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Pathophysiology > Test 4-Renal & Urological > Flashcards

Test 4-Renal & Urological Flashcards

1
Q

Decreased perfusion of the kidneys activates what system?

A

RAAS

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2
Q

The RAAS system increases what?

A

Sodium and water retention (can lead to hypertension)

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3
Q

Kidneys produce _____ to increase red blood cells

A

Erythropoietin

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4
Q

Kidneys synthesize ______ which helps absorb _______

A

Vitamin D; Calcium

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5
Q

Failing kidneys does what to RBCs

A

lowers them

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6
Q

What happens to calcium levels in the blood in kidney failure?

A

Hypocalcemia

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7
Q

A problem before the kidneys

A

Prerenal dysfunction

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8
Q

A problem after the kidneys

A

Postrenal dysfunction

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9
Q

Results from an injury to the kidney itself

A

Intrarenal dysfunction

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10
Q

What causes intrarenal dysfunction?

A

Nephrotoxic drugs, streptococcal infections, and systemic diseases

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11
Q

What causes prerenal failure?

A

Heart failure, trauma, and shock

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12
Q

Prerenal failure occurs when?

A

Blood flow and perfusion to the kidneys is reduced

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13
Q

Postrenal failure occurs when?

A

An obstruction prevents outflow from the kidneys

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14
Q

What is the classic back pain sign from the kidneys called?

A

Costovertebral angle pain

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15
Q

Blood in the urine

A

Hematuria

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16
Q

Proteins in the urine

A

Proteinuria

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17
Q

Measures urine concentration

A

Specific Gravity

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18
Q

Glucose in the urine most commonly results from what?

A

Hyperglycemia (can indicate diabetes)

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19
Q

What can be seen in urine after intense exercise?

A

Proteins

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20
Q

What in the urine may indicate damage to structures of the renal system?

A

Blood

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21
Q

What in the urine may indicate liver damage?

A

Bilirubin and Urobilinogen

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22
Q

What in the urine may indicate an infection of the renal system?

A

Nitrates and leukocyte esterase

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23
Q

What are 2 waste products that should be filtered and removed by the kidneys?

A

Blood Urea Nitrogen (BUN) and Creatinine

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24
Q

Increased _____________ may indicate reduced glomerular filtration rate (GFR)

A

serum creatinine

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25
Q

An increase in BUN levels

A

Azotemia

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26
Q

What are two forms of kidney dialysis?

A
  1. Peritoneal dialysis

2. Hemodialysis

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27
Q

What is the most common urological problem?

A

Obstruction

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28
Q

Distention of the renal pelvis

A

Hydronephrosis

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29
Q

Dilation of the ureter

A

Hydroureter

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30
Q

Stones located anywhere in the urinary tract

A

Urolithiasis

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31
Q

Stones can be categorized based off of what?

A

Their location

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32
Q

What is the most common cause of UTIs?

A

E. coli

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33
Q

Asymptomatic bacteriuria is diagnosed when?

A

2 consecutive urine cultures grow a colony count exceeding 100,000 bacteria

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34
Q

Bladder walls shows small tears and hemorrhages when the bladder is distended

A

Non-ulcerative interstitial cystitis

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35
Q

A lesion called a Hunner ulcer is present on histological exam of the bladder wall

A

Ulcerative interstitial cystitis

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36
Q

What interstitial cystitis (IC) is relieved with attempts to empty the bladder?

A

Ulcerative IC

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37
Q

What is the most common form of bladder cancer?

A

Transitional cell carcinoma

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38
Q

Doctor who cares for the kidneys

A

Nephrologist

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39
Q

Doctor who cares for the whole renal/urological system

A

Urologist

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40
Q

What is excessive in parathyroid conditions?

A

Calcium

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41
Q

Kidneys are a major player in _____ excretion

A

Potassium

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42
Q

Kidneys maintain what balance?

A

Acid-Base (Bicarbonate: Metabolic Buffer)

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43
Q

Kidneys make sure there is not too much or too little what in the body?

A

Water

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44
Q

What percentage of the body’s blood is filtered through the kidneys?

A

20%

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45
Q

Kidneys require ______ pressure to function

A

Hydrostatic

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46
Q

Blood begins process of filtration pushed through hydrostatic pressure through what part of the Nephron?

A

Bowman’s Capsule

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47
Q

The amount of blood filtered the glomerulus per minute

A

Glomerular filtration rate (GFR)

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48
Q

At what age does the GFR decrease?

A

30 years old

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49
Q

What part of the Nephron does more water absorption than electrolytes take place?

A

Proximal tubule

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50
Q

What part of the Nephron does more electrolyte absorption than water take place?

A

Distal tubule

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51
Q

What part of the Nephron is where most water and salt is reabsorbed and urea is excreted?

A

Loop of Henle

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52
Q

The breakdown product of muscle excreted by the kidneys

A

Creatinine

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53
Q

Increased creatinine indicates what?

A

Kidneys are not functioning properly

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54
Q

What creatinine test is the more common lab test?

A

Serum

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55
Q

A ________ GFR indicates decreased renal function

A

Decreased

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56
Q

________ levels of BUN indicate decreased renal function

A

Increased

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57
Q

Urea is what kind of waste?

A

Nitrogenous

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58
Q

What are the risk factors for kidney stones?

A
  • Dehydration
  • Hypercalcemia
  • Hyperparathyroidism
  • Gout
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59
Q

What kind of diet should people with recurrent kidney stones avoid?

A

Purine diet (Meats)

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60
Q

The formational of stone (calculi) in the kidney.

A

Nephrolithiasis

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61
Q

Nephrotic Syndrome is caused by:

A
  • HTN
  • Glomerulonephritis
  • Diabetes
  • Autoimmune
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62
Q

What is the pathology of Nephrotic Syndrome?

A

Endothelial cell and basement membrane damage leads to loss of protein (albumin) leads to edema because of decreased oncotic pressure

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63
Q

Infection of the kidney

A

Nephritis

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64
Q

Clinical presentation of Nephrotic Syndrome

A
  • Albuminera
  • Low blood albumin levels
  • Edema
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65
Q

60% of Acute Kidney Injuries (AKI) are _____ disorders

A

Prerenal

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66
Q

What are the first organs to sense a drop in blood pressure?

A

Kidneys

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67
Q

What are the four phases of AKI?

A
  1. Initial insult (condition disrupts kidney function)
  2. Oliguria (low GFR, low urine output, fluid overload)
  3. Diuresis (large unconcentrated urine outflow)
  4. Recovery (healthy nephrons take over function of damaged nephrons)
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68
Q

What is the patho of AKI?

A

Decreased GFR of the blood leads to azotemia, high serum creatinine, and fluid retention

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69
Q

The higher the category of CKD in GFR indicates what?

A

The higher level of disease

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70
Q

What neurological condition is caused from Chronic Renal Failure?

A

Encephalopathy (Causes confusion, stupor, and coma)

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71
Q

What conditions in the blood result because of CRF?

A

Anemia and Thrombocytopenia

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72
Q

What electrolyte and mineral imbalances happen because of CRF?

A

Potassium, Calcium, and Vitamin D

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73
Q

Where is peritoneal dialysis inserted?

A

Through the abdomen

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74
Q

What is hemodialysis given through?

A
  • a central line

- arteriovenous fistula (vibrates)

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75
Q

What in males can cause an urological obstruction?

A

Benign prostatic hypertrophy (BPH)

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76
Q

Obstruction of the kidneys can lead to:

A

Hydronephrosis and hydroureter

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77
Q

Symptoms of nephritis:

A

Fever, chills, pain, CVA tenderness, frequency, dysuria

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78
Q

Infection of the bladder

A

Cystitis

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79
Q

How does cystitis occur?

A

When bacteria enters the bladder

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80
Q

What symptoms present in elderly with a UTI?

A
  • confusion
  • disorientation
  • hyptotension
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81
Q

UTIs in elderly can lead to what?

A

Urosepsis (caused by bacterial endotoxins)

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82
Q

Inflammation of the bladder not associated with a known bacteria

A

Interstitial cystitis

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83
Q

What does micturate mean?

A

To urinate

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84
Q

When the endocrine system is in dysfunction what is the body suffering from?

A

Hormone deficiency
Hormone excess
Hormone resistance

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85
Q

What are the three keys to understanding the disorders of the endocrine system?

A
  1. normal functioning
  2. hypofunction vs hyperfunction
  3. location of the dysfunction
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86
Q

The regulatory link that keeps the body’s hormones in balance

A

negative feedback system

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87
Q

The hypothalamus secretes what?

A

Corticotropin-Releasing Factor (CRF)

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88
Q

CRF stimulates what?

A

The pituitary gland

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89
Q

Pituitary gland secretes what?

A

Adrenocorticotropic Hormone (ACTH)

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90
Q

ACTH stimulates what?

A

The adrenal gland

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91
Q

The adrenal gland secretes what?

A

Cortisol

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92
Q

What gland senses increased levels of cortisol?

A

The pituitary gland

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93
Q

When the negative feedback system fails, what does it result in?

A

Dysregulation of hormones

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94
Q

When the endocrine gland secretes an inadequate amount of hormone

A

Hypofunction

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95
Q

When the endocrine gland secretes an excessive amount of hormone

A

Hyperfunction

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96
Q

The endocrine gland itself causes the dysfunction is what type of endocrine disorder?

A

Primary

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97
Q

The pituitary gland causes the dysfunction is what kind of endocrine disorder?

A

Secondary

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98
Q

The hypothalamus is the root of dysfunction in an endocrine disorder

A

Tertiary

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99
Q

The pituitary is comprised of how many sections?

A
  1. Anterior pituitary

2. Posterior pituitary

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100
Q

What tropic hormones does the anterior pituitary gland release?

A

FSH, LH, Adrenocorticotropic hormone, TSH, Prolactin, Growth Hormone

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101
Q

What hormones are released by the posterior pituitary gland?

A

ADH and oxytocin

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102
Q

ADH and oxytocin are created where?

A

Hypothalamus

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103
Q

Disorders of ADH result from

A

fluctuating water and ADH levels

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104
Q

Occurs from a lack of secretion of ADH from the posterior pituitary

A

Central diabetes insipidus

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105
Q

What is SIADH?

A

Syndrome of Inappropriate ADH

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106
Q

Overproduction of ADH

A

SIADH

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107
Q

What glands regulate the body’s metabolism?

A

Thyroid glands

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108
Q

Insufficient levels of T3 and T4

A

Hypothyroidism

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109
Q

Symptoms of hypothyroidism

A
  • weight gain
  • fatigue
  • feelings of being cold
  • decreased heart rate
  • confusion
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110
Q

The most common cause of hypothyroidism

A

Hashimoto’s Thyroiditis

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111
Q

Excessive amounts of T3 and T4

A

Hyperthyroidism

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112
Q

Symptoms of hyperthyroidism

A
  • Weight loss
  • Tremors
  • Increased HR
  • Feelings of being warm
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113
Q

The most common cause of thyroid hyperfunction

A

Grave’s disease

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114
Q

Four small glands located posterior to the thyroid gland

A

Parathyroid

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115
Q

________ hormone regulates calcium levels

A

Parathyroid Hormone (PTH)

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116
Q

Parathyroid hormone lowers _______ levels

A

Phosphate

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117
Q

Parathyroid dysfunctions come in which 2 forms?

A
  1. Primary (problem with PTH itself)

2. Secondary (due to problems w/calcium levels)

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118
Q

How does primary hypoparathyroidism occur?

A

Due to the destruction or removal of the PTH glands

119
Q

Lack of PTH results in what 2 conditions?

A

Hypocalcemia and Hyperphosphatemia

120
Q

How does secondary hypoparathyroidism occur?

A

From any disorder that causes hypercalcemia

121
Q

What is the main cause of primary hyperparathyroidism?

A

Tumors of the parathyroid gland

122
Q

What typically causes secondary hyperparathyroidism?

A

Kidney failure (lowers calcium levels)

123
Q

What is the work horse of the body?

A

The adrenal gland

124
Q

How many parts does the adrenal gland consist of?

A

The cortex and the medulla

125
Q

What does the adrenal cortex produce?

A
  • Mineralcorticoids (aldosterone)
  • Glucocorticoids (cortisol)
  • Androgens
126
Q

What is the adrenal cortex stimulated by?

A
  • CRH from the hypothalamus

- ACTH from the anterior pituitary

127
Q

What does the adrenal medulla produce?

A
  • Epinephrine

- Norepinephrine

128
Q

Why does the adrenal medulla release epinephrine and norepinephrine?

A

In response to SNS activation

129
Q

What is the condition characterized by a lack of hormones from the adrenal cortex?

A

Addison’s Disease

130
Q

Decreased cortisol causes what?

A

Hypoglycemia

131
Q

Decreased aldosterone has what effect on sodium and potassium?

A

Decreased sodium; increases potassium

132
Q

Reduced androgens may suppress what in women?

A

Libido

133
Q

Due to a pituitary disorder in which not enough ACTH is produced

A

Secondary adrenal insufficiency

134
Q

An excess of adrenal cortex hormones results in what condition?

A

Cushing’s disease

135
Q

A tumor of the pituitary gland produces elevated

A

ACTH

136
Q

What does elevated ACTH do to blood glucose

A

Increases it (decreases wound healing)

137
Q

What condition is characterized by a moon face and buffalo hump?

A

Cushing’s disease

138
Q

A hyperactive adrenal gland disorder characterized by high cortisol; ACTH is low

A

Cushing’s syndrome

139
Q

Prolonged used of ___________ can result in Cushing’s syndrome

A

Corticosteroids

140
Q

A disorder of the adrenal medulla (hallmark of adrenal excess)—increases epinephrine and norepinephrine

A

Pheochromocytoma

141
Q

Disease of glucose regulation

A

Diabetes

142
Q

Elevated glucose in the blood

A

Hyperglycemia

143
Q

Which cells of the pancreas release insulin?

A

Beta cells

144
Q

What helps move glucose from the blood and into body cells?

A

Insulin

145
Q

Low glucose in the blood

A

Hypoglycemia

146
Q

Stimulates the liver to release glucose in the blood

A

Glucagon

147
Q

Which diabetes is characterized by the lack of insulin?

A

Type 1 Diabetes

148
Q

Pancreas can produce insulin, but the cells have become resistant to accept it

A

Type 2 Diabetes

149
Q

Risk factors for type 2 diabetes

A
  • obesity

- lack of activity

150
Q

Three common tests to test for diabetes include:

A
  1. Fasting blood glucose level
  2. Oral glucose tolerance test
  3. Glycated hemoglobin test (A1c test)
151
Q

How many months does the A1c monitor?

A

the preceding 3 months

152
Q

Which diabetes always needs insulin?

A

Type 1 diabetes

153
Q

What are the three lifestyle modifications when treating diabetes?

A
  1. Diet (50% carbs; 30% fats; 20% proteins)
  2. Exercise
  3. Health Maintenance
154
Q

Which organ produces glucose?

A

Liver

155
Q

Which organ absorbs insulin?

A

Small intestine

156
Q

Which organ releases insulin?

A

Pancreas

157
Q

Which medicines help the pancreas produce insulin?

A

Sulfonylureas and Meglitinides

158
Q

What two things do biguanides and thiazolidinediones do?

A
  1. prevents the liver from producing more glucose for the blood
  2. help cells become more sensitive to insulin
159
Q

What are the two categories of insulin?

A
  1. Conventional

2. Insulin analogues

160
Q

What is insulin classified off of?

A

Onset of action

Rapid acting, Intermediate acting, Long-acting

161
Q

High blood glucose levels damage what cells?

A

Endothelial

162
Q

The three classic symptoms of diabetes

A

Polyuria, Polydipsia, Polyphagia

163
Q

What is the endocrine system consisted of?

A
  • Glands
  • Specialized cell clusters
  • Hormones
164
Q

What is the role of the endocrine system?

A
  • Regulates the body’s metabolic activities

- Maintains homeostasis

165
Q

What are the three processes of endocrine dysfunction?

A
  • hormone deficiency
  • hormone excess
  • hormone resistance
166
Q

What are the causes of endocrine dysfunction?

A
  • autoimmunity
  • chemical mediator dysfunction
  • tumor
  • trauma/ischemia
  • removal
167
Q

A disorder characterized by the body making too little ADH from the posterior pituitary or lack of response from the kidneys to ADH

A

Diabetes Insipidus

168
Q

What does Diabetes Insipidus cause?

A

The body to lose too much water, leads to dehydration, frequent urination and thirst. Can cause confusion.

169
Q

What is the effect of SIADH?

A

The body holds on to water which leads to fluid volume overload, hyponatremia, weakness, confusion, and H/A

170
Q

What is another name from Acromegaly?

A

Gigantism

171
Q

What are some symptoms of acromegaly?

A
  • Large jaws and facial bones

- Large hands, feet, and long bones

172
Q

An autoimmune destruction of the thyroid, a congenital condition called cretinism, lack of iodine, or lack of stimulation due to lack of TSH from the anterior pituitary are causes of what condition?

A

Hashimoto’s Thyroiditis

173
Q

An autoimmune stimulation of the thyroid, thyroiditis, tumors of the thyroid, too much iodine intake, excessive stimulation of TSH from the anterior pituitary are all causes of what condition?

A

Grave’s Disease

174
Q

What condition causes lethargy, hypotension, N&V, anorexia, hypoglycemia, aldosterone imbalance leading to hyponatremia, hyperkalemia, darkening of the skin and mucous membranes, personality change and emotional lability?

A

Addison’s Disease

175
Q

Which condition can cause weight gain in the central area of the body, facial edema, stretch marks, hirsutism, fat on the cervico-thoracic region?

A

Cushing’s Disease/Syndrome

176
Q

Diabetes is a disorder of _________ metabolism.

A

Carbohydrate

177
Q

High blood glucose damages what cells?

A

Endothelial

178
Q

High blood glucose promotes an environment that prevents healthy cell healing and promotes _______ growth.

A

Pathogen

179
Q

What will be in a person’s urine with diabetes?

A

Sugar or Ketones (Glycosuria/Ketonuria)

180
Q

What are the normal capillary blood sugars?

A

70-100 mg/dL

181
Q

What is the normal Hgb A1C levels for a person without diabetes?

A

<5.7

182
Q

In a patient with diabetes, what does the ADA recommend for their A1C levels?

A

<6.5

183
Q

Why is C-Peptide looked at in Diabetes?

A

Because when insulin is secreted, so is C-Peptide. Low or absent C-Peptide levels indicate type 1 diabetes

184
Q

How many months does the A1C look at?

A

Previous 3 months (due to the hemoglobin turnover rate)

185
Q

Why are minimal ketones present in Type 2 Diabetes?

A

Because insulin is present, so fat is not broken done

186
Q

Why are ketones present in Type 1 Diabetes?

A

Cells think they are starving so the body compensates by breaking down fat which results into fatty acids that are converted to ketones

187
Q

Which type of diabetes leads to a state of metabolic acidosis?

A

Type 1

188
Q

A symptom of DKA that involves hyperventilation as the body attempts to compensate for metabolic acidosis through the respiratory system by blowing off CO2

A

Kussmaul’s respiration

189
Q

Which diabetes is characterized by ketone breath/body odor?

A

Diabetic Ketoacidosis (Type 1)

190
Q

What are symptoms of hypoglycemia?

A
  • Shaking
  • Sweating
  • Anxious
  • Dizziness
  • Hunger
  • Tachycardia
  • Impaired Vision
  • Weakness/Fatigue
  • Headache
  • Irritable
191
Q

What is the 15 x 15 rule in acute hypoglycemia?

A

Treat with 15 gm of carbs and recheck the blood sugars in 15 minutes

192
Q

What are the long term complications of diabetes?

A
  • Cerebrovascular disease
  • Retinopathy
  • Heart disease
  • Nephropathy
  • Autonomic neuropathy
  • Poor WBC function
  • PAD
  • Peripheral neuropathy
193
Q

The disorders of the upper GI tract affect what?

A
  • esophagus
  • stomach
  • small intestine
194
Q

What are some self-induced causes of upper GI disorders?

A
  • smoking
  • alcohol abuse
  • frequent use of NSAIDs
195
Q

Difficulty swallowing; what causes it?

A

Dysphagia (normally result of neuromuscular dysfunction)

196
Q

stomach acid that flows backwards, enters the esophagus, and causes pain/discomfort; what causes it?

A

GERD (happens when the LES does not close properly)

197
Q

Inflammation of the esophagus; what causes it?

A

Esophagitis (can arise from acid reflux, candida albicans infection, or ingestion of chemicals)

198
Q

Upper GI bleeding (UGIB) can lead to what?

A
  • Hematemesis: blood in vomit

- Melena: blood in stool

199
Q

What is a condition in the esophagus that is typically a result of hepatic portal hypertension?

A

Esophageal varices

200
Q

A portion of the stomach that pushes upward through the opening in the diaphragm which disrupts the closure of the LES

A

hiatal hernia

201
Q

A condition in the pyloric valve that prevents the stomach from emptying normally

A

Pyloric Stenosis

202
Q

An inflammatory erosion of the stomach or duodenal lining

A

Peptic Ulcer Disease (PUD)

203
Q

What are some causes of PUD (peptic ulcer disease)?

A
  • H. Pylori Infection
  • NSAIDs
  • stress
  • caffeine
  • smoking
204
Q

What is a symptom of PUD?

A

Pain between meals that is alleviated with eating

205
Q

The rapid emptying of gastric contents

A

Dumping syndrome

206
Q

How many forms can gastritis occur?

A

2

  1. Acute- usually caused from medications (NSAIDs)
  2. Chronic- H. Pylori most common cause
207
Q

Infections of the small intestine, stomach, and large intestine lead to what?

A

Gastroenteritis

208
Q

What causes gastroenteritis?

A
  • Norovirus
  • E-Coli (157)
  • Salmonella
  • Shigella
  • C-Diff
209
Q

What is the most common symptom of gastroenteritis?

A

Diarrhea

210
Q

An autoimmune response to a gluten-derived peptide that causes inflammation in the intestinal villi?

A

Celiac disease

211
Q

How can celiac disease be confirmed?

A

Through antibody testing and an intestinal biopsy

212
Q

Inflammation of the peritoneal membrane

A

Peritonitis

213
Q

What is the cause of peritonitis?

A

Caused by bacterial infection or leakage of intestinal contents

214
Q

What are the triad of symptoms of peritonitis?

A
  • abdominal pain
  • rigidity
  • rebound tenderness
215
Q

Affects the entire GI tract and the whole thickness of the GI wall

A

Crohn’s Disease

216
Q

Which disease has skip lesions and cobblestoning?

A

Crohn’s Disease

217
Q

Affects only the large intestine, begins in the rectum and extends upwards

A

Ulcerative Colitis

218
Q

What layers of the intestinal wall are effected in Crohn’s disease?

A

Upper layers only

219
Q

Formation of an anal fistula and anal fissure are common in what disease?

A

Crohn’s disease

220
Q

Pseudopolyps are common in what disease?

A

Ulcerative colitis

221
Q

Inflammation of the appendix resulting from blockage of the appendix and bacterial growth

A

Appendicitis

222
Q

What is the pH of the stomach?

A

1.5-2

223
Q

Small outpouchings of the weakened intestinal wall that become inflammed

A

Diverticulitis

224
Q

What are the three alterations in motility of the large intestine?

A
  1. irritable bowel syndrome (IBS)
  2. Bowel obstruction
  3. Volvulus
225
Q

When the motor functions of the bowel slow down or increase?

A

Irritable bowel syndrome (can be bouts of diarrhea, constipation, and abdominal distention)

226
Q

What is the etiology of IBS?

A

no known etiology

227
Q

What is the physical obstruction of the bowel called?

A

Mechanical obstruction

228
Q

What is a nonmechanical obstruction of the bowel?

A

Weakened intestinal muscles

229
Q

What are the bowel sounds in a complete bowel obstruction?

A

there are no sounds

230
Q

When the large intestine becomes twisted

A

Volvulus

231
Q

What can a volvulus lead to?

A

Bowel obstruction and ischemia

232
Q

What are the roles of the liver?

A
  • Body’s processing plant
  • Aids in digestion
  • Aids in fat, protein, and carbohydrate metabolism
  • Filters and detoxifies the blood
  • Synthesizes albumin
  • Converts bilirubin
233
Q

What is the most common cause of dysphagia?

A

Stroke

234
Q

Elevated Bilirubin levels in the blood

A

Hyperbilirubinemia

235
Q

Why does hyperbilirubinemia occur?

A
  • increased RBC hemolysis
  • hepatocellular injury
  • bile duct obstruction
236
Q

What causes an UGIB?

A
  • Peptic ulcer disease (generally in stomach or lower intestine)
  • Alcoholism
237
Q

Elevated bilirubin can result in what physical symptom?

A

Jaundice (yellowing of the skin)

238
Q

Portal hypertension increases the risk of what?

A
  • Esophageal varices

- Upper GI bleed

239
Q

How does portal hypertension occur?

A

Blood comes from the GI tract, which normally goes to the liver, but begins to back up

240
Q

Dilated, superficial veins that become visible around the umbilicus

A

Caput Medusa

241
Q

The enlargement of the liver is called what

A

hepatomegaly

242
Q

What can liver damage lead to?

A
  • hepatomegaly
  • RUQ tenderness
  • decreased coagulation factors (clotting disorders/prolonged PT)
  • elevated ammonia levels
  • caput medusa
243
Q

Who does hiatal hernia occur most in?

A

The elderly

244
Q

What do liver function tests measure?

A

hepatic injury

245
Q

Hepatocellular injury can be measuring by checking for what liver enzymes?

A
  • Aspartame aminotransferase (AST)

- Alanine aminotransferase (ALT)

246
Q

Inflammation of the liver

A

Hepatitis

247
Q

Which form of hepatitis are transmitted by the fecal-oral route?

A

Hep A & E

248
Q

Which form of hepatitis is primarily transmitted via blood through IV drug usage?

A

Hep C

249
Q

Which form of hepatitis is spread by blood products, body fluids, and sexual contact?

A

Hep B

250
Q

One of the most common liver disorders in the United States

A

Nonalcoholic fatty liver disease

251
Q

Epigastric and/or abdominal pain is usually present how long after eating in PUD?

A

2-3 hours

252
Q

Nonalcoholic fatty liver disease is associated with what syndrome?

A

Metabolic

253
Q

Which hepatitis may present as an acute, reversible condition?

A

Alcoholic hepatitis

254
Q

What does alcohol do to the liver?

A

Damages it; alcohol is a toxin to the liver

255
Q

What are three accessory organs that participate in the function of the GI tract

A
  • gallbladder
  • pancreas
  • biliary duct
256
Q

Dysfunction in the gallbladder can affect dysfunction in what other organ?

A

Pancreas (and visa versa)

257
Q

Inflammation of the gallbladder

A

Cholecystitis

258
Q

Cholelithiasis

A

Gallstones

259
Q

What are the most common gallstones?

A

Cholesterol stones

260
Q

What are the risk factors of the gallbladder disease?

A
  • age
  • female disease
  • obesity
261
Q

What are the symptoms of gallbladder disease

A
  • nausea
  • vomiting (especially after high fat meals)
  • RUQ pain that radiates to the shoulder area
262
Q

Biliary duct obstruction can lead to what?

A

Liver dysfunction

263
Q

Increase in the osmotic load presented to the intestinal lumen because of diminished absorption

A

Osmotic diarrhea

264
Q

Mucosa lining is inflamed, edematous, and unable to reabsorb fluid or nutrients

A

Inflammatory diarrhea

265
Q

Occurs when an organism stimulates the intestine to secret fluid and mucus

A

Secretory diarrhea

266
Q

Caused by intestinal neuromuscular disorders

A

Motility diarrhea

267
Q

Biliary duct obstruction can lead to what in the bloodstream?

A

Bilirubin and bile salts

268
Q

When pancreatic dysfunction occurs, the pancreas is vulnerable to _________

A

autodigestion (pathophysiology of pancreatitis)

269
Q

Inflammation of the pancreas

A

Pancreatitis

270
Q

What are the two types of pancreatitis?

A
  1. acute

2. chronic

271
Q

Celiac disease leads to malabsorption of what essential nutrients?

A
  • Vitamin D
  • Vitamins
  • Fat
  • Proteins
  • FeSO4
272
Q

Small intestines are often due to _________

A

surgical adhesions or scar tissue

273
Q

What is the number 1 cause of chronic pancreatitis?

A

Heavy alcohol use

274
Q

Pancreatic calcifications observed on an abdominal xray are conditied pathological signs of what condition?

A

Chronic pancreatitis

275
Q

Pancreatic cancer has a _____ mortality rate

A

high

276
Q

Cancer of the pancreas most commonly arises from where?

A

Ductal cells

277
Q

Signs and symptoms of pancreatic cellular damage include:

A
  • elevation of pancreatic amylase and lipase in blood
  • sudden onset of paint that radiates to back
  • Cullen and Grey Turner sign (indicates bleeding in retroperitoneal area)
278
Q

How long do you have to listen for absent bowel sounds?

A

5 minutes

279
Q

Which inflammatory bowel disease can predispose to colon cancer?

A

Ulcerative colitis

280
Q

Varicosities of the lower rectum that includes pain, burning and itching

A

Hemorrhoids

281
Q

Bleeding in the stool that is bright red comes from ________

A

large intestine

282
Q

The presence of diverticula is called

A

diverticulosis

283
Q

Unconjugated bilirubin is often _______

A

prehepatic (typically seen in newborns)

284
Q

Conjugated process is often _______

A

intrahepatic

285
Q

Posthepatic hyperbilirubinemia happens where?

A

After the liver

286
Q

What is another name for jaundice?

A

Icterus

287
Q

Signs of liver dysfunction

A
  • elevated bilirubin levels
  • low albumin
  • prolonged bleeding times
  • elevated liver functions (AST and ALT)
288
Q

Symptoms of hepatitis

A
  • dark urine
  • splenomegaly
  • jaundice
  • Flu-like symptoms: anorexia, fatigue, fever, nausea, vomiting
  • hepatomegaly
289
Q

Cirrhosis and liver failure decreases what liver functions?

A
  • detoxification
  • bile synthesis and fat digestion
  • albumin synthesis
290
Q

Why can dysfunction of the gall bladder lead to dysfunction of the pancreas?

A

-the common bile duct becomes obstructed with gallstones

291
Q

Who are most likely to develop gallstones?

A

-Full, fertile, females over 40; high calorie; high cholesterol diets

292
Q

Alcohol ______ damages cells of the pancreas.

A

directly

293
Q

Collection of fluid rich in pancreatic enzymes, blood, and necrotic tissue; if ruptures, can lead to relapse of pancreatitis.

A

Pseudocyst of the pancreas

294
Q

What is amylase and lipase?

A

Digestive enzymes

Pathophysiology (8 decks)

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