PATH 370 Quiz #5
PATH 370 Quiz #5
Study online at https://quizlet.com/_d045fy
1. type 2 diabetes most common form of DM
mellitus
insulin resistance and beta cell dysfunction lead to a relative lack of insulin --
hypoinsulinemia
- suspect decreased number of insulin receptors of abnormal translocation of
glucose transporters
- as disease progresses, insulin production may be impaired
risk factors:
female sex
obesity
aging
sedentary lifestyle
nonketotic hyperglycemia hyperosmolar coma can develop, more common in
older adults
hyperosmolar coma (HHNK) occurs because endogenous insulin suppresses ke-
tone formation and thus prevents ketoacidosis
dehydration develops with high osmolality and hemoconcentration of erythrocytes,
proteins, and creatine
2. hormonal regula- 1. glucose in ingested food causes a brief rise in insulin release (first phase)
tion after a meal
2. continued glucose causes the second phase: insulin production
3. ingestion of nutrients stimulates the release of glucose-dependent insulinotrop-
ic polypeptide (GIP) and glucagon-like peptide 1 (GLP-1) from cells in the gut
the effect on blood glucose is known as the incretin effect
3.
1 of 30
, PATH 370 Quiz #5
PATH 370 Quiz #5
Study online at https://quizlet.com/_d045fy
General manifes- Acute liver failure
tations of hepato- jaundice, decreased clotting factors, hypoalbuminemia , decreased vitamins D and
cellular failure K (osteomalacia -- vitamin D; poor blood-clotting factor production -- vitamin K)
4. hormonal regula- GIP and GLP-1 stimulate the production of insulin
tion GLP-1 inhibits glucagon
glucose oxidized in the cell (glycolysis) and used primarily for glycogenesis (pro-
duction of glycogen in liver and muscle)
glycolysis ----> glycogenesis (glucagon)
5. portal hyperten- sluggish blood flow resulting in increased pressure in portal circulation
sion
congested venous drainage of the GI tract
clinical manifestations:
anorexia
varices (esophageal, gastric, hemorrhoidal)
ascites
6. gastroe- Abnormal veins in the lower part of the tube running from the throat to the
sophageal stomach.
varices
complex venous network surrounds the proximal part of the stomach and esoph-
agus
collateral venous pathways surround the proximal part of the stomach and esoph-
agus and dilates in response to elevated portal pressure
clinical features:
affects about half of cirrhotic patients
variceal bleeding is a life threatening condition
- mortality = 50%
2 of 30
, PATH 370 Quiz #5
PATH 370 Quiz #5
Study online at https://quizlet.com/_d045fy
- two distinct phases of a variceal hemorrhage
1. coincident with and shortly after bleeding
2. period of 6-8 weeks following initial bleeding
* greatest risk of rebleed occurs in the first 72 hours (lethal)
clinical manifestations:
hematemesis, melena, bright red rectal bleeding, anemia, shock
treatment:
fluid resuscitation
- normal saline via large-bore IV lines
correcting the coagulopathy and stopping further bleeding with blood compo-
nents and clotting factors replaced
- parenteral vitamin K, fresh frozen plasma, platelets, recumbent factor VIIa
vasopressin, nitroglycerin
- lowers portal pressure
emergency EGD
- endoscopic sclerosis
endoscopic ligation of esophageal varices
- suctioning and ligation of varix
7. Chrohn's disease affects all layers of the intestinal wall of the proximal portion of the colon or terminal
(regional enteri- ileum
tis or granuloma-
tous colitis) suggestive findings are ulcerations, strictures, fibrosis, and fistulas
clinical manifestations:
intermittent bolus of fever
diarrhea, if bloody, not as severe as ulcerative colitis
constant chronic RLQ pain (may have mass or tenderness)
8. chronic active he- progressive liver destruction inflammatory disease of liver
patitis
3 of 30
PATH 370 Quiz #5
Study online at https://quizlet.com/_d045fy
1. type 2 diabetes most common form of DM
mellitus
insulin resistance and beta cell dysfunction lead to a relative lack of insulin --
hypoinsulinemia
- suspect decreased number of insulin receptors of abnormal translocation of
glucose transporters
- as disease progresses, insulin production may be impaired
risk factors:
female sex
obesity
aging
sedentary lifestyle
nonketotic hyperglycemia hyperosmolar coma can develop, more common in
older adults
hyperosmolar coma (HHNK) occurs because endogenous insulin suppresses ke-
tone formation and thus prevents ketoacidosis
dehydration develops with high osmolality and hemoconcentration of erythrocytes,
proteins, and creatine
2. hormonal regula- 1. glucose in ingested food causes a brief rise in insulin release (first phase)
tion after a meal
2. continued glucose causes the second phase: insulin production
3. ingestion of nutrients stimulates the release of glucose-dependent insulinotrop-
ic polypeptide (GIP) and glucagon-like peptide 1 (GLP-1) from cells in the gut
the effect on blood glucose is known as the incretin effect
3.
1 of 30
, PATH 370 Quiz #5
PATH 370 Quiz #5
Study online at https://quizlet.com/_d045fy
General manifes- Acute liver failure
tations of hepato- jaundice, decreased clotting factors, hypoalbuminemia , decreased vitamins D and
cellular failure K (osteomalacia -- vitamin D; poor blood-clotting factor production -- vitamin K)
4. hormonal regula- GIP and GLP-1 stimulate the production of insulin
tion GLP-1 inhibits glucagon
glucose oxidized in the cell (glycolysis) and used primarily for glycogenesis (pro-
duction of glycogen in liver and muscle)
glycolysis ----> glycogenesis (glucagon)
5. portal hyperten- sluggish blood flow resulting in increased pressure in portal circulation
sion
congested venous drainage of the GI tract
clinical manifestations:
anorexia
varices (esophageal, gastric, hemorrhoidal)
ascites
6. gastroe- Abnormal veins in the lower part of the tube running from the throat to the
sophageal stomach.
varices
complex venous network surrounds the proximal part of the stomach and esoph-
agus
collateral venous pathways surround the proximal part of the stomach and esoph-
agus and dilates in response to elevated portal pressure
clinical features:
affects about half of cirrhotic patients
variceal bleeding is a life threatening condition
- mortality = 50%
2 of 30
, PATH 370 Quiz #5
PATH 370 Quiz #5
Study online at https://quizlet.com/_d045fy
- two distinct phases of a variceal hemorrhage
1. coincident with and shortly after bleeding
2. period of 6-8 weeks following initial bleeding
* greatest risk of rebleed occurs in the first 72 hours (lethal)
clinical manifestations:
hematemesis, melena, bright red rectal bleeding, anemia, shock
treatment:
fluid resuscitation
- normal saline via large-bore IV lines
correcting the coagulopathy and stopping further bleeding with blood compo-
nents and clotting factors replaced
- parenteral vitamin K, fresh frozen plasma, platelets, recumbent factor VIIa
vasopressin, nitroglycerin
- lowers portal pressure
emergency EGD
- endoscopic sclerosis
endoscopic ligation of esophageal varices
- suctioning and ligation of varix
7. Chrohn's disease affects all layers of the intestinal wall of the proximal portion of the colon or terminal
(regional enteri- ileum
tis or granuloma-
tous colitis) suggestive findings are ulcerations, strictures, fibrosis, and fistulas
clinical manifestations:
intermittent bolus of fever
diarrhea, if bloody, not as severe as ulcerative colitis
constant chronic RLQ pain (may have mass or tenderness)
8. chronic active he- progressive liver destruction inflammatory disease of liver
patitis
3 of 30
