Hepatitis
Transmitted by fecal-oral, sexual, & parental routes. It is prevented by vaccine and hygiene. When you do have it, expect to have symptoms like abrupt fever, nausea, abdominal discomfort, dark urine, & jaundice. Lab results will show anti-HAV antibodies such as elevated IgM as an indicator for acute infection and elevated IgG indicates previous infection.
What is Hepatitis A?
Alcohol dehydrogenase (ADH) which comes involves the cytoplasm & Microsomal ethanol-oxidizing system (MEOS) when there is too much alcohol build-up which involves the endoplasmic reticulum + uses CYP enzymes
What are the pathways that metabolize alcohol (EtOH)?
cumulative toxic effects of alcohol metabolism on liver, inflammation, oxidative stress from lipid peroxidation, and malnutrition.
Alcohol is transformed to acetaldehyde and too much = fibrosis
What is alcoholic cirrhosis?
55 year-old patient with history of smoking, diabetes, alcohol abuse, and gallstones present to the hopsital with LUQ & epigastric abdominal pain. After taking the patient's labs, results showed elevated serum amylase/lipase. The patient also suffers from SIRS, ARDS, and complete organ failure. The patient is NPO, taking Tylenol, and is on the fluid/electrolyte replacement protocol. This is known as a reversible inflammation of pancreas due to premature activation of pancreatic enzymes.
What is Pancreatitis?
What is Urinary Tract Cancer ?
This is virus can be acute or chronic. It is transmitted parenteral, sexual, placental, & blood exposure. Prevention involves vaccination and precautions. If you have contracted the virus, symptoms would be Hep A and may lead to cirrhosis, liver failure, or carrier state. Lab results would show anti-HBs, anti-HBc, & anti-HBe antibodies.
What is Hepatitis B?
Accumulation of fat in hepatocytes (steatosis) that occurs quickly due to binge drinking but is reversible if alcohol intake is ceased.
What is fatty liver disease?
Patient has is suffering from liver failure and has distended, tortuous veins in the lower esophagus and stomach. This leaves them at high risk for rupture and hemorrhage due to lack of coagulation factors/thrombocytopenia.
What are Esophageal Varices in Portal Hypertension?
Passage of urine via the detrusor muscle contraction
*we sense fullness at 400-500mL of urine
*bladder is a low-pressure storage system (< urethra)
What is Micturition?
This virus is chronic. It is transmitted via parenteral, sexual, placenta, & blood exposure. There is NO vaccine so precaution is the only preventative measure. It is often asymptomatic but high chance of developing cirrhosis, liver failure, & cancer as a byproduct. Lab results will show HCV RNA and non-protective antibodies.
What is Hepatitis C?
A patient comes in reporting abrupt onset of jaundice. The patient discloses they partake in excessive alcohol consumption which is known to causes inflammation and necrosis of liver cells.
What is alcoholic hepatitis?
Patient present with ascites, varices, hemorrhoids, and congestive splenomegaly which lead to the development of anemia, leukopenia, & thrombocytopenia which puts them at risk for infection & bleeding. These are consequences of ⇧ pressure and dilation of venous channels behind portal vein as venous blood returns to heart from abdominal organs collect in portal vein & travel through liver before entering vena cava.
What is Portal Hypertension?
Performing a physical examination which include(s): Postvoid residual (PVR) volume which is estimated by palpation and percussion. Pelvic Exam (genital atrophy, pelvic prolapse, pelvic mass, perineal skin condition)
Lab and Radiology Tests: urine + blood tests, ultrasound bladder scan (best way to confirm urinary retention volumes)
What is the process for evaluating bladder function?
Requires HBV coinfection, may be acute or chronic, & can be prevented by HBV vaccine.
What is Hepatitis D?
The end result of EtOH-related hepatocyte injury. Also known as liver failure.
What is alcoholic cirrhosis?
Patient presents to the clinic confused and experiencing asterixis (flapping hand tremor). Later, the patient starts convulsing for long durations which lead to the patient being put into a medically-induced coma. After being awoken from the coma, the patient has memory loss and personality changes with impaired speech and motor function. Their lab results showed an accumulation of neurotoxins (ammonia) due to impaired detoxifying function of the liver.
"HEY, I May Collapse Completely, Please Avoid Crazy"
What is Hepatic Encephalopathy?
Cause: congenital or acquired
Degree: partial or complete
Duration: acute or chronic
Level: upper or lower urinary Tract
Manifest: bladder distention, hesitancy, straining, small/weak stream, frequent, incomplete emptying sensation, overflow incontinence
This virus is acute or chronic in immunocompromised persons. There is a vaccine available but not in N. America but can be prevented by hygiene & clean water. It is transmitted by fecal-oral route. Symptoms are similar to Hep A but are more sever in pregnant women due to elevated hormone levels making it difficult fight infection.
What is Hepatitis E?
Patient comes in reporting weight loss and weakness. The nurse observes splenomegaly, ascites, thrombocytopenia, gynecomastia, spider angiomas, & varices.
Pathophysiology: irreversible infammatory, fibrotic liver disease
What is Cirrhosis?
Patient presents to the clinic with yellowish discoloration of the eyes and their lab results showed elevated levels of bilirubin in the blood ( >2.5 mg/dL). The CNA collected a urine sample and the urine was amber-colored.
Prehepatic: excessive hemolysis of RBCs
Intrahepatic: liver disease
Posthepatic: obstructive/cholestatic jaundice, gallstone
What is jaundice?
Involuntary loss/leakage of urine which is more common in older adult women. There are 4 types:
*Stress: involuntary due to laughing, coughing, sneezing, lifting, etc
*Overactive: involuntary due to hyperactive detrusor muscle associated w/ urgency
*Overflow: involuntary due to intravesical pressure exceeds maximal urethral pressure
*Functional: inability to access place to void/get help with voiding (factors outside lower urinary tract)
Treatment: BPH (Elderly)
What is Urinary Incontinence?