Week 11: Gastrointestinal Pathologies Part 3

Question 1

Cholelithiasis

Answer 1

• gallstones
• most made out of cholesterol (radiolucent)
• pigment stones contain calcium (radiopaque)
• gallstones can leave gallbladder though bile duct and enter GI tracts (some get stuck on the way)

Question 2

Cholecystitis

Answer 2

• acute inflammation of the gallbladder
• usually occurs after impacted gallstone obstructs the cystic duct
• may require surgery
• gallstones may injure the mucosal wall, allowing bacteria to enter
• can become emphysematous cholecystitis: acute infection of gallbladder wall by gas forming organs = surgical emergency)

Question 2

Choledocholithiasis

Answer 2

• the presence of at least one gallstone within the common bile duct
• may block duct
• radiographic appearance: may see stones themselves or filling defect for blocked duct

Question 2

Cholangitis

Answer 2

inflammation of the entire bile duct system

Question 3

Hepatitis

Answer 3

• inflammation of the liver, usually from a viral infection
• hepatitis A/E, B or C

Question 4

Hepatitis A and E

Answer 4

transmitted from fecal oral route: consumption of food or water contaminated with fecal particles, often from poor hand hygiene

Question 4

Hepatitis B

Answer 4

contracted by exposure to contaminated blood or blood products, or through sexual contact

Question 5

Hepatitis C

Answer 5

common cause of chronic hepatitis , cirrhosis and hepatocellular carcinoma; contracted by blood transfusion or sexual contact

Question 6

Liver Cirrhosis

Answer 6

• end stage liver disease, chronic destruction of liver cells and structures
• major cause is alcoholism (10-20 yrs), viral hepatitis, or drugs/chemicals
• fibrous connective tissue (scar tissue), which has no liver cell function, replaces the destroyed liver cells
• liver initially enlarged due to regeneration but then shrivels as scarring contracts and become bumpy and nodular
• decreed albumin production causes fluid to leak out of circulation (edema of lower limbs)
• decreased albumin and increased venous pressure produces ascites
• portal vein obstruction creates collateral circulation
• jaundice occurs from destruction or blockage of bile ducts

Question 7

Ascites

Answer 7

• accumulation of fluid in the peritoneal cavity, usually due to liver damage (hepatitis, cirrhosis, fatty liver)
• causes abdominal distention
• tight, hard abdomen
• increase technical factors

Question 8

Hepatocellular Carcinoma

Answer 8

• liver cancer
• most commonly occurs with underlying liver disease (alcoholic or post necrotic cirrhosis, HBV, HCV

Question 9

Liver Hemangiomas - Benign Vascular Tumours

Answer 9

• hepatic or cavernous hemangiomas, usually asymptomatic
• if over 10cm = giant hemangioma
• can cause edema and jaundice

Question 10

Acute Pancreatitis

Answer 10

• enzymes activates that cause pancreas to digest itself
• common cause excessive alcohol consumption, less often from gallstones blocking ampulla or water causing inflammatory response as bile refluxes into pancreas
• jaundice may occur if swollen pancreas blocks bile duct

Question 11

Chronic Pancreatitis

Answer 11

• repeated injury causes formation of scar tissue
• usually alcohol related
• pancreas cannot produce digestive enzymes (insulin and glucagon)

Question 12

Pancreatic Carcinoma

Answer 12

• most common pancreatic cancer is adenocarcinoma (cancer that starts in the glands of the lining of the pancreas)
• 60% are located in the head of the pancreas
• har may enlarge, block bile duct and cause obstructional jaundice

Question 12

Diabetes Mellitus

Answer 12

• common endocrine disorder
• pancreas fails to secrete insulin or failure of target cells thought out the body to respond to insulin
• lack of insulin prevents glucose from entering cells which leads to hyperglycemias as glucose stays in blood
• body pH lowers (acidosis) and dehydration can occur (diabetic coma)
• symptoms: polyuria, polydipsia and glycosuria

Question 13

Hypoglycemia

Answer 13

• Low blood sugar
• can occur with diabetic patients if too much insulin, not enough food or too much exercise
• suddenly feel lightheaded, faint, shaky, sweaty
• give them sugar

Question 14

Pneumoperitoneum

Answer 14

• free air in the peritoneal cavity
• often caused by perforation of the GI tract, such as form a perforated peptic or duodenal ulcer or septic infection, penetration injuries or blunt trauma
• peritonitis can occur
• indicates a surgical emergency