Hepatobiliary 2

Question 1

acute (hemorrhagic) pancreatitis

Answer 1

• disease of exocrine pancreas
• occurs after large meal or excess alcohol consumption
• 35-60% have gallstones

Question 2

prognosis of acute pancreatitis

Answer 2

• most recover completely (5% mortality)

- rare severe chemical peritonitis and shock may lead to ARDS

Question 3

Where is 60% of carcinoma of the pancreas?

Answer 3

head of pancreas

Question 4

courvoisier law

Answer 4

painless enlargement of gallbladder w/ jaundice likely due to pancreatic head carcinoma (not stone in common bile duct)

Question 5

Trousseau sign

Answer 5

• complication of pancreas carcinoma
• migratory thromboplebitis
• 10% of patients

Question 6

Diabetes Mellitus Type I names

Answer 6

• Insulin Dependent
• IDDM
• Juvenile
• Ketosis prone

Question 7

Diabetes Mellitus Type 1

Answer 7

5-10% of cases

• failure of insulin synthesis
• depletion of Beta Cells
• Abrupt onset
• carb intolerance
• hyperglycemia
• ketoacidosis

Question 8

Diabetes Mellitus Type 2

Answer 8

non-insulin-dependent
NIDDM
adult onset
ketosis resistant

Question 9

Diabetes Mellitus type 2

Answer 9

90-95% of cases
failure to respond to insulin
-increased insulin resistance or deranged insulin secretion
-most central obesity + onset after 40
-not prone to ketoacidosis

Question 10

Diabetes Type 2 and insulin

Answer 10

• mild to mod insulin deficiency
• delayed or inadequate insulin secretion may develop
• insulin resistance (impaired ability to react to circulating insulin; decrease in number of cell surface insulin receptors)

Question 11

Which type of diabetes has hyperglycemia more often?

Answer 11

Diabetes type 2 has hyperglycemia 5x more often

Question 12

Which diabetes is ketoacidosis unusual?

Answer 12

Diabetes Type 2 (Stress or surgery)

Question 13

Predisposing factors of both diabetes

Answer 13

obesity
pregnancy
trauma
infections
stress

Question 14

clinical features of both diabetes

Answer 14

polydypsia
polyuria
polyphagia
weight loss
muscle weakness

Question 15

late complications of diabetes

Answer 15

cardiovascular atherosclerosis and arteriosclerosis (more severe and extensive than non-diabetics of the same age + gender)

Question 16

In diabetes, athersclerosis + arteriosclerosis involve microvasculature of what 3 organs?

Answer 16

brain, heart, kidney

Question 17

Late complications of diabetes after atherosclerosis + arteriosclerosis

Answer 17

stroke
myocardial infarction
gangrene of extremities, especially toes
nephron ischemia

Question 18

What is the most common cause of end stage renal disease? **

Answer 18

DIABETES

Question 19

Bacterial + Fungal infections

Answer 19

• late complication of diabetes
• poor blood supply due to vasculature disease
• phagocytosis + bacterial activity of neutrophils impaired

Question 20

Late complication of diabetes of the skin, mucosal, bone, UTI

Answer 20

follicular infections, boils, candidiasis, cellulitis, erysipelas

Question 21

pneumonia, klebsiella pneumonia, sinus mucormycosis, pseudomonas aeruginosa, chronic osteomyelitis

Answer 21

Late complication of diabetes of the skin, mucosal, bone, UTI

Question 22

acute pyelonephritis + recurrent lower UTI

Answer 22

Late complication of diabetes of the skin, mucosal, bone, UTI

Question 23

Kimmelstiel Wilson Syndrome

Answer 23

intercapillary, nodular glomerulosclerosis w/ hypertension + edema lead to proteinuria
-onset 20 yrs post diabetes

Question 24

long term complications of diabetes

Answer 24

1 cerebrovascular disease
2 diabetetic retinopathy, cataracts glaucoma
3 ischemic heart disease
4 diabetic nephropathy

Question 25

``` 1 severe atherosclerosis 2 peripheral neuropathy w/ trophic ulceration 3 necrobiosis lipoidica 4 skin infections 5 ischemia of lower limbs (gangrene) ```

Answer 25

long term complications of diabetes

Question 26

Oral manifestations of diabetes usually associated with which type of diabetes?

Answer 26

diabetes type 1

Question 27

Sialadenosis (enlargement of parotid)

Answer 27

Oral manifestations of BOTH types of diabetes

Question 28

more prone to these oral infections during diabetes

Answer 28

- bacterial (gingivitis +periodontitis) | - fungal (candidiasis, asperigillosis + mucormycosis)

Question 29

impaired wound healing during in oral cavity during diabetes

Answer 29

- more likely to have advanced periodontal disease | - more likely to have complications after surgery (tooth extraction)

Question 30

enlargement of erythema of gingiva + some xerostomia are oral manifestation in what disease?

Answer 30

diabetes

Question 31

marasmus (withering)

Answer 31

- severe malnutrition or emanciation resulting from inadequate calorie intake (esp young children) - failure to thrive, loss of subcutaneous fat, muscle wasting - no edema

Question 32

kwashiorker

Answer 32

- Ghanaese for "red boy" | - inadequate protein intake despite adequate calorie intake

Question 33

iron deficiency anemia

Answer 33

- hypocromic microcytic anemia | - atrophy of tongue and gastric mucosa