Gastrointestinal Pathology II
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40 terms
Terms | Definitions |
|---|---|
 liver's functions | carb, protein, fat and bilirubin metabolism; production of bile salts; metabolic detoxification; storage of minerals and vitamins (D, A, E, K); blood reservoir; clotting factors |
| metabolism of liver | metabolism and waste disposal--albumin, clotting factors, vitamin K; cytochrome P450; fats - fatty acids - energy |
| signs of liver dysfunction | jaundice; ascites; symptoms related to portla hypertension, ammonia elevated in failure |
| portal hypertension | hypertension in vessels tha tdrain into liver due to obstruction of flow through the kidney; long term causes varices, ascites, splenomegaly, hepatic encephalopathy |
| esophageal varices | complication of liver disease relataed to elevated portal pressure causing backflow of blood into GI structures; mortality associated with hemorrhage is 50%; prophylaxis recommended for those with cirrhosis and screening every 2-3 years |
| ascites | accumulation of fluid in peritoneal cavity; third spacing; low albumin reduces vascular pull and decreased Na and water excretion in kidney increases in hydrostatic push; liver disease/portal hypertension |
| ALT (SGPT) | elevated with liver damage (hepatitis, toxins) |
| AST (GGT) | elevated with alcohol induced liver disease; statins, tylenol, acne drugs |
| albumin | decreased in hepatitis, liver tumors, cirrhosis, ascites |
| jaundice | caused by hyperbilirubinemia; excessive hemolysis of blood cells; occlusion of bile ducts; liver damage |
| jaundice of the newborn | immature liver unable to handle breakdown of red cells from birth trauma |
| liver failure | acute or chronic; acute develops suddenly and 75% die within first few days; function lost; related to multiple organ failure; organ transplant or extracorporeal devices |
| liver abscess | amebic liver abcesses-Entamoeba histolytica; organisms: pseudomonas, proteus, klebsiella, escherichia coli, staphylococcus, streptococcus |
| hepatitis | toxic caused by adverse drug reactions or other substances; polypharmacy can induce toxic type; nausea, vomiting, lethargy early |
| hepatitis A (HAV) | contaminated food; institutions; lifetime immunity; fecal/oral, blood; incubation 2-6 weeks |
| hepatitis E (HEV) | epidemic areas; fecal/oral |
| hepatitis B (HBV) | parenteral/sexual/perinatal transmission; immunization available; 90% death of infants; 4-24 weeks; develops chronic hepatitis |
| hepatitis C (HCV) | parenteral/sexual/perinatal transmission; can be chronic |
| hepatitis D (HDV) | parenteral/sexual/perinatal transmission; actually coinfection with HBV |
| viral hepatitis-parenteral/sexual/perinatal transmission | blood exposure; sexual activity; hemodialysis; health care workiers; IV drug users; organ transplant |
| autoimmune hepatitis | chronic inflammatory disorder related to circulating antibodies and high serum globulin levels |
| cirrhosis | characterized by diffuse inflammation and fibrosis; liver cell death with normal cells replaced by scar tissue; predisposing factors |
| Laennec's cirrhosis | related to alcoholism |
| cardiac cirrhosis | related to congestive heart failure |
| post necrotic cirrhosis | related to hepatoxins and viral hepatitis |
| complications of cirrhosis | portal hypertension; esophageal varices; ascites; hepatorenal syndrome-renal failure related to liver disease |
| hemochromatosis | common finding is excessive iron storage which can result in cellular damage in liver |
| thalassemia | patients that do not receive chelation have excess iron stores |
| chelation therapy | may be give to lower iron overload potential |
| gall bladder | stores and concentrates about 50 mL of bile which is formed in liver |
| sphincter of Oddi | controls the flow of bile into the duodenum |
| duodenum | releases cholecystokinin in response to lipids, amino acids, and alcohol consumption; steatorrhea |
| cholelithiasis/gallstones | more common in women; increased with age and obesity; form over 2-3 years; up to 2.5 cm; obstrn of duct results in complications |
| cholecystitis | inflammation of gall bladder usually related to stones and obstruction; RUQ pain with chills and fever with Murphy's sign (RUQ pain with temp respiratory arrest) |
| functions of pancreas | exocrine: secretion of enzymes; endocrine: insulin production and release |
| acute pancreatitis | inflammation of the pancrase resulting in varying stages of pancreatic injury; causes: biliary stones and alcohol, 10%-no identifiable cause; activation of enzymes before entering the duodenum, producing autodigestion; elevated serum amylase and lipase; leukocytosis and hyperglycemia |
| acute pancreatitis con. | pain, N/V; alcohol intake; physical exam findings-fever, abdominal symptoms, decreased peristalsis, Cullen's sign (purplish periumbilical ecchymosis) |
| acute pancreatitis complications | pseudocysts-can obstruct other structures or rupture; pancreatic infection; chronic pancreatitis |
| chronic pancreatitis | persistent and progressive damage to tissue; often alcohol related; recurrent bouts with progressive injury and scarring; destruction of the exocrine paenchyma and replacement w/fibrous tissue; symptoms similar to acute |
| cancers of GI tract | esophagus; stomach; liver; pancreas; gall bladder; small intestine; colon (3rd most common CA) and is familial adenomatous polyposis; rectum; usually adenocarcinoma |
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