Week 5 knowledge check:
Gastrointestinal and Hepatobiliary
Disorders
hepatitis markers - correct answer ✔IgG: G=gone (infection is gone)
IgM: M=antibody made Minute infected (acute infection)
HBsAg: hep B surface antigen = infection
Anti-HBs: hep B surface antibody = immunity
after HP shots - correct answer ✔
gastroesophageal reflux disease (GERD) - correct answer ✔-backflow of
contents of the stomach into the esophagus, often resulting from abnormal
function of the lower esophageal sphincter, causing burning pain in the
esophagus
-risk: obesity, hiatal hernia, drugs/chemicals that relax the LES
(Anticholinergics, nitrates, calcium channel blockers, nicotine), delayed gastric
emptying (Gastroparesis, ulcers)
-s/sx: pain after 1 hr fo eating, worse pain if lies down or ABD pressure
increase r/t coughing, vomiting, straining
-dx: esophageal endoscopy, tissue biopsy to assess dysplastic changes
-tx: PPIs, weight loss, smoking cessation, elevate head, no tight clothing
pancreatitis - correct answer ✔-between ages 50-60, more in blacks
-risk: Obstructive binary tract disease, alcoholism, peptic ulcers,
hyperlipidemia, smoking and genetics
,-acute and chronic
Acute live failure - correct answer ✔-very rare, from severe impairment of
liver cells without preexisting liver disease or cirrhosis
-Acetaminophen is leading cause
-death of hepatocytes may be viral or toxic injury
-will develop 6-8 weeks after viral hepatitis or 5 days to 8 weeks after
acetaminophen OD
-elevated conjugated and unconjugated bilirubin
chronic liver failure - correct answer ✔
gall bladder disease - correct answer ✔-includes inflammation, infection,
stones, or obstruction of the gallbladder
-UQ abd pain
-Cholelithiasis=gallstone
-Cholecystitis=inflammation of the gallbladder
diverticulitis - correct answer ✔-inflammation of the diverticula
-predisposing factors: older age, genetics, obesity, smoking, ASA/NSAIDs
-can occur anywhere in the GI tract
-s/sx: pain in lower ABD, diarrhea
tx: ultrasound, sigmoidoscopy, colonoscopy, increase fiber intake to increase
stool weight to lower colonic pressures
, jaundice - correct answer ✔-yellow pigmentation of the skin caused by
hyperbilirubemia (>2.5-3)
-cause: obstruction to bile flow (gallstones), intrahepatic obstruction
(Cirrhosis), excessive hemolysis of RBCs
bilirubin - correct answer ✔orange-yellow pigment in bile; formed by the
breakdown of hemoglobin when red blood cells are destroyed
upper GI bleed - correct answer ✔-in the esophagus, stomach, duodenum
-frank, bright red blood
-causes: Bleeding esophageal or gastric varies, a Mallory-Weiss tear at the
esophageal-gastric junction on , NSAIDs, ASA,
lower GI bleed - correct answer ✔-bleeding from the jejunum or ileum of the
small intestine, colon, rectum
-causes: polyps, IBD, diverticular disease
hectic encephalopathy - correct answer ✔-neurologic syndrome, impaired
behavioral, cognitive and motor function
-3 types: Type A (rapidly during acute fulminant hepatitis), Type B (after
portosystemic bypass or shunting w/out liver dx) and type C (slowly with
cirrhosis)
-combo of biochemical and neurotransmission alterations, Free neurotoxins
going to brian
-most hazard is Ammonia which is the end products of intestinal protein
digestion
-s/sx: memory loss, irritability, lethargy
