Phys Patho lecture 4-8 part C

Coffee ground emesis

Blood from stomach mixed with chyme, resembles coffee ground

Melena

Black tarry stool

Occult blood

not seen by the naked eye in stool or urine, but detectable by chemical tests.

Hematemesis

blood in vomit —> looks red not touched by anything in the stomach

Hematachezia

passage of fresh red blood from the rectum—> RED

Esophageal disorders

• Dysphagia

• Esophageal diverticulum

• Esophageal tear

• GERD

Acid secretion stimuli

• Gastrin

• Histamine

• Vagus nerve (cholinergic) ach

GERD

Gastroesophageal reflux disease, a chronic condition where stomach acid flows back into the esophagus, causing heartburn and potential damage.

Sphincter not as contracted

• decreased esophageal tone

• decreased salivation

• impaired esophageal clearance

• Impaired tissue resistance

• Delayed gastric emptying

Barrets esophagus

change in squamous to columnar epithelium. Increase risk of cancer in esophagus

Peptic Ulcer disorder

a condition where stomach acid creates open sores in the lining of the stomach or the first part of the small intestine. It can be caused by H. pylori infection or prolonged use of NSAIDs.

Stress Ulcers

caused by trauma such as burns, surgery, or severe illness. These ulcers occur due to a decrease in blood flow to the stomach lining, resulting in erosion and inflammation.

Acidosis, decreased motility, bile salts (Increased alkaline not good)

Crohns disease

• Deep in submucosa

• skips areas (lesions)

• ileum, colon

• diarrhea common

• rectal bleeding rare

• fistulas common

• strictures common

• perineal abscess common

Risk for cancer rare

Ulcerative colitis

• Inflammation ulcerative

• mucosal level and has pseudopolyps

• continuous lesion

• rectal and left colon

• diarrhea common

• rectal bleeding common

• fistuals rare

• strictures rare

• perineal abscess rare

Risk for cancer common

Bilirubin

break down of heme, causes Jaundice akA Icterus

Tests for Hepatobiliary function

Increased ALT

Increase AST

Increase gamma glutamyltransferase

increased alkaline phosphate

Serum Protein levels

aka Albumin. If low prognosis bad and may indicate liver dysfunction or chronic disease.

Prothrombin time

how long it takes for blood to clot. If high bad

Hep A and E

Enteric (FECAL ORAL)

Hep B, C, D

parenteral (through bodily fluids) and can lead to chronic liver infection and increased risk of liver cirrhosis or cancer.

Hep D

CANNOT survive on its own without Hep B

Acute hepatitis Phases

1. Prodromal or preicterus period = No jaundice

2. Icterus = Jaundice present

3. convalescent period = better

Hep B, C, D

one may carry but show no symptoms and infect others

Cirrhosis

a late stage of scarring (fibrosis) of the liver caused by many forms of liver diseases and conditions, such as hepatitis and chronic alcoholism. NOT REVERSIBLE

Acetyladehyde

Toxic to liver

Portal hypertension

increased blood pressure in the portal venous system, often resulting from liver cirrhosis.

splenomegaly

enlargement of the spleen due to increased pressure in the portal venous system, often associated with liver diseases such as cirrhosis. can lead to anemia, leukopenia, thrombocytopenia

Portosystemic shunting of blood

can cause :

1. Hemrrhoids due to collateral channels

2. Ammonia toxicity —→ hepatic encephalopathy

Ascites

increase in fluid in peritonea cavity resulting from portal hypertension or liver dysfunction.

Aldosterone

A steroid hormone produced by the adrenal glands that helps regulate sodium and potassium levels, influencing blood pressure and fluid balance.

Esophageal Varices

enlarged veins in the esophagus that occur due to increased pressure in the portal venous system, often leading to life-threatening bleeding.

Can cause “back up” flow into the esophagus creating thin walled varicosities in Submucosa

Hepatic encephalopathy

failing liver no metabolizing ammonia (nitrogenous waste) causing neurotoxicity in CNS

Cholelithiasis

Gall stones causing acute pancreatitis associated with alcohol abuse and cause hyperglycemia