SysPath - Digestive Path 4
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Questions and Answers

Which of the following best describes the primary mechanism by which excessive alcohol consumption leads to alcoholic hepatitis?

  • Alcohol promotes the growth of beneficial gut bacteria, leading to an overstimulation of the immune system and inflammation in the liver.
  • Alcohol increases the liver's production of clotting factors, leading to thrombotic events and liver ischemia.
  • Alcohol directly stimulates bile production, leading to inflammation of the bile ducts and subsequent liver damage.
  • Alcohol is metabolized into toxic byproducts that directly damage hepatocytes, leading to inflammation and impaired liver regeneration. (correct)

A 45-year-old male with a history of heavy alcohol use presents with jaundice, ascites, and right upper quadrant abdominal pain. Which of the following pathological findings would most likely be observed in a liver biopsy?

  • Fatty infiltration (steatosis) and hepatocyte necrosis (correct)
  • Bridging fibrosis with regenerative nodules
  • Granulomatous lesions with central necrosis
  • Bile duct proliferation with ductopenia

According to the information provided, which factor increases a person's risk of developing alcoholic hepatitis, assuming all other variables are constant?

  • Being male and consuming >100g of alcohol daily for 10 years
  • Being female and consuming >100g of alcohol daily for 10 years (correct)
  • Being female and consuming <14g of alcohol daily for 20 years
  • Being male and consuming <14g of alcohol daily for 20 years

What is the most effective treatment for alcoholic hepatitis?

<p>Complete cessation of alcohol consumption (A)</p> Signup and view all the answers

A patient with alcoholic hepatitis has recently stopped drinking alcohol. Which of the following outcomes is most likely?

<p>The liver damage can be semi-reversible and further damage can be prevented. (C)</p> Signup and view all the answers

Which of the following systemic complications is NOT typically associated with continued alcohol use and its effects on the liver?

<p>Pulmonary fibrosis affecting the respiratory system (C)</p> Signup and view all the answers

A client with alcoholic hepatitis is seeking massage therapy. What factor is MOST important in determining the appropriateness of massage for this client?

<p>The severity and nature of the client's presenting symptoms. (D)</p> Signup and view all the answers

What percentage of Hepatitis C cases typically progress to chronic hepatitis?

<p>Approximately 75% (C)</p> Signup and view all the answers

Which of the following statements accurately describes the typical progression and complications of chronic hepatitis?

<p>Chronic hepatitis often presents with mild symptoms initially, with potential progression to cirrhosis, liver failure, or liver cancer over many years. (D)</p> Signup and view all the answers

Portal hypertension, a complication of cirrhosis, can lead to which of the following conditions?

<p>Splenomegaly and ascites (B)</p> Signup and view all the answers

Hepatic encephalopathy, a complication of chronic hepatitis, is MOST commonly associated with cirrhosis caused by which type of hepatitis?

<p>Hepatitis C (B)</p> Signup and view all the answers

A patient with chronic hepatitis caused by long-term use of a specific medication may experience what outcome if the medication is discontinued?

<p>The hepatitis may completely resolve, reducing the risk of further liver damage. (D)</p> Signup and view all the answers

Which diagnostic method is considered essential for a definitive diagnosis of hepatitis, to determine severity and identify the specific cause?

<p>Liver biopsy (A)</p> Signup and view all the answers

Which of the following is the most common cause of chronic hepatitis?

<p>Hepatitis C virus (A)</p> Signup and view all the answers

Which of the following is a potential long-term complication of chronic hepatitis, particularly in cases related to Hepatitis C?

<p>Splenomegaly due to portal hypertension (B)</p> Signup and view all the answers

A client with a history of chronic hepatitis C presents with confusion and cognitive difficulties. This is MOST likely related to:

<p>Hepatic encephalopathy (A)</p> Signup and view all the answers

Unlike Hepatitis C and B, which hepatitis viruses do NOT typically progress to a chronic state?

<p>Hepatitis A and E (A)</p> Signup and view all the answers

A client with chronic hepatitis caused by long-term use of a specific medication is MOST likely to experience what outcome if the medication is discontinued?

<p>Complete resolution of the hepatitis (C)</p> Signup and view all the answers

While lab work can help determine the severity and cause of hepatitis, what diagnostic procedure is ESSENTIAL for a definitive diagnosis?

<p>Liver biopsy (C)</p> Signup and view all the answers

Which of the following signs and symptoms is LEAST likely reported in the early stages of chronic hepatitis?

<p>Jaundice (C)</p> Signup and view all the answers

Co-infection with chronic hepatitis B and which other hepatitis virus is MOST likely to result in cirrhosis?

<p>Hepatitis D (D)</p> Signup and view all the answers

Which of the following explains why females are at a higher risk of developing alcoholic hepatitis compared to males?

<p>Females have lower levels of alcohol dehydrogenase, leading to higher blood alcohol concentrations. (A)</p> Signup and view all the answers

A patient presents with anorexia, jaundice, and ascites. Based on the information, which of the following underlying conditions is MOST likely?

<p>Alcoholic hepatitis (A)</p> Signup and view all the answers

A liver biopsy of a patient with suspected alcoholic hepatitis reveals steatosis. Which pathological process describes steatosis?

<p>Fatty appearance of hepatocytes due to focal necrosis. (A)</p> Signup and view all the answers

A 45-year-old patient with a history of heavy alcohol use (>100g daily for 20 years) is diagnosed with alcoholic hepatitis. What is the most effective treatment to manage the underlying cause of their condition?

<p>Complete and sustained abstinence from alcohol. (B)</p> Signup and view all the answers

Considering the long-term effects of alcohol on the liver, which of the following outcomes is MOST likely to improve with sustained alcohol cessation?

<p>Reduced risk of further liver damage. (B)</p> Signup and view all the answers

What is the primary characteristic of cirrhosis?

<p>Irreversible replacement of normal liver tissue with non-functional scar tissue. (C)</p> Signup and view all the answers

Which of the following complications is directly associated with portal hypertension caused by cirrhosis?

<p>Esophageal varices (C)</p> Signup and view all the answers

What is the MOST common composition of gallstones in individuals with cholelithiasis?

<p>Cholesterol (A)</p> Signup and view all the answers

A patient presents with colicky RUQ pain that radiates to the right shoulder, increasing over 15 minutes and plateauing for 30-60 minutes. Which condition is MOST likely?

<p>Cholelithiasis (C)</p> Signup and view all the answers

Why is massage contraindicated when a patient presents with symptoms of cholelithiasis obstruction, such as nausea, vomiting, and colicky RUQ pain?

<p>Massage may worsen the obstruction and increase discomfort. (D)</p> Signup and view all the answers

What is the PRIMARY mechanism behind acute cholecystitis caused by gallstones?

<p>Blockage of the cystic duct by gallstones causes inflammation of the gallbladder. (C)</p> Signup and view all the answers

A patient with a history of biliary colic presents with severe, steady pain in the RUQ, fever, and a positive Murphy’s sign. Which condition is MOST likely?

<p>Acute cholecystitis (B)</p> Signup and view all the answers

Why is massage absolutely contraindicated for a patient experiencing acute cholecystitis?

<p>It can exacerbate the inflammatory response and potentially lead to complications. (D)</p> Signup and view all the answers

Which diagnostic finding is MOST indicative of Primary Biliary Cholangitis (PBC)?

<p>Positive anti-mitochondrial antibodies (AMA) (D)</p> Signup and view all the answers

What is the PRIMARY goal of treatment for Primary Sclerosing Cholangitis (PSC)?

<p>To slow disease progression, manage symptoms, and prevent complications. (B)</p> Signup and view all the answers

In acute pancreatitis, what is the MOST common cause?

<p>Gallstones (A)</p> Signup and view all the answers

A patient presents with severe epigastric pain radiating to the back, nausea, vomiting, and elevated serum lipase and amylase levels. What condition is MOST likely?

<p>Pancreatitis (D)</p> Signup and view all the answers

Why is acute pancreatitis an absolute contraindication for massage therapy?

<p>Massage may increase the risk of pancreatic enzyme release into the bloodstream. (D)</p> Signup and view all the answers

The dysfunction of which protein is central to the pathophysiology of cystic fibrosis?

<p>CFTR (Cystic Fibrosis Transmembrane Conductance Regulator) (C)</p> Signup and view all the answers

What symptom is MOST commonly an early indication of pancreatic carcinoma?

<p>Jaundice (D)</p> Signup and view all the answers

Why is screening for Hepatocellular Carcinoma (HCC) recommended annually for individuals with chronic hepatitis B but only when hepatitis C has progressed to cirrhosis?

<p>The risk of developing HCC is higher in chronic hepatitis B patients compared to those with hepatitis C, unless cirrhosis is present. (A)</p> Signup and view all the answers

What is the primary goal of antiviral drug treatment in patients with chronic, progressive hepatitis B and C?

<p>To stop inflammation and prevent further liver damage, although the virus may not be completely eliminated. (D)</p> Signup and view all the answers

What is the most crucial intervention for managing Metabolic dysfunction–Associated Steatotic Liver Disease (MASLD)?

<p>Implementing a comprehensive weight loss strategy, including dietary changes and exercise. (A)</p> Signup and view all the answers

What is the 'two-hit' model in the pathophysiology of Metabolic dysfunction–Associated Steatohepatitis (MASH)?

<p>Hepatic fat accumulation followed by increased oxidative stress and lipid peroxidation (D)</p> Signup and view all the answers

Why does Hepatocellular Carcinoma (HCC) often have a poor prognosis?

<p>Early detection and treatment are hindered by the vague nature of the symptoms, leading to late-stage diagnosis. (D)</p> Signup and view all the answers

In the context of chronic hepatitis B, why might antiviral treatment need to be indefinite in approximately 5% of cases?

<p>The virus tends to recur once drug therapy ends, necessitating ongoing treatment to prevent further liver damage. (A)</p> Signup and view all the answers

What is the primary reason for recommending hepatitis B vaccination and immunoglobulin for family members and close contacts of individuals with hepatitis B?

<p>To prevent transmission of the virus and provide both immediate and long-term protection. (B)</p> Signup and view all the answers

What is the significance of recognizing cardiovascular disease as a frequent cause of death in individuals with Metabolic dysfunction–Associated Steatohepatitis (MASH)?

<p>It underscores the need for comprehensive management of metabolic risk factors beyond just liver health. (D)</p> Signup and view all the answers

What is the clinical significance of distinguishing between simple hepatic steatosis (NAFLD) and Metabolic dysfunction–Associated Steatohepatitis (MASH)?

<p>MASH carries a significant risk of progressing to cirrhosis, while simple steatosis has little clinical relevance. (B)</p> Signup and view all the answers

In the context of Hepatocellular Carcinoma (HCC), what does 'tumor embolization' involve, and what is its purpose?

<p>Blocking the blood supply to the tumor to cause its death and prevent further growth. (C)</p> Signup and view all the answers

How does the presence of cirrhosis affect the approach to managing and screening for Hepatocellular Carcinoma (HCC)?

<p>Cirrhosis increases the risk of HCC, necessitating regular screening and surveillance. (A)</p> Signup and view all the answers

What distinguishes metastatic liver cancer from Hepatocellular Carcinoma (HCC)?

<p>Metastatic liver cancer is far more common than HCC and originates from other primary sites. (A)</p> Signup and view all the answers

A client with Metabolic dysfunction–Associated Steatotic Liver Disease (MASLD) is seeking massage therapy. Which of the following considerations is MOST important for the massage therapist?

<p>Determining the appropriateness of massage based on the client’s symptoms and overall health status. (C)</p> Signup and view all the answers

According to the information provided, what is the recommendation regarding massage therapy for clients with chronic hepatitis, Metabolic dysfunction–Associated Steatotic Liver Disease (MASLD), or Hepatocellular Carcinoma (HCC)?

<p>There are no general contraindications, and the appropriateness of massage is determined by the client's symptoms. (D)</p> Signup and view all the answers

A client with a history of cirrhosis is undergoing screening for Hepatocellular Carcinoma (HCC). Which diagnostic method is MOST likely to be used for initial screening?

<p>Advanced imaging techniques such as ultrasound, CT scan, or MRI to visualize the liver and detect any abnormalities. (C)</p> Signup and view all the answers

A client with chronic hepatitis B is undergoing antiviral treatment. Which statement is most accurate regarding the expected outcome of this treatment?

<p>Antiviral treatment can effectively manage the disease, but recurrence is common once the treatment is stopped in most cases. (C)</p> Signup and view all the answers

A patient is diagnosed with Metabolic dysfunction–associated steatohepatitis (MASH). Which of the following pathological findings is most indicative of the early stages of this condition?

<p>Hepatocyte ballooning, lobular inflammation, and steatosis. (A)</p> Signup and view all the answers

A patient with Metabolic dysfunction–associated steatohepatitis (MASH) also has several other health conditions. Which of the following is the most common cause of mortality in individuals with MASH?

<p>Cardiovascular disease (C)</p> Signup and view all the answers

A patient is diagnosed with hepatocellular carcinoma (HCC) secondary to cirrhosis. What is the most significant factor contributing to the poor prognosis associated with HCC?

<p>Late-stage diagnosis due to vague and nonspecific symptoms. (D)</p> Signup and view all the answers

A client with chronic hepatitis C has developed cirrhosis. According to the provided information, what screening protocol should this client undergo?

<p>Annual ultrasound and blood work. (C)</p> Signup and view all the answers

A patient is diagnosed with Metabolic dysfunction–associated steatotic liver disease (MASLD). What is the most critical initial treatment recommendation for this patient?

<p>Weight loss through diet and exercise. (D)</p> Signup and view all the answers

A client with a history of chronic hepatitis B is considering massage therapy. Which of the following considerations is most important for determining the appropriateness of massage?

<p>The client's current symptoms and overall health status. (B)</p> Signup and view all the answers

A patient with Metabolic dysfunction–associated steatohepatitis (MASH) asks about the underlying cause of their condition. What pathophysiological explanation is most accurate for MASH?

<p>Hepatic fat accumulation and increased oxidative stress. (A)</p> Signup and view all the answers

A patient diagnosed with hepatocellular carcinoma (HCC) asks about preventative measures for their family. Which of the following interventions is most relevant for preventing HCC in at-risk individuals?

<p>Hepatitis B vaccination and treatment of chronic hepatitis C. (A)</p> Signup and view all the answers

A client with a history of heavy alcohol use has been diagnosed with cirrhosis and now presents with new onset abdominal pain, fever, and weight loss. Which of the following conditions should be the primary concern?

<p>Hepatocellular carcinoma (HCC). (D)</p> Signup and view all the answers

Which of the following statements best describes the relevance of liver biopsy in the context of chronic hepatitis?

<p>Liver biopsy helps confirm the severity and cause of the disease process. (B)</p> Signup and view all the answers

A client with a history of Metabolic dysfunction–associated steatohepatitis (MASH) is also being treated for hypertension and hyperlipidemia. Which treatment modification would be most appropriate for managing MASH in this client?

<p>Consult with the prescribing physician regarding medications to reduce cholesterol or blood pressure. (D)</p> Signup and view all the answers

A massage therapist is working with a client who has a history of hepatocellular carcinoma (HCC). What is the most important consideration for the therapist when planning the massage session?

<p>Modifying the massage based on the client's symptoms and overall health status. (C)</p> Signup and view all the answers

Which of the following factors is most strongly associated with the development of Metabolic dysfunction–associated steatohepatitis (MASH)?

<p>Obesity and metabolic syndrome. (A)</p> Signup and view all the answers

A patient with chronic hepatitis B is seeking advice on how to prevent transmission to family members. Which of the following measures is the most effective?

<p>Family members and close contacts should receive the hepatitis B vaccine and immunoglobulin. (C)</p> Signup and view all the answers

A patient presents with severe RUQ pain, nausea, vomiting and a positive Murphy's sign. Ultrasound reveals a thickened gallbladder wall and fluid accumulation. Which condition is MOST likely indicated by these findings?

<p>Acute cholecystitis secondary to gallstones (D)</p> Signup and view all the answers

A 55-year-old female presents with fatigue, pruritus, and jaundice. Blood tests reveal elevated liver enzymes and anti-mitochondrial antibodies (AMA). Imaging shows inflammation of the bile ducts. Which of the following is the MOST likely diagnosis?

<p>Primary biliary cholangitis (A)</p> Signup and view all the answers

A 48-year-old male with a history of heavy alcohol use presents with severe epigastric pain radiating to the back, along with nausea and vomiting. Which lab findings would MOST strongly support a diagnosis of acute pancreatitis?

<p>Elevated serum lipase and amylase (B)</p> Signup and view all the answers

A 10-year-old child is diagnosed with cystic fibrosis. What is the underlying mechanism that leads to the various complications associated with this disease?

<p>A genetic defect causing dysfunction of chloride channels, resulting in thick mucus production. (A)</p> Signup and view all the answers

A 60-year-old patient presents with insidious onset of epigastric pain, jaundice, and unexplained weight loss. Which diagnostic imaging modality is MOST appropriate as an initial step to evaluate for potential pancreatic carcinoma?

<p>CT scan of the abdomen (C)</p> Signup and view all the answers

What is the primary difference between the etiology of acute versus chronic pancreatitis?

<p>Acute is most commonly caused by gallstones, chronic by alcohol. (D)</p> Signup and view all the answers

A patient with cholelithiasis is experiencing colicky RUQ pain, nausea, and vomiting. What massage considerations are MOST appropriate?

<p>Massage is locally contraindicated if symptoms of obstruction are present. (B)</p> Signup and view all the answers

A patient with chronic cholecystitis is MOST likely to present with which pathological change in their gallbladder?

<p>Thick-walled, scarred, and small gallbladder (A)</p> Signup and view all the answers

Ursodeoxycholic acid (UDCA) is a common treatment for which biliary condition, and what is its primary mechanism of action?

<p>Primary biliary cholangitis; helps move bile through the liver and reduces scarring (D)</p> Signup and view all the answers

Which of the following is the MOST significant risk factor for developing carcinoma of the pancreas?

<p>Smoking (A)</p> Signup and view all the answers

What is the MOST common early symptom of pancreatic carcinoma that prompts patients to seek medical attention?

<p>Jaundice (A)</p> Signup and view all the answers

A patient presents with signs and symptoms indicative of acute pancreatitis. What is the MOST important initial step in their treatment?

<p>Fasting, IV fluids, analgesics, and antiemetics (D)</p> Signup and view all the answers

What is the underlying cause of the complications associated with Primary Sclerosing Cholangitis (PSC)?

<p>Inflammation and scarring of the bile ducts cause narrowing, leading to liver damage. (D)</p> Signup and view all the answers

A 45-year-old male presents with fatigue, itching, and jaundice. Imaging reveals beading of the bile ducts. Given this information, which condition is MOST likely?

<p>Primary sclerosing cholangitis (A)</p> Signup and view all the answers

Why are massage therapists advised to avoid seeing patients with cystic fibrosis when they (the therapist) are ill?

<p>Ill therapists pose a high risk of transmitting respiratory infections to CF patients. (C)</p> Signup and view all the answers

Flashcards

Alcoholic Hepatitis

Liver inflammation caused by excessive alcohol intake over time.

Alcoholic Hepatitis Risk Factors

Females are at higher risk; heavy drinkers may show symptoms in their 30s and severe problems by their 40s.

Alcoholic Hepatitis: Pathology

Fatty liver (steatosis) due to hepatocyte necrosis, reversible with stopping alcohol intake.

Alcoholic Hepatitis: Symptoms

Loss of appetite, jaundice, right upper quadrant/epigastric pain, ascites, and tender hepatomegaly.

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Alcoholic Hepatitis: Treatment

Only effective treatment is stopping alcohol consumption; liver transplant if necessary.

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Chronic Hepatitis

Liver inflammation lasting longer than 6 months, commonly caused by hepatitis B and C viruses.

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Most Common Cause of Chronic Hepatitis

Hepatitis C is responsible for 60-70% of chronic hepatitis cases.

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Symptoms of Chronic Hepatitis

Low-grade fever and RUQ discomfort. Jaundice appears much later.

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Complications of Portal Hypertension

Splenomegaly (enlarged spleen), ascites (abdominal fluid), spider angioma, caput medusae.

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Hepatic Encephalopathy

Deterioration of peripheral nervous system and brain function due to increased serum toxins.

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Potential Outcomes of Untreated Chronic Hepatitis

Cirrhosis, liver failure, and liver cancer.

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Diagnosis of Chronic Hepatitis

Biopsy is essential for definitive diagnosis.

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Massage and Alcoholic Hepatitis

Massage appropriateness determined by the patient’s symptoms.

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Liver Biopsy in Hepatitis

Confirms disease severity and cause in chronic hepatitis.

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Chronic Hep B Screening

Annual ultrasound and blood work for liver cancer screening.

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Chronic Hep C Screening

Screen only if cirrhosis has developed.

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Massage for Chronic Hepatitis

Focus on alleviating patient's discomfort and symptoms.

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MASLD Definition

Fatty liver in the absence of significant alcohol consumption.

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MASH Pathologic Findings

Hepatocyte ballooning, inflammation, and steatosis.

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MASH Pathophysiology

Hepatic fat accumulation and increased oxidative stress.

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MASH Treatment

Weight loss, cholesterol control, blood pressure management, diabetes control, limit OTC drugs, avoid alcohol.

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Massage and MASLD

Determine appropriateness based on patient symptoms.

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Hepatocellular Carcinoma (HCC)

Most common primary liver tumor, often caused by cirrhosis.

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HCC Early Signs

Abdominal pain, fever, weight loss, palpable mass in RUQ.

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HCC Prevention

Hepatitis B vaccine, treatment of Hep C, alcoholism programs, screening.

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HCC Treatment Options

Chemotherapy, radiation, tumor embolization, surgical resection, transplant.

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HCC Prognosis

Vague symptoms lead to late diagnosis and poor prognosis. Low 5 year survival rate.

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Massage and HCC

Determine appropriateness based on patient's symptoms.

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Cirrhosis

Irreversible replacement of normal liver tissue with non-functional scar tissue.

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Cholelithiasis (Gallstones)

Collections of solid material in the gallbladder.

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Cholecystitis

Inflammation of the gallbladder, often due to gallstones.

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Primary Biliary Cholangitis (PBC)

Autoimmune disease causing inflammation and destruction of bile ducts within the liver.

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Primary Sclerosing Cholangitis (PSC)

Inflammatory disease causing scarring and narrowing of bile ducts (intra and extrahepatic).

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Pancreatitis

Inflammation of the pancreas where digestive enzymes activate within the pancreas.

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Cystic Fibrosis (CF)

Multisystem genetic disorder causing thick mucus buildup, affecting lungs, pancreas, and other organs.

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Pancreatic Carcinoma

Malignant tumors of the pancreas, most commonly adenocarcinomas.

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Acute Cholecystitis Pain

Sudden, severe pain in the RUQ, often caused by gallstones.

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Chronic Cholecystitis

Chronic inflammation of gallbladder with repeated attacks of biliary colic.

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Pancreatitis Pain

Severe epigastric and LUQ pain that often radiates to the back.

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Antibody Serology

A test done to check for anti-mitochondrial antibodies (AMA) which are very common in PBC.

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Sweat Test

High chloride levels in sweat is an indication of diagnosis of cystic fibrosis.

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Whipple Procedure

Removal of the head of the pancreas, the duodenum, gallbladder and bile duct for pancreatic cancer.

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Grey Turner Sign

Bruising along the flank d/t retroperitoneal bleeding.

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Alcoholic Hepatitis Definition

Inflammation of the liver caused by long-term, excessive drinking.

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Alcohol's Effect on Liver

Damage to liver cells due to alcohol toxicity, causing inflammation.

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Alcoholic Hepatitis Amount

Greater than 100g daily for > 20 years

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Histological Finding in AH

Fatty liver appearance due to hepatocyte necrosis, reversible if alcohol stops.

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Most Effective Treatment

Stopping alcohol consumption is the most effective.

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Chronic Hepatitis: Definition

Liver inflammation lasting over 6 months; often due to hepatitis B, C, or certain medications.

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Complications of Chronic Hepatitis

Cirrhosis leading to portal hypertension, splenomegaly, ascites, spider angioma, caput medusae, and hepatic encephalopathy.

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Ascites

Fluid accumulation in the abdominal cavity due to portal hypertension.

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Potential Outcomes of Chronic Hepatitis

Continued inflammation can result in cirrhosis, liver failure, and/or liver cancer.

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Chronic Hepatitis Treatment

Eliminate cause, antiviral drugs (PO or SQ), corticosteroids, or liver transplant in advanced cases.

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Antiviral efficacy in Hepatitis

SQ injections are most effective for Hep C, stopping inflammation. 45-75% improve in 6-12 months.

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Chronic Hepatitis B Screening

Those with chronic hep B require annual ultrasound and blood work to screen for liver CA.

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Preventative care for Hep B

Family and close contacts should receive vaccine and immunoglobulin.

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Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD)

Previously nonalcoholic fatty liver disease (NAFLD); steatosis in the absence of significant alcohol consumption

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Forms of MASLD

Simple hepatic steatosis (NAFLD) and Metabolic dysfunction–associated steatohepatitis (MASH).

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Metabolic dysfunction–associated steatohepatitis (MASH)

Formerly known as Non-alcoholic steatohepatitis (NASH), progresses to cirrhosis in 10-20% of cases

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MASH Associations

Obesity and metabolic syndrome.

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MASH Symptoms

Usually asymptomatic until overt hepatic failure; fatigue and RUQ pain can occur. Increased risk of hepatocellular carcinoma

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Hepatocellular Carcinoma (HCC) Symptoms

Vague abdominal pain, fatigue, loss of weight and appetite which cause late stage Dx and poor prognosis

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Hepatocellular Carcinoma (HCC) Diagnosis

Blood tests, physical exam looking for palpable liver mass, advanced imaging (US, CT, MRI), Biopsy to confirm unclear cases

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Hepatocellular Carcinoma (HCC) Treatment

Chemotherapy, radiation, and tumor embolization. Surgical resection with high recurrence. Transplant if no metastasis.

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Massage and Chronic Hepatitis

Determined by patient’s symptoms; no general contraindications.

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Massage and Hepatocellular Carcinoma

Determined by patient’s symptoms; no general contraindications.

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Cirrhosis Definition

Irreversible damage to the liver, replaced by non-functional scar tissue.

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Portal hypertension

High blood pressure in the portal vein system due to liver cirrhosis.

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Esophageal Varices

Swollen veins in the esophagus due to portal hypertension, which can lead to severe bleeding.

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Cholecystitis Definition

Inflammation of the gallbladder

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Cholecystitis Etiology

Gallstones block the cystic duct, causing inflammation of the gallbladder

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Primary Biliary Cholangitis

Autoimmune destruction of bile ducts in the liver.

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Primary Sclerosing Cholangitis

Inflammatory disease causing scarring and narrowing of bile ducts (intra and extrahepatic).

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