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Patho Test Next Week
Terms in this set (322)
What's renal agenesis?
One or both kidneys don't develop
How can you tell a baby has renal agenesis?
There isn't as much amniotic fluid since the baby's urine is excreted into it
What's renal hypoplasia?
The kidneys are small
What are the job of kidneys?
Filter blood and control the volume of fluid in the body
How much do kidneys receive of your resting cardiac output (aka renal fraction)? i.e. how much blood do they get?
What's the difference between afferent and efferent arterioles?
Afferent brings blood to the glomerulus and then nephron while efferent takes blood away
How much of the blood entering the glomerulus from the afferent arteriole goes into the nephron? The other percent stays in the glomerulus and leaves through the efferent arteriole and back into circulation
How many nephrons are in each kindey?
The glomerulus and Bowman's capsule are attached and share a _. This thing has pores so things can filter out and go into the nephron
The _ the blood pressure, the _ the glomerular filtration rate. Why is that?
Higher because there's more pressure which makes more filtrate leave the capillaries through the pores of the basement membrane with the Bowman's capsule and go into the nephron
How many liters of urine is it normal to make in a day?
What's the normal glomerular filtration rate?
The _ the glomerular filtration rate, the _ your urine output. Does this make sense?
Higher yes since more filtrate is being put through the nephron, it needs to then escape the body
Is more filtrate excreted through the urine or reabsorbed?
What are one of the most common forms of kidney disease?
Glomerular disease where glomerular filtration rate is either too fast or slow
Where's primary glomerular disease taking place?
Originates from glomerulus
Where's secondary glomerular disease taking place?
Disease that originates from another organ like hepatitis
How do you know if someone has a glomerular disease?
Elevated BUN levels, sudden hypertension, protein in their urine, and edema
If the kidneys are reabsorbing too much water, what's the level of glomerular filtration rate and blood pressure?
What happens if you have a decreased glomerular filtration rate?
elevated creatinine and urea levels
A loss of negative ionic charge barriers result in what?
Protein in the urine
If you're losing protein in your urine, you don't have as much protein in your blood and there's more particles and protein outside the capillaries than inside. This means water is going to move _ the capillaries through osmosis and stay in the interstitial fluid
If you're losing protein in your urine, you don't have as much protein in your blood and there's more particles and protein outside the capillaries than inside. This means water is going to move OUTSIDE the capillaries through osmosis and stay in the outside interstitial fluid. What's this result in?
Main protein in the blood
How do most glomerular diseases originate?
Antibodies attack the glomerulus
What is proliferative glomerular disease?
Too many glomerular cells are being made
What is membranous glomerular disease?
The basement membrane is thickening
What's a diffuse change when talking of glomerular disease?
Involves all the glomeruli
How do antigen-antibody complexes cause glomerular disease?
They're circulating in the blood from somewhere else and become trapped in the glomerulus as they're trying to be filtered
What's acute nephritic syndrome?
The glomerulus becomes inflammed and blocked up. It's also proliferative
What do you expect to see in acute nephritic syndrome?
Decrease in permeability (duh), bloody urine from the capillary wall damage, slight protein in the urine, small amount of urine due to decrease glomerular filtration rate, and edema
Small amounts of urine
What's the difference in proliferation between rapidly progressve glomerulonephritis and acute infectious glomerulonephritis?
In RPG, proliferation takes place in the glomerulus whereas in AIG, proliferation takes place in the endothelial cells
What's acute infectious glomerulonephritis?
Happens after strep infection, measles, mumps, or chickenpox
What's rapidly progressve glomerulonephritis? and symptoms
Severe glomerulus injury without a specific cause. Rapid decline of glomerulus filtration rate, no space in Bowman's capsule, and can progress to acute renal failure or death
What's systemic lupus eythrematosus?
Antibodies attack nuclear proteins like DNA so this can take place in many different cell and organ types since they have DNA. They get trapped in the glomerulus, monocytes turn into macrophages once they leave the blood, attack the antibodies and inflammation occurs
What's Goodpasture syndrome?
Antibodies attack the glomerular basement membrane and pulmonary alveolar membrane since both membranes share an antigen. They get trapped in the glomerulus, monocytes turn into macrophages once they leave the blood, attack the antibodies and inflammation occurs
What's nephrOtic syndrone?
Increased permeability of the glomerulus.
Who is primary nephrOtic syndrome likely to occur?
Who is secondary nephrOtic syndrome likely to occur as the result of another disease like diabetes?
What are symptoms of nephrOtic syndrome?
Massive loss of protein in urine, low levels of albumin in blood, lipids in urine and blood, edema, and risks of not clotting since all your clotting proteins are being peed out
Where's Berger (IgA) disease likely to take place? What are you likely to see?
In the mesengeum (between the capillaries of the glomerulus) inflammation takes place. You see little protein and blood in urine
What's Alport syndrome?
Hereditary defect of the glomerulus basement membrane.
Who gets Alport syndrome more severe? boys or girls
Boys can lead to chronic renal failure
What are you to see in Alport syndrome?
How are chronic glomerulonephritis characterized>
Small kidneys and sclerosed glomeruli. Develops slowely to end stage renal disease over a number of years
What do you see in lupus (autoimmune against DNA. They attack numerous tissues)?
Blood and protein in urine
What type of sensitivity is lupus (autoimmune against DNA. They attack numerous tissues)?
What's diabetic glomerulosclerosis?
Too much glucose messes with the basement membrane and mesangial (between the capillaries of the glomerulus)
In diabetic glomerulosclerosis, the glomerulus filration rate is HIGH and _ _ albumin is being excreted in the urine
Can diabetic glomerulosclerosis be reversed?
Yes by controlling glucose intake
The renal tubules filter blood by _ reabosrbing items the body needs to survive
In the descending loop of Henle of the nephron, what's being reabsorbed?
In the ascending loop of Henle of the nephron, what's being reabsorbed?
Where does most reabsorption take place?
Proximal tubule right outside the glomerulus
In the collecting duct and distal tubule of the nephron, what's being reabsorbed?
Water only moves out of the proximal tubule and descending loop of Henle of the nephron, if there's a _ concentration of salt and solutes outside
Loop diuretics like Lasix, block the NKCC transporter prevents salt and solutes being reabsorbed, which keeps water inside the nephron so fluid levels in your body _ and urine output _
Fluid levels in your body fall and urine output increases
What does the NKCC do?
Moves sodium, potassium, and chloride out of the nephron to be reabsorbed
What's acute pyelonephritis?
Infection mostly caused by E coli
What's the most common route of infection with acute pyelonephritis?
Ascending from the bladder so it travels up the ureters
Who is most likely to get acute pyelonephritis?
Catheters and pregnant women
Is polycystic kidney disease inherited?
What are manifestations of polycystic kidney disease?
No symptoms if cysts are small, a lot of blood in urine, become infected from UTIs, hypertension, and end stage renal failure
Obstruction can occur anywhere in renal system and at any age
What are causes of obstructive disorders of the renal system?
Pregnancy, kidney stones, and tumors
From an obstructive disorder, you can develop hydronephrosis which is
Fluid can't be drained so it's backing up and staying in the renal pelvis
The stasis (not going anywhere) or urine can lead to what 2 things that i've had before?
Infection and stones
To form kidney stones, what 3 things do you need
Saturated urine (haven't peed in awhile), two crystals to stick together, and the deficiency of stone inhibitors like citrate and magnesium
Noncolicky Pain from kidney stones (opposite of what I had) is caused by stones distending the renal pelvis. Pain is constant. May get worse after drinking _ amounts of fluid
Uric acid (type of kidney stone) is also associated with _ which is the formation of crystals in the toes
Wilm's Tumor (malignant cancer of the kidneys) is the most common malignant cancer of adults or kids?
What are 2 signs of Wilm's Tumor (malignant cancer of the kidneys) in kids?
Asymptomatic large abdominal mass and hypertension
What's the survival rate of kids with Wilm's Tumor (malignant cancer of the kidneys)?
In Adult Renal Cell Carcinoma, where is the cancer most likekly to appear?
The tubules and collecting ducts
In Adult Renal Cell Carcinoma, is it more likely in men or women?
What is Adult Renal Cell Carcinoma charaterized by?
Lack of warning signs, diverse manifestations, and resistant to treatment
What's the treatment and prognosis of Adult Renal Cell Carcinoma>
Surgery and prognosis is poor
When the kidneys fail, less waste is removed so waste remains in the body. Homeostasis is thrown off track. Unable to regulate fluid, electrolyte (sodium, chloride, potassium), and pH balance. BUN and creatinine levels are high since the kidneys are not filtering things out.
Renal function is approximated by what?
Initial and current creatinine levels
High blood concentration of nitrogen waste products like uric acid and creatinine
What's acute renal failure?
Rapid decline of kidney function and progressive azotemia (high blood concentration of nitrogen waste products)
In acute renal failure, glomerular filtrate rate is _ and person doesn't show symptoms
What's prerenal ACUTE kidney failure classification?
Injury occurs to kidney due to not enough blood reaching the kidneys
What's postrenal ACUTE kidney failure classification?
Injury occurs to kidney due to bstructed urine outflow (kidney stone)
What's the most common form/classification of acute renal failure
Prerenal where kidney isn't getting enough blood
What causes acute prerenal renal failure?
Shock (low blood pressure), loss of blood, vasoconstriction so NSAIDs and endotoxins (bacteria cause inflamm response)
What are manifestations of acute prerenal renal failure?
Occurs when blood is 1/4 of what it's supposed to be, less sodium filtered out, increase in urea compared to creatinine.
Acute tubular necrosis is most often caused by what?
Infection or kidneys not getting enough blood (acute prerenal renal failure)
Is acute tubular necrosis permanent or reversible?
WHo is more likely to get acute tubular necrosis?
Those who had surgery, burns, sepsis, and low blood volume
In acute tubular necrosis, glomerular filtration rate _ improves with restoration of blood flow to the kidneys
_ ureters must be occluded in order to have renal failure
What's the onset of acute renal failure?
Hours to days. Happens fast
We judge acute renal failure according to the time from onset of the event (ischemia, toxin exposure) to tubular injury occurs
Acute renal failure has symptoms of what?
Edema and pulmonary congestion
You can get _ of the blood with acute renal failure since you're unable to sufficiently remove waste products and your glomerular filteration rate is so low
How do you tell you're getting better from acute renal failure?
Look at increase UOP rather than BUN levels
Does kidney damage persist in those with acute renal failure?
Chronic kidney failure is progressive and _ destruction of kidney structures
What conditions cause chronic kidney failure>
Diabetes, hypertension, polycystic kidney disease, and glomerulonephritis
The higher your glomerular filtration rate means you have a lot of nephrons. HOWEVER, if your glomerular filtration rate is low, this means you have
What are some manifestations of chronic renal failure?
Hypertension, hyperkalemia, heart failure, edema, uremia, acidosis, and anemia
Considering the internal and external spincter of the bladder, which one do we have control over?
Lack of voluntary control over peeing
Females are more prone to what since our urethras are so short?
UTIs and incontinence
Males are more prone to what since their urethras are so long?
Urine passes through what organ on men? If this enlargens, then it makes it harder for them to pee
What are 2 factors for lower urinary tract infections?
Incontinence and obstruction (pee can't flow out and becomes stasis)
How do you know someone is having urinary obstruction (urine isn't flowing out of the lower urinary tract and becoming stasis)?
Weak stream, have to go a lot since bladder isn't totally emptying, harder to push the urine out
What is Post Void Risidual Volume?
After you pee, how much urine is left in the bladder
What causes obstruction so someone can't pee or it's more difficult to pee?
Prostate has enlargened or narrowing of the meatus (hole) out of the bladder and through the internal and external spincters
Compensatory and decompensatory changes to you not peeing take place so urine doesn't _ and just sit inside the bladder
What's the detrusor muscle?
Muscle around the bladder that squeezes urine out to empty out
What are the compensatory changes your body makes so urine doesn't become retained?
Detrusor muscle hypertrophies since it has to work harder, it's harder to suppress your need to urinate (incontinence), and diverticuli (sacs) form on the bladder from the excess pressure
What are the decompensatory (body isn't compensating anymore) changes your body makes after compensatory changes failed to ensure urine doens't become retained?
Weak stream, overstretching of the bladder muscles makes it harder for them to contract, and urine remains in the bladder which leads to infection
The micturation reflex (your body beginning to feel like it's time to go) when your bladder is full to how much?
The micturation reflex: your bladder starts to stretch once it reaches 150-250 ml and a _ signal is sent up the spinal cord since we have no voluntary control over this
The micturation reflex: your bladder starts to stretch once it reaches 150-250 ml and a autonomic signal is sent up the spinal cord. A _ signal is sent back down the spinal cord to tell the detrusor muscle to contract.
Can you override the micturation reflex (your body beginning to tell you it's time to pee)?
Yes by contracting the external spincter
The micturation reflex: your bladder starts to stretch once it reaches 150-250 ml and a autonomic signal is sent up the spinal cord. A parasympathetic signal is sent back down the spinal cord to tell the detrusor muscle to contract. A signal also goes to the _ telling it that you need to pee
Spastic bladder dysfunction (overractive bladder) is the failure to store urine. You have lesions above the _ region of the spinal cord which cause the internal spincter to contract and won't let you go when you don't want to.
Above the sacral region of the spinal cord we have sympathetic neurons that can be activated. They cause contraction of the _ spincter and won't let you go. So sypathetic control is stopping urine flow. So when you don't want to pee, you won't pee.
Neurogenic Areflex Bladder is a condition where the bladder _. The neurons in the sacral region of the spinal cord or the peripheral nerves that control the detrusor contraction and bladder emptying aren't working.
Fails to contract and empty
The sympathetic nervous system tells you to stop and won't let you go. So if there's something wrong with the regions above the sacral region of the spinal cord, you're going to have a _ bladder. Makes sense because the sympathetic is fight or flight and doesn't want you to go in an extreme situation.
The parasympathetic nervous system tells you to go and lets you pee. So if there's something wrong with the regions below the sacral region of the spine cord, you're going to have a bladder that _. Makes sense because parasympathetic is rest and digest and want you to go.
Doesn't contract and empty
SOOO: What are the 4 types of urinary incontinence?
Stress, overactive, other, and overflow
What stress incontinence?
You pee during activities of increased intraabdominal pressure.
What are activities where you would pee during stress incontinence?
Sneezing, laughing, and coughing
What's overactive incontinence?
You have a lot of urgency and frequency but you may not pee accidentally
What's other incontinence?
Decreased bladder compliance or your bladder can't stretch enough to hold all the urine
What's overflow incontinence?
You have a lot of pressure in your bladder to the point where you can't hold your pee anymore and take anymore pressure
What's the word for inflammation of the bladder
kidney infection. UTI has went all the way up to it
What's the most common pathogen to cause UTIs?
Lower or Upper UTI: Inflammation of the renal pelvis and you exhibit MANY symptoms of systemic infection like fever and chills
Lower or Upper UTI: Pathogens hang out in the urine, cause MINIMAL systemic symptoms of infection, and cause irritative symptoms when you pee like frequency, burning, and cloudy urine
When is acute cystitis (bladder infection) more likely to occur?
Who is acute cystitis (bladder infection) more likely to occur in?
Elderly due to immobility, prostate enlargening, low immune system, low hydration, and medication intake
Acute cystitis (bladder infection) is more likely to progress to _ in kids
Pyelonephritis (kidney infection)
What's a urinary analgesic?
Meds to make it less painful to pee
What are risk factors for UTIs?
Urinary retraction and reflux since urine isn't getting out and just becoming stasis, women who have sex, women who have went through menopause, and those with catheters
90% of the cancers of the bladder originate from the transitional cells that line the bladder. What are these cells responsible for?
Allowing the bladder to stretch
At what age and race are you more likely to get bladder cancer?
70 and white
What are risk factors to get bladder cancer?
Smoking cigs and working in the rubber and cable industries from the breakdown of dyes used there
What's the most common symptom of bladder cancer?
Painless bloody urine
What's urothelial neoplasia?
New, abnormal growths of the epithelial lining of the bladder
80% of urothelial neoplasms (new, abnormal growths of the epithelial lining of the bladder) are _ where they look like fingers
What are the 3 parts of the small intestine?
Duodenum, jejunum, and ileum
What art the parts of the large intestine?
Cecum, ascending, transverse, descending, sigmoid, and rectum
What's the mucosal layer's function of the intestines?
Layer where absorption takes place and enzymes are mucus are secreted.
What's mucus do in the intestines?
Mucus serves a protective role so things don't digest themselves
In what layer of the intestines if mucus secreted?
What are the 3 layers of the intestines?
Mucosal, submucosal, and smooth muscle
What causes dysphagia?
Narrowing of the esophagus, lack of spit, muscles are weak, and disruption of the nerves
What's achalasia-failure to relax?
The lower esophageal spincter doesn't relax and let food into the stomach
What are bad things that can happen as a result of achalsia-failure to relax?
The esophagus can become dilated above the lower esophageal spincter and breathing in the food once you lay down
The esophagus goes through a hole in the diaphragm. This hole is called what
What's a hernia?
Tissue pushing through a hole into a place where it shouldn't be
In this type of hernia, part of the stomach is above the diaphragm through the hiatus hole. There's no symptoms and it's not a big deal since food DOESN'T get trapped up there
In this type of hernia, part of the stomach is above the diaphragm through the hiatus hole and keeps pushing through. Causes a pouch up there where food DOES get trapped. Can be a cause for surgery if enough of the stomach gets up there.
Who is a paraesophageal hiatal hernia more likely to happen to and why?
Ppl over 50 due to diaphragm muscle weakness
Reflux of chyme from the stomach into the esophagus
What's causes GERD?
Lower esophageal spincter isn't doing it's job or pressure in the stomach is so high that it blows the spincter open
How do you treat GERD? We're reducing acidity so the esophagus stops hurting
Antacids which neutralize the acid in the stomach, histamine2 receptor antagonists (histmine activates parietal cells which secrete hydrochloric acid), and proton pump inhibitors
To lower acidity in the stomach in someone who has GERD whose acid is going up in their esophagus, antacids which neutralize the acid in the stomach, histamine2 receptor antagonists (histmine activates parietal cells which secrete hydrochloric acid), and proton pump inhibitors. Are these things lowering or raising the pH?
What's a stricture?
Narrowing of the esophagus
A _ can form in the esophagus from the repeated damage of stomach contents touching it. Can form scar tissue as a result
One tissue becomes a different type of tissue due to repeated damage like smoking cigs or GERD
If you have a Barrett Esophagus, what's that? Is it cancerous?
The repeated damage of stomach acid in the esophagus turns the squamous tissue into columnar (metaplasia). Yes
Where does Adenocarcinoma occur?
Lower third of esophagus and stomach
Where does Squamous Carcinoma occur?
Middle of esophagus
The mucosal lining of the stomach is inflammed
What are characteristics of acute gastritis?
Inflammation comes in short bursts and pain doesn't last long. ONLY INVOLVES THE STOMACH
What are some irritants that cause acute gastritis (inflammation comes in short bursts and pain doesn't last long)?
NSAIDs, steroids, caffeine, spicy food, and alcohol
What's the difference between an ulcer disease in the stomach and gastritis?
There's no erosions in gastritis, just inflammation
In chronic gastritis, there's atrophy of the _ epithelium of the stomach
In chronic gastritis, the ongoing inflammation in the stomach can lead to _ and this can lead to carcinomas (cancer)
Dysplasia (cells become different cells and lose their identity)
In this disease, this bacteria damages the stomach lining.
H pylori produces toxins that damages the mucosal lining of the stomach causes inflammation at first and eventually ulcers. Most common cause of what kind of ulcers?
The most common cause of peptic ulcers are H pylori. WHat's the second most common cause?
Chronic Autoimmune Gastritis is associated with other autoimmune (body is attacking itself) diseases such as
Diabetes and Addison's disease
In Chronic Autoimmune Gastritis, the antibodies attack the parietal cells which secrete HCl and intrinsic factor. What's important about intrinsic factor?
Binds to vitamin B12 so B12 can be absorbed into the blood
In Chronic Autoimmune Gastritis, the antibodies attack the parietal cells which secrete HCl and intrinsic factor which binds to vitamind B12 so it can be absorbed into the blood. By the parietal cells being attacked, B12 isn't being absorbed and stomach has little acid. What's B12 do?
Making new RBCs and putting lipids on the myelin sheaths of neurons. Causes anemia and neurological damage
In chemical gastropathy, you've had stomach and intestine surgery. As a result , pyloric spincter loses it's ability to make sure contents leave and stay out of the stomach. _ and _ secretions come into the stomach through this faulty spincter and can cause inflammation
Pancreatic and bile
Where do peptic ulcers occur? Why do they form?
In stomach and duodenum from the constant inflammation and subsequent damage to the protective mucosal lining.
What are signs of peptic ulcers?
Pain in the midline when the stomach is empty. Pain goes away with antacids and food since the acid isn't as intense then.
Stress ulcers are related to what?
Burns, illness, and injury to nerves.
Stress ulcers are related to burns, illness, and injury to nerves. The subsequent reduced plasma volume can lead to _ and _ which cause the ulcer to form in the stomach.
Ischemia and necrosis
Who are at particular risks for stress ulcers? What do we do for them?
ICU patients. We give them proton pump inhibitors and histamine2 receptor antagonists to reduce stomach acidity
If you have this type of ulcer, you ulcers that develop from brain trauma. Your brain tells your body to make an overproduction of stomach acid
Crohn disease and ulcerative colitis are two types of what disease?
Inflammatory bowel disease
What's Crohn disease?
Recurrent inflammatory response that affects ANY area of the GI tract
At what age are your more likely to get Crohn disease?
20s and 30s
If the intestinal mucosa looks like cobblestone and there's skip lesions (demarcated lesions surrounded by normal looking tissue), what disease do you have?
What are symptoms of Crohn disease?
Fever, diarrhea, pain, and fluid and electrolyte imbalance since these skip lesions can't absorb things
Where are likely to see ulcerative colitis?
In the rectum where is spreads upward
In Crohn disease, you have skip lesions where there's lesions that don't absorb surrounded by healthy lesions. In ulcerative colitis, the lesions are
Are you more likely to get colon cancer from ulcerative colitis or Crohn disease?
What's infectious enterocolitis?
Viruses and bacteria infect the GI tract
In infectious enterocolitis, what does your intestines do to get rid of the bacteria and viruses?
Secrete exudate to dilute the toxins and make you vomit from hypermotility to get to food out
In infectious enterocolitis, do you see increased or decreased intestinal function? Increased or decreased motility
Decreased intestinal function and increased motility
In infectious enterocolitis, there's decreased _. As a result, food isn't absorbed, water is drawn into the bowels, and you have diarrhea
What are three types of infectious enterocolitis?
Rotavirus, C diff, and E coli
The three types of infectious enterocolitis are rotavirus, C diff, and E coli. Which one is more serious to kids?
Rotavirus because of dehydration due to vomiting and diarrhea
What's the primary cause of C diff?
Taking antibiotics so it's opportunistic
What does C diff lead to?
Hemorrhage, necrosis, diarrhea, and inflammation
What's the life threatening form of C diff?
In rotovirus, fever and vomiting lasts 2 days but diarrhea lasts for a week. The virus sheds for several days even if the kid isn't showing anymore symptoms so they are still infectious. Who is this a big deal for?
How can you get diverticula (sacs through weak layers on the intestinal wall due to increased pressure inside the bowels) on your bowels?
Low fiber and decreased physical activity
How does having more fiber help prevent diverticula (sacs through weak layers on the intestinal wall due to increased pressure inside the bowels)?
The intestines wouldn't have to squeeze to hard to get food through since there'd be more bulk from the fiber
DiverticulITIS forms from diverticulosis where the diverticulas have became inflammed and perforated. How would we treat them?
Antibiotics, eat fiber, shit regularly, and have clear liquids
What's the difference between acute and chronic diarrhea?
Acute is caused by infectious agents like bacteria and viruses whereas chronic is cause by inflammatory bowel disease
What's the difference between noninflammatory and inflammatory diarrhea?
Non: Large volume of shit due to increase in water content of it, not bloody, and has abdominal pain. Inflamm: Inflamm happens in the colon so there is less shit and it's not very watery, fever, blood diarrhea, and lower pain
What's the difference between normal and slow transit constipation?
Normal is problems shitting but responds to fluids and fiber. Slow is infrequent bowel movements that are usually neurogenic
What causes constipation?
Sedentary lifestyle, neurogenic problems, holding it in, excessive use of antacids, and not eating enough fiber
What's the difference between mechanical and paralytic bowel obstruction?
Mechanical is when something is physically blocking the shit from moving forward whereas paralytic is movement stops due to neurologic impairment
There's 3 causes of mechanical obstruction: This one is when part of your bowel is sucked up into another segment of bowel. It's like it's trying to digest itself
There's 3 causes of mechanical obstruction: This one is when your bowel twists up counterclockwise
What are the results of obstruction of the bowels?
Gas and fluid build up, vomiting since food can't go out the other end, and bacteria can grow where the obstruction is
What does the peritoneal cavity surround?
The entire gut
The peritoneum (peritoneal cavity surrounds the entire gut) is capable of containing an infection by performing a profound inflammatory response and producing a lot of exudate. SO, anything that leaks out of an organ and into the peritoneal cavity could cause what?
Peritonitis (inflammation of peritoneal lining of abdomen)
How can you get Peritonitis (inflammation of peritoneal lining of abdomen)?
Infection (bacteria break open from an organ)
What a symptom of Peritonitis (inflammation of peritoneal lining of abdomen)?
Pain that's aggravated with movement
What syndrome is this? Something prevents the bowels from absorbing nutrients and fluid like being lactose intolerant
Malabsorption syndrome: In lactase deficieny, the enzymes that break down lactase are _ produced leading to one not being able to handle lactose in their system
Malabsorption syndrome: Bile salts may not be produced by the liver so _ can't be broken down and absorbed
The difference between lactose sensitivity and lactose intolerance is that you can _ your body to absorb lactose again whereas in lactose intolerance, you can't absorb it all
By your liver not producing bile salts, your body can't break down and absorb fats. Your body needs fats to break down fat soluble _
In celiac disease, it's a genetic disease where you can't break down _
Celiac disease is a _ cell immune mediated response to gluten which leads to intense inflammation in the GI. You can break celiac down but your body has a huge inflammatory response to it and makes you sick
The T cell immune mediated response to gluten which leads to intense inflammation in the GI of celiac disease leads to loss of _ _ in small intestine. So you can't absorb things as well after these inflammation attacks
Is an adenoma (tumor that forms in glandular tissue) benign of malignant?
Is an adenocarcinoma (tumor that forms in glandular tissue) benign or malignant?
What are three things the liver is responsible for?
Bile production, bilirubin excretion, and drug and hormone metabolism
The liver makes bile and it's then stores in the gallbladder. When you have a _ meal, the gallbladder contracts and bile is excreted into the duodenum which then the bile salts digest _
Absorption happens in the intestines and what is absorbed goes directly to the _.
Absorption happens in the intestines and what is absorbed goes directly to the liver. Rather than blood just carrying these things around in general circulation, it's then sent to the liver so the liver can _ anything that shouldn't be there and then break it down
Absorption happens in the intestines and what is absorbed goes directly to the liver. Rather than blood just carrying these things around in general circulation, it's then sent to the liver so the liver can detoxify anything that shouldn't be there and then break it down. How is it sent there?
Hepatic portal vein
Blood from hepatic portal vein (came from digestive tract where stuff has been absorbed) and hepatic artery mix once inside the liver. _ cells line up around these now connected arteries and veins and pick up chemicals from the blood and modify the blood's composition
Blood from hepatic portal vein (came from digestive tract where stuff has been absorbed) and hepatic artery mix once inside the liver. Hepatic cells line up around these now connected arteries and veins and pick up chemicals from the blood and modify the blood's composition. At the end of the conveyter belt, they empty into _ vein and go to the heart
Glucose is stored as _ in the liver
Glucose is stored as glycogen in the liver. When needed, it's converted into glucose. If you have too much glucose, it's used to make
The liver _ lipids to make energy
Where are lipids made?
Jaundice is caused by an accumulation of what>
What are causes of jaundice?
Excessive destruction of RBCs, liver cells aren't taking enough bilirubin in, bilirubin remains unconjugated, and bile flow is obstructed
The liver converts unconjugated bilirubin into conjugated bilirubin. Bilirubin will attach to a _ and float around.
The liver converts unconjugated bilirubin into conjugated bilirubin. Bilirubin will attach to a albumin and float around. The liver places the bilirubin with another molecule (NOW CONJUGATED), which makes it _ and can then be excreted in bile.
What are 4 things that cause hepatitis?
Viruses, drugs and alcohol, autoimmune disorders, and infectious agents
Is there a cure for viral hepatitis?
What strains of hepatitis virus is there a vaccination for?
A and B
How is Hepatitis A transmitted (how can someone else get it)?
Fecal oral route. Didn't wash hands or drank dirty water
How is Hepatitis E transmitted (how can someone else get it)?
Fecal oral route. Didn't wash hands or drank dirty water
Hepatitis B becomes chronic when mixed with what other viral hepatitits strain?
How is Hepatitis B and D transmitted (how can someone else get it)?
Blood, oral, mother to child, and sexual contact
How is Hepatitis C transmitted (how can someone else get it)?
Blood to blood. Sharing needles
You can have Hep B without Hep D, but can you have Hep D without Hep B?
Hep A and Hep E only cause _ hepatitis
Hep B and Hep C can cause _ and _ hepatitis
Acute and Chronic
You didn't wash your hands after shitting and now a MONTH later you feel sick. You've had a month long INCUBATION period. What Hepatitis do you have?
Hep A: The virus replicates in the liver, is excreted in the bile, and is now is moving thru the digestive system. What's this called?
Hep A: IgM antibodies fight first early in the disease and lats for awhile, but the _ antibodies fight after a month and continue for years
You had sex with someone and now 2-4 MONTHS later you feel sick. You've had a 2-4 month long INCUBATION period. What hepatitis do you have?
Hep B: There's 3 antigens and antibodies from Hep B that serve as markers for us. WHat are they?
HBsAG, HBeAG, and Anti-HBs
Hep B: There's 3 antigens and antibodies from Hep B that serve as markers for us. HBsAG, HBeAG, and Anti-HBs. This one is the earliest to appear and is the most routinely measured
Hep B: There's 3 antigens and antibodies from Hep B that serve as markers for us. HBsAG, HBeAG, and Anti-HBs. This one appears after you've been immunized for Hep B and after HBsAG (the first one to appear and most routinely measured) goes away
Hep B: There's 3 antigens and antibodies from Hep B that serve as markers for us. HBsAG, HBeAG, and Anti-HBs. The presence of this one indicates the Hep B virus is replicating
You've shared a needle with someone and now LESS THAN A MONTH later you feel sick. You INCUBATION period is less than a month. WHat hepatitis do you have?
How can you tell someone has Hep C?
They symptoms get better and then worse repeatedly
In Hep C, ppl's symptoms get really good and bad repeatedly. What do we test for to know the have the disease and their liver is really damaged?
Autoimmune hepatitis: Liver can start to attack it's own hepatocytes (live cells). It's _ and progressive
Disease where you have liver failure from hepatitis that progresses to where you have a coma in 2-3 weeks. These ppl have no chronic liver disease
Acute fulminate hepatits
What's the number 1 cause for Acute Fulminate Hepatitis (Disease where you have liver failure from hepatitis that progresses to where you have a coma in 2-3 weeks. These ppl have no chronic liver disease)?
Having too much acetaminophen (tylenol)
The liver metabolizes drugs in the same way it metabolizes bilirubin: it breaks it down (like RBCs), and then couples it with another substance (after bilirubin has been paired with albumin, it will be paired with something else) to become more _
The liver _ hormones like glucagon, thyroxine, and insulin
The liver breaks acetaminophen down, but leaves a small amount of toxic residue that can be _ and excreted. This is normal and causes no harm in small amounts
Combined with another molecule
To metabolize drugs and break them down, they go down the hepatic portal vein and connected artery which is surrounded by hepatocytes (liver cells) which make _ enzymes
To metabolize drugs and break them down, they go down the hepatic portal vein and connected artery which is surrounded by hepatocytes (liver cells) which make CYP enzymes. What do CYP enzymes do?
There are several different CYP enzymes to deal with different molecules. i.e. one takes care of CO2 while another deals with FeC
The liver breaks acetaminophen down, but leaves a small amount of toxic residue that can be combined with another molecule and excreted. This is normal and causes no harm in small amounts.
HOWEVER, if you take too much _, this toxic residue builds up and can become harmful
Constantly drinking alcohol causes a deficiency of molecule _ which is required for fatty acid synthesis (triglycerides) which are required for energy.
Constantly drinking alcohol causes a deficiency of molecule NAD which is required for fatty acid synthesis (triglycerides) which are required for energy. Break the fatty acid tails of triglycerides down and you have
Constantly drinking alcohol causes a deficiency of molecule NAD which is required for fatty acid synthesis (triglycerides) which are required for energy. If you don't have NAD, triglycerides build up causing
Fatty liver disease
Alcoholic liver disease takes place in 3 stages which are
Steatosis, alcoholic hepatitis, and cirrhosis
Alcoholic liver disease takes place in 3 stages which are steatosis, alcoholic hepatitis, and cirrhosis. In this stage, the liver has fat deposits and is getting bigger. No symptoms and goes away after you stop drinking
Alcoholic liver disease takes place in 3 stages which are steatosis, alcoholic hepatitis, and cirrhosis. In this stage, there's liver inflammation and liver cell failure. Jaundice happens since the liver can't do its job of getting rid of bilirubin due to all the alcohol
Alcoholic liver disease takes place in 3 stages which are steatosis, alcoholic hepatitis, and cirrhosis. In this stage, scar tissue blocks important pathways and the liver can't do it's job. It's end stage liver disease
With Non Alcoholic Fatty Liver Disease, instead of alcohol, the same thing can occur with _ where there's so much of it accumulating and it blocks important pathways and you lose liver function
Steatohepatitis is what?
You have inflammation of the liver because of the huge amounts of fat. Seen in Non Alcoholic Fatty Liver Disease
Who is likely to get Non Alcoholic Fatty Liver Disease?
Ppl with type 2 diabetes and obese
Is liver cirrhosis reversible?
No because the functional hepatocytes have been replaced with scar tissue which have formed bands and cut off important pathways
What are symptoms of early liver cirrhosis?
Your liver is big, weight loss, weakness, pain, and anorexia
What are symptoms of late liver cirrhosis?
Jaundice, liver failure, and portal vein hypertension (portal vein trying to go to liver, but the liver is non functional and resistant so there's a back up and build up of pressure in the vein)
What's portal vein hypertension?
portal vein trying to go to liver, but the liver is non functional and resistant so there's a back up and build up of pressure in the vein
What causes portal vein hypertension?
What happen when there's an obstruction in the portal vein causing portal vein hypertension?
Pressure in the vein increases, organs engorge with blood, and new vessels called shunts form to bypass the liver which is bad since the blood didn't get to be metabolized and detoxified by the liver and yet now it's in general circulation
At what loss of liver function are you considered in liver failure?
If you're in liver failure, what's going to happen?
Anemia, low WBCs, low platelets, bleeding disorders, edema, low cholesterol, jaundice, decreased steroid production so your sexual functions are going to be off, and low blood sugar
What are cholelithiasis?
What are the most common type of gallstones (cholelithiasis) made out of?
If someone doesn't have a gallbladder, can they eat fat since bile salts in bile break fat down?
Yes, but have to eat small amounts of it
Who is most likely to have gallstones (cholelithiasis)?
Obese ppl or women who have had many kids
What are 3 factors to contribute to you getting gallstones (cholelithiasis)?
Abnormalities in the bile (like too much cholesterol which is the most common type of gallstone to get), bile stasis, and inflammation of the gallbladder
If you have acute cholecytitis (gallbladder inflammation), do you have a partial or a total obstruction?
If you have acute cholecytitis (gallbladder inflammation), you have pain. You feel pain after you eat or drink alcohol. Why?
Because gallbladder is trying to do its job, but can't especially since these things require a lot of work
acute cholecytitis (gallbladder inflammation), you have pain. Does pain subside if you move to a different position?
acute cholecytitis (gallbladder inflammation), you have elevated serum levels. i.e. bilirubin levels increase. What would you expect to see then?
Jaundice, vomiting, and fever
Reduction or stoppage of bile flow
What causes cholestasis (reduction or stoppage of bile flow)?
Disorders of the liver, pancreas, or bile duct. If you have stones or hepatits
If you have cholestasis (reduction or stoppage of bile flow), bile accumulates and forms plugs in the bile ducts of the liver. These can rupture and damage liver cells. This liver enzyme can then be released into the blood. We can do a test over this and see that damage is taking place in the hospital
If you have cholestasis (reduction or stoppage of bile flow), you have increased bile salts in the blood and skin instead of being normally released into the small intestine. This can lead to itching. What is this symptom called?
In acute pancreatitis, there's a blockage of the pancreatic duct which leaves _ trapped in the pancreas and they become active and eat the pancreas.
The pancreas makes enzymes for everything that we eat
In acute pancreatitis, there's a blockage of the pancreatic duct which leaves enzymes trapped in the pancreas and they become active and eat the pancreas. You have massive pain and inflammation leads to large volumes of exudate and _ blood volume
In acute pancreatitis, there's a blockage of the pancreatic duct which leaves enzymes trapped in the pancreas and they become active and eat the pancreas. You start to see these enzymes where, which is a red flag that something is wrong?
In the blood
In acute pancreatitis, there's a blockage of the pancreatic duct which leaves enzymes trapped in the pancreas and they become active and eat the pancreas. You start to see these enzymes in the blood. Triglycerides are broken down into _ and the cells that need that fat will die.
In acute pancreatitis, there's a blockage of the pancreatic duct which leaves enzymes trapped in the pancreas and they become active and eat the pancreas. You start to see these enzymes in the blood. Triglycerides are broken down into fatty acids and the cells that need that fat will die.
THEN, calcium will be deposited into these dying cells causing
If you have acute pancreatitis, you have problems controlling your blood _ levels from the damage to the pancreas
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