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Patho Final Study guide chapters 21-24
Terms in this set (21)
What are the characteristics of cirrhosis?
Diffuse scarring of the liver from any substance capable of injuring the liver. Can be caused by: Alcoholic liver disease, Chronic hepatitis, Severe liver necrosis, Repeated liver injury from drugs and chemicals, Longstanding bile duct obstruction. Manifestations: Liver failure, Portal hypertension, Ascites, collateral circulation formation. Inability to inactivate estrogen in males that leads to testicular atrophy, loss of sex drive, breast hypertrophy
What are the characteristics of fatty liver?
Fat accumulates in liver secondary to injury. Common in heavy drinkers and alcoholics but may be caused by chemicals and solvents. Impaired liver function but injury is still reversible
What are the characteristics of hepatitis?
Can be Viral, A, B, C, D, E, Epstein Barr EB, Alcoholic. They are all a virus that attacks the liver.
What are the characteristics of diabetes type I?
Insulin deficiency. Occurs primarily in children & young adults. Results from damage to pancreatic islets leading to reduction or absence of insulin secretion. Often follows a viral infection that destroys the pancreatic islets. Abnormal immune response may play part: production of autoantibodies directed against islet cells. With a hereditary predisposition
Complications of diabetes type I
a. prone to ketoacidosis
b. Response to insulin: normal
c. Response to oral antidiabetic drugs: unresponsive
d. Plasma insulin levels are absent or low.
What are the characteristics of diabetes type II?
Inadequate response to insulin. Typically an adult-onset diabetes. More common than Type 1. Becoming more common in children. Hereditary. Happens usually because of obesity. Islet function is not completely normal as pancreas is not able to increase insulin output to compensate for the insulin resistance
Complications of diabetes type II
a. prone to hyperosmolor nonketotic coma due to marked hyperglycemia
b. Response to insulin: reduced
c. Response to oral antidiabetic drugs: Responsive
d. Plasma insulin levels are normal or high.
What are the characteristics of pancreatitis?
Caused by escaped pancreatic juice from the ducts into the substance of the pancreas, which leads to destruction of the pancreatic acinar and islet tissue activated by pancreatic enzymes, accompanied by acute inflammation of the affected pancreatic tissue. People who drink alcohol are very prone to this and alcohol is a stimulus for pancreatic secretions and it induces spasms. Chronic pancreatitis is repeated episodes of mild acute pancreatitis and each bout destroys some pancreatic tissue leaving scars behind. Eventually enough tissue is destroyed that the person has difficulty digesting and absorbing nutrients because there isn't enough tissue to produce adequate digestive enzymes. Can also lead to diabetes.
a. Patients who drink excessive amounts of alcohol are prone to pancreatitis.
b. Mild episodes are accompanied by abdominal pain and elevated pancreatic enzymes.
c. Each bout destroys some pancreatic tissue.
What causes antibiotic-associated enterocolitis?
Broad-spectrum antibiotics destroy normal intestinal flora
i. Allows growth of anaerobic spore-forming bacteria, Clostridium difficile not inhibited by antibiotic taken
ii. Organisms produce toxins causing inflammation and necrosis of colonic mucosa
iii. Diarrhea, abdominal pain, fever
b. Diagnosis: stool culture, toxin in stool
c. Treatment: stop antibiotic treatment; give vancomycin or metronidazole
i. Drugs that decrease intestinal motility will prolong illness
What causes gastric ulcers?
Digestion of the mucosa by acid gastric juice.
i. Digestion of mucosa due to increased acid secretions and digestive enzymes (gastric acid and pepsin)
ii. Helicobacter pylori injures mucosa directly or through increased acid secretion by gastric mucosa
iii. Common sites: distal stomach or proximal duodenum
Complications of peptic ulcers?
hemorrhage, perforation, peritonitis, obstruction from scarring
Treatment of peptic ulcers?
i. Antacids: block acid secretion by gastric epithelial cells
ii. Antibiotic therapy: against H. pylori
iii. Surgery if medical therapy fails
What are the characteristics of diverticulosis of the colon?
Outpouchings or diverticula of colonic mucosa through weak areas in the muscular wall of large intestine. Low-residue diet predisposes to condition as increased intraluminal pressure must be generated to propel stools through colon. Acquired, usually asymptomatic, seen in older people. Common site: sigmoid colon
a. Low-residue diet predisposes to colon diverticula
b. Ulceration of lining of diverticula caused by fecal material in the diverticula may cause bleeding from the ulcerated diverticulum.
c. Diverticulum may become infected, causing diverticulitis.
What are the characteristics of Crohn disease?
Usually involves primarily the small intestine Chronic inflammation and ulceration of mucosa with thickening and scarring of bowel wall. Inflammation may be scattered with normal intervening areas or "skip areas. Might be genetic condition caused by abnormally regulated immune system that will be present through patients life. Most patients have abdominal pain and diarrhea. It characterized by inflammation in the gastro intestinal tract/digestive tract which includes the mouth, esophagus, stomach, small intestines, large intestines and anal region but Crohn's disease mostly effects the last part of the small intestine, the Ileum.
3 risks factors of Crohn disease?
i. Genetic predisposition
ii. Environmental factors - infections, smoking, antibiotics, NSAIDS
iii. Dysregulated immune response in GI tract causing inflammation.
Treatment: drugs and possible surgical resection of affected part of bowel
Four types of acid-base imbalance
respiratory acidosis, respiratory alkalosis, metabolic acidosis and metabolic alkalosis
increase in carbonic acid. Inefficient excretion of carbon dioxide by lungs.
Is the failure of lungs to excrete carbon dioxide (so retention of CO2), secondary to things like chronic lung disease such as Pulmonary Emphysema
decrease in carbonic acid. Hyperventilation lowers PCO2
Too much oxygen usually happens from severe anxiety.
decrease in bicarbonate. Excess endogenous acid depletes bicarbonate
an increase in the concentration of plasma bicarbonate relative to the concentration of carbonic acid which shifts pH to the alkaline side.
increase in bicarbonate. Excess plasma bicarbonate.
How do the kidneys and the lungs contribute to the acid-base balance of the body?
Lungs: control carbonic acid (H2CO3)concentration
Kidneys: control bicarbonate concentration
Body produces large amts of acid from normal metabolic processes, such as breakdown of proteins and glucose or oxidation of fat. Body fluids remain slightly alkaline. pH is maintained within a narrow range: 7.38 to 7.42. Regulatory mechanisms maintain pH. Neutralize and eliminate the acids as soon as they are produced to maintain normal pH
a. Blood buffers: resist pH change
b. Lungs: control carbonic acid (H2CO3)concentration
c. Kidneys: control bicarbonate concentration
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