thrombocytopoesis (no clots)
spread to other organs liver and spleen and many myeloid cells now in circulation to clot

46
Q

symptoms of CML

A

fatigue and heaviness in abdomen, thrombotic incidents, fever sweating, pain in bones, weight loss, hemorrhagic diathesis

47
Q

physical exam of CML

A

leukemids, pale skin, exessive pain in liver and spleen, infarction of spleen,

48
Q

lab test of CML

A

bloodcount: inc WBC and dec RBC (anaemia) dec platelets
blood smear shows immature myeloid cells
check philedelphia (22 9)

49
Q

instrumental tests of CML

A

bone marrow smear will show more myeloid cells compared to erythroblast
abdominal ultrasound

50
Q

complications of CML

A

blast crisis –> CML turns into myeloblast leukaemia
thrombosis

51
Q

Chronic lymphoid leukaemia definition

A

unctrolled proliferation of lymphocytes and supress other parts of hemopoiesis

52
Q

Chronic lymphoid leukaemia definition

A

uncontrolled proliferation of lymphocytes and supress other parts of hemopoiesis

53
Q

classification of CLL

A

chronic B and chronic T cell leukemia

54
Q

etiology of CLL

A

EBV infection and chromosome anomalies Male more likely

55
Q

symptoms of CLL

A

anaemia, serious infection, enlargement of lymph nodes, fatigue, weight loss, bleeding from gums

56
Q

physical examination of CLL

A

pale skin and mucosa, luekmids

57
Q

lab test for CLL

A

blood count shows inc lymphocytes and dec RBC and platelets, smear shows the nuclei of the immature lymphocytes
specific genetic tests

58
Q

instrumental tests of CLL

A

bone marrow spear, biopsy of lymph node, abdominal ultrasound and CAT to see enlarged spleen and lymph nodes

59
Q

complications of CLL

A

severe infection and sepsis, lymphosarcoma (lymph nodes degenerate malignantly)

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