LIVER, BILIARY TRACT, PANCREATIC PROBLEMS
What are the stones in cholelithiasis made from and caused by?
made from: cholesterol, bile salts and calcium
caused by: supersaturated cholesterol
Which peptic ulcer has pain that worsens with eating?
Gastric ulcers
Advanced age, obesity and manual labor puts you at a higher risk of which diesease?
Osteoarthritis
What would the CD4 count have to be under to be diagnostic of AIDS? Are there other diagnostic factors?
CD4 count under 200 is indicative of AIDS
other diagnostic criteria- wasting syndrome 10%, kaposi sarcoma, pneumocitis jiroveci pnemonia, invasive cervical cancer, mycobacterium tuberculosis, and non-hodgkins lympohoma.
What is the 3 step process for cancer development?
1. Initiation- alteration of DNA
2. Promotion- reversible reproduction of altered cell
3. Progression- increased growth rate (possibly angiogenisis and metastasis)
What labs would you expect with a pancreatitis patient?
Amylase and Lipase increased
Calcium decreased
What layer of the GI tract is affected in Gastritis?
Mucosa layer of the stomach
Describe the RF factor. What disorder has the RF factor?
IgG antibodies formed
New antibodies are made AGAINST the IgG.
2 antibodies are together this is RF factor.
Rheumatoid Arthritis.
What are the four processes of pain?
1. Transduction- stimulus and activation
2. Transmission- impulse and transfer
3. Perception- recognition and defined
4. Modulation- interpretation and response
What levels are increased/decreased in Tumor lysis syndrome? How does tumor lysis syndrome happen?
Elevated: Uric acid, potassium, phosphate, myoglobin
Decreased: calcium
Tumor lysis syndrome is when the chemo is working 'too good' that cells are lysis and their contents are going into the bloodstream.
Portal Hypertension is a complication of what? And what is portal hypertension?
Complication of Cirrhosis
Liver scarring blocks blood flow to the liver, causing a collateral circulation to develop
What are the two inflammatory bowel diseases? Where is the pain located in each?
Chrons disease RLQ worsens after meals
Ulcerative Colitis LLQ
Lupus is what kind of hypersensitivity reaction? Describe this reaction.
Lupus is a type 3 hypersensitivity reaction. Overreactive B and T cells
complement system is the mediator causing cell lysis
What causes metabolic acidosis and what manifestations would you see with this imbalance?
⬇️ PH ⬇️ BICARBONATE
causes: shock, kidney disease, severe diarrhea, ketoacidosis
manifestations: kussmal respirations, hyperkalemia
what are the normal levels for each electrolyte? calcium, potassium, sodium, magnesium and phosphate.
calcium- 9-10.5
potassium- 3.5-5
sodium- 135-145
magnesium- 1.3-2.1
phosphate- 3.4-5
Where would cholecystitis pain be located?
RUQ- can refer to the right shoulder/scapula
fatty foods make it worse
What is celiac disease? And what is a unique trait only to celiac disease?
small intestine mucosa is damaged leading to malabsorption of gluten
unique trait: dermatitis herpetiformis rash
What are the 7 manifestations for compartment syndrome?
Pain
poikilothermia
paresthesia
pallor
paralysis
pulselessness
pressure
What is the RAAS system step by step? what triggers it and what is the result?
RAAS SYSTEM
triggered by hypotension
Renin released by the kidneys, angiotensin 1 converts to angiotensin 2 which causes aldosterone secretion by the adrenal glands (sodium and water reabsorbed by nephrons)
result: fluid retention and raised BP
What could you give a patient to help balance out hypernatremia?
a hypotonic fluid
What are some unique manifestations of Cirrhosis?
Red Palms, Asterixis, Factor Hepaticus, Caput Medusae, Spider Angioma
What are some symptoms of a LARGE bowel obstruction?
severe distention, constipation, gradual onset, ribbon like stool, fecal vomiting possible if obstruction is low
What are the 6 steps of the fracture healing process?
1. Fracture hematoma- blood clot forms
2. Granulation tissue- blood clot converted to gran tissue
3. Callus formation- osteoblasts build a callus around fractured parts
4. Ossification- callus hardens
5. Consolidation- fracture closes takes up to one year
6. Remodeling- excess bone tissue is reabsorbed by osteoclasts
Kidney disease, addisons disease and trauma are causes of what electrolyte imbalance?
Hyperkalemia
Name the 6 mediators in the Inflammation response and what they do.
1. Prostaglandin- vasodilation, promote fever and pain sensation
2. Thromboxane- vasoconstriction, blood clotting, goal is to stop bleeding
3. Leukotrienes- Increased capillary permeability, and airway narrowing
4. Histamine- Vasodilation, and increased capillary permeability, released by degranulation of mast cells
5. Kinin- increased capillary permeability, pain sensation and leukocyte recruitment
6. Complement- vasodilation and increased capillary permeability, chemotaxis and cell lysis