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Pathophysiology > Liver and GI > Flashcards

Flashcards in Liver and GI Deck (15):
1

Phototherapy in a newborn:

Converts bilirubin to the water soluble form

2

Your patient has pancreatitis with obstruction of the common bile duct. As a result you would expect to see:

Increased serum amylase
Increased serum lipase
Jaundice
Increased conjugated bilirubin

3

What is true about Hep C?

Hep C is a high risk for need contamination in medical personnel

4

Gastric ulcers are associated with:

Chemotherapy
Aspirin
Chronic alcohol consumption
H. pylori

5

Third spacing is seen with

Nephritic syndrome
Uremia
Cirrhosis
Ascites

6

Your patient has a pancreatic tumor with obstruction of the common bile duct. As a result, you would expect to see:

Clay colored stools, dark urine

7

Development of a peptic ulcer may be associated with:

H. pylori

8

Your patient has developed cirrhosis. Give three possible causes for this happening.

Cause 1: Alcohol
Mechanism:
Alcoholmetabolized in liverforms acetylaldehydedamages hepatocytesnecrosis and inflammation and fibrosisscar liverloss of functioncirrhosis

Cause 2: Hep B and C
Mechanism:
Hep B/Cinfection and liver necrosisnecrotic tissuereplaced with cirrhosis tissuescarringcirrhosis

Cause 3: gallstones
Mechanism:
Gallstonesinflammation of bile ductscarring proximal to obstructionloss of functioncirrhosis

9

Three manifestations of cirrhosis

Manifestation 1: dec LOC
Mechanism:
Cirrhosisliver inflammation and necrosisliver failuredec ammonia converted to ureano excretioninc NH3 in bloodcrosses BBBdec LOC

Manifestation 2: edema
Mechanism:
Cirrhosisliver inflammationnecrosisdec hormone metabolisminc ADH and aldosteroneNa and H20 retentioninc volumeinc ISFedema

Manifestation 3: bleeding/anemia
Mechanism:
Cirrhosisinflam of livernecrosisdec liver functiondec vitamin K absorbeddec clottingbleeding (anemia)

10

Your patient is in liver failure. Give three manifestations of liver failure.

Manifestation 1: dec LOC
Mechanism:
Liver failureimpaired glucose synthesis and metabolismhypoglycemiadec glucose to braindec LOC

Manifestation 2: bleeding/anemia
Mechanism:
Liver failureimpaired protein metabolismdec synthesis of clotting factorsdec clottingbleeding (anemia)

Manifestation 3: edema/third spacing
Mechanism:
Liver failuredec metabolized steroid hormonesinc aldosteroneNa and H2O retentioninc ISF volumeinc Pcedema and third spacing

11

Your patient has developed portal HTN. Give one possible cause for this and the mechanism.

Cause 1: Cirrhosis/liver failure
Mechanism:
Cirrhosis/liver failurescarring in liverobstructiondec blood to liverbackflow to portal veininc volume in portal veinportal HTN

12

Four manifestations of portal HTN

Manifestation 1: dec LOC
Mechanism:
Portal HTNblood can’t enter liverdec liver functionammonia isn’t converted to ureainc ammonia in bloodinc NH3 blood shunted into circulationcrosses BBBdec LOC

Manifestation 2: anemia/bleeding
Mechanism:
Portal HTNdec blood to liverblood backs up to spleensplenomegalycells tied up and sequestered in spleendec circulating RBCs, leukopenia, thrombocytopeniadec clottingbleeding/anemia

Manifestation 3: ascites/third spacing
Mechanism:
Portal HTNdec blood to liverinc pressure in peritoneal capillaryinc Pcfluid pushed from capillary to interstitumfluid accumulates in bellyascites/third spacing

Manifestation 4: hemorrhoids/esophageal varices
Mechanism:
Portal HTNdec blood to livershunted blood backs upinc pressure in rectal veins, inc pressure in esophageal veinshemorrhoids, esophageal varices

13

Mechanism for developing renal failure

Portal HTNdec blood to liverblood backs up to spleensplenomegalycells tied up in spleenthrombocytopeniadec CF, dec plateletsbleedinghypovolemiadec blood flow to kidneyrenal failure

14

Two possible treatments for renal failure

Treatment 1: shunt
Mechanism:
Shunt placedshunts excess portal bloodblood into venous circulationdec portal volumedec portal HTNportal HTN treated

Treatment 2: supply lost
Mechanism:
Supply lost bloodreplace CF, blood, and vitamin K lostdec blood loss and inc clottingdec bleedingdec blood lossportal HTN treated

15

Your patient has developed edema and is anemia. Give one possible GI cause for developing both of these. Your patient also has a dec LOC, give a different GI pathology to develop this and the mechanism.

Cause: Malabsorption
Mechanism for edema/third spacing:
Malabsorptiondec amino acid absorbedprotein depletiondec PiCdec fluid pulled into capillaryaccumulation in interstitumedema/third spacing

Cause: Malabsorption
Mechanism for anemia/bleeding:
Malabsorptiondec vitamin K absorbeddec clottingbleeding(dec RBC circulatinganemia)

Cause: Intestinal Obstruction
Mechanism for decreased LOC:
Intestinal Obstructioninc intralumin pressuredec Na and H20 in blood from interstitumdec vascular volumedec BP, dec tissue perfusionhypovolemiadec O2 blood to braindeprived RASdec LOC