Layout of abdomen
Look at picture
Where is pain felt for an appendicitis?
diffuse pain umbilical region –> lower right quadrant
What is a hiatus hernia?
When stomach pushes up through diaphragm
-can contribute to acid reflux
Symptoms of GORD and what can it lead to?
What are risk factors?
Symptoms - Heartburn, regurgitation, may be worse after eating or lying down
Lead to - Can lead to barrets oesophagus - which is where squamous epithelium turns to gastric epithelium in oesophagus (increased risk in men over 50, big bmi and smoking)
- increased risk of adenocarcinoma (smoking, alcohol, diet)
What is pernicious anaemia
Caused by low b12 in the body (can result from antibodies against parietal cells - make IF, inadequate intake, ileal absorption function reduced)
Cure - give b12 intramuscular, supplements
Peptic ulcers - cause and drug names to cure
Symptoms -pain, bleeding, perforation
What do Omeprazole, clarithromycin and amoxycillin in combination treat?
helicobacter pylori- stomach ulcers
Cirrhosis
Ascites
abnormal fluid accumulation in abdomen - can result from portal hypertension (portal vien blockage to liver)
-increase hydrostatic pressure in portal vien - fluid moves out
splenomegaly
enlargement of spleen
can result from portal hypertension
Hep A
Hep B
can get both acute and chronic hepatitis - may lead to cirrhosis
-blood borne
Hep C
Alcoholic liver disease
Non-alcoholic fatty liver disease
Haemochromatosis
excessive accumulation of iron
-genetic defect - excessive iron absorption
AST, ALT
(inside liver) hepatic inflammation, hepatocellular injury viral hepatitis liver toxins/drugs cirrosis
ALP, GGT
Bile blockage (portal tract) - cholestasis (bile cannot flow from liver to gall bladder/duodenum) Gall stones , tumour
Jaundice
yellow coloured skin due to too much bilirubin in blood
albumin and clotting factors
liver is only source
decreases when there is decreased synthesis due to cirrhosis
-increased loss
-illness
both represent that liver not function properly to make these
globulins
reflect inflammation , high levels - chronic hepatitis , cirrhosis
gilberts syndrome
-bilirubin unconjugated, but other liver function tests normal
bilirubin
causes jaundice
biliary obstruction or heptocellular injury
Causes of portal hypertension
pre hepatic - portal vien thrombosis
Hepatic - cirrosis
post hepatic - hepatic vien thrombosis, right sided heart failure