1 NR 325 Exam Three Study Guide Hepatobiliary and Pancreas Anomalies and Reproductive and Breast Disorders 1)Hepatitis Inflammation of the liver, must have blood test to diagnosis it Symptoms are flu like, jaundice, dark urine
Labs: AST/ ALT (liver enzymes)
a)Hepatitis A a.Contracted though feces, and orally through physical contact such as eating raw or undercook food, or drinking contaminated water.b.Flu like symptoms c.Vaccine is avaible d.Acute inflammation e.RNA b)Hepatitis B a.Transmission via childbirth, unprotected sex and IV drug abuse b.Linked to liver cancer
c.Test: hbv antigen markers
d.Can be Chronic inflammation e.DNA c)Hepatitis C a.Transmission blood, child birth, Drug abuse, sexually intercourse
b.Gold standard: HCV RNA test, early detection as soon as two weeks after
infection
c.Test: enzyme immunoassay -IgG
d.Can be Chronic inflammation e.RNA d)Hepatitis D a.Needs HBV b.Transmission via the blood, childbirth, unprotected sex and IV drug abuse c.Can be Chronic inflammation 1 / 3
2 d.RNA e)Hepatitis E a.Contracted though feces, and orally through physical contact such as eating raw or undercook food, or drinking contaminated water.b.No vaccine c.Very serious for pregnant women d.Acute inflammation e.RNA 2) Pancreatitis a)Acute a.Acute inflammation of the pancreas b.Most common in middle age men and women, and affect African Americans the most
c.Causes: Gallbladder disease, alcohol intake, smoking, medications
d.Patho: autodigestion of the pancreas
e.CM: abdominal pain LUQ, sudden onset deep pain, worse with eating,
nausea and vomiting, low-grade fever, leukocytosis, hypotension, tachycardia, jaundice, decrease bowel sounds, crackles in lung
f.Greys turner spot: bluish flank discoloration
g.Cullen’s sign: bluish periumbilical discoloration
h.Complications:
Local
i.Pseudocyst: buildup of fluid, enzyme, tissue surround by a wall. Amylase
levels remain elevated ii. abscess : collection of pus
Systemic 1.Pulmonary pneumonia 2.Acute respiratory distress syndrome ARDS
i.Test:
i.The serum amylase level is usually elevated early and remains elevated for 24 to 72 hours.ii.Serum lipase level
j.Diagnostic test:
i.X-ray, CT, ERCP K. Medications:
Dopamine, Morphine, Proton pump inhibitor, Antacids, 2 / 3
3 Chvostek’s sign is contraction of facial muscles in response to a light tap over the facial nerve in front of the ear.Trousseau’s sign is a carpal spasm induced by inflating a blood pressure cuff above the systolic pressure for a few minutes b)Chronic a.Continuous prolonged inflammation of the pancreas
b.Causes: trauma, alcohol use, gallstones, tumor, autoimmune disease
Obstructive pancreatitis inflammation of the sphincter of Oddi in association with cholelithiasis Non obstructive pancreatitis inflammation and sclerosis, mainly in the head of the pancreas and around the pancreatic duct
c.CM: abdominal pain, abdominal tenderness, malabsorption, weight loss,
dark urine, diabetes, fatty stools
d.TEST: serum amylase and lipase may be elevated slightly or not at all,
depending on the degree of pancreatic fibrosis. Serum bilirubin and alkaline phosphatase levels may be increased. There is usually mild leukocytosis and an elevated sedimentation rate.3) Cholecystitis a)Inflammation of the gallbladder b)Can be acute or chronic c)obstruction caused by gallstones or biliary sludge.
d)PATHO: inflammation
e)CM: pain, fever, indigestion, nausea, vomiting, restlessness, URQ tenderness, and rigidity, fat intolerance, heartburn, flatulence, dyspepsia
f)COMPLICATIONS: gangrenous cholecystitis, subphrenic abscess, pancreatitis,
cholangitis
- / 3