Transcript Midterm Study Liver Be able to describe the anatomy of the liver

Midterm Study
Liver
• Be able to describe the anatomy of the liver from gross to
internal and the lobule.
• important physiologic function the liver performs
• what join together to form the common bile duct?
• what two major sources deliver blood to the liver?
• what is a sinusoid? Why does cancer metastasize to the liver
frequently?
• what vitamins are formed and stored in the liver? Why does
administration of these vitamins and medications need to be
carefully followed in people with hepatic disease?
• describe storage and breakdown of glucose by the liver
• describe the liver function in formation of phospholipids
• what happens to osmotic pressure in the plasma in liver
disease?
• why do people with liver disease bruise easily?
• where do plasma proteins enter the blood stream?
• a thorough history will reveal what signs and symptoms, in
general, in liver disease?
• when are venous hums ascultated?
• what causes steatorrhea?
• when are AST and ALT elevated? elevated serum ammonia?
decreased serum cholesterol? hypoalbuminemia?
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what is the role of a normally functioning gallbladder?
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what happens within the bile in gallbladder disease that increases
likelihood of stone formation?
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what innervation does the gallbladder respond to? what is the role
of CCK and PCZ in relation to the GB and where is it released
from?
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what is secretin and what releases it?
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Know the three major forms of hepatitis - A, B, and C. Know that
there are other forms - not anything else about them. A, B, C infection, symptoms, treatment
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know non-viral hepatitis: common causes, symtoms, treatment esp
with regard to over-dose acetaminophen as it is quite dangerous.
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causes and incidence of cirrhosis
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signs and symptoms - systemically of cirrhosis.
liver abscess
• causes of pyogenic abscess
Fatty Liver
• causes of fatty liver.
• diagnosis of fatty liver.
• treatments
• what is the role of patient education
Hepatic Encephalopathy
• what is it? why does it happen? what are
the four stages of hepatic
encephalopathy?
• treatment
Gallbladder: know symptoms, causes,
possible treatments, and worst case
outcomes
• cholelithiasis
• choledocholelithiasis
• cholangitis
• cholecystitis
• cholesterolosis
• acalculous cholecystitis
• gallstone ileus - what is it, who most commonly is
diagnosed with it, what is the most common cause?
WOW! THAT WAS A LOT OF
INFORMATION
Now that we have heard this how do we study?
Important things to know: general ear anatomy location of external ear canal, middle ear, inner ear
and what each is composed of anatomically
What are the common causes of otitis externa?
What’s the difference between acute otitis externa
and chronic otitis externa?
More Study:
Where is otitis media located?
What are some risk factors in otitis media:
TM perforation, mastoiditis..
What are predisposing factors to OM? eg.
exposure to smoking
Study continued...
Mastoiditis is a RED FLAG - how would you recognize it, what are signs
and symptoms, when would you refer?
What happens in the disease progression of otosclerosis? Describe the
Rinne/Weber test
What’s happens in Meniere’s Disease? Who is most commonly
diagnosed with it and what are their signs and symptoms? List nonsurgical treatments eg. Diuretics, dietary changes...
What is the difference between Acute Vestibular Labyrinthitis and
bacterial labyrinthis?
Study MORE!
What are the two types of hearing loss? What are
some common causes for hearing loss? Name some
ototoxic drugs, the dB levels for prolonged noise
exposure hearing loss, maternal exposures and
neonatal exposures that can lead to hearing loss?
What are some causes of sudden hearing loss and
why is it a medical emergency?
Motion sickness: what is the cause?
Study...
•
General anatomy of the sinuses and throat: where are sinuses? Which are
which? Nasopharynx? Oropharynx? “Throat”?
•
Why are infections in this area (EARS, NOSE, THROAT and eventually EYES) something to watch/be concerned about?
•
What is the time frame to be aware of when treating epistaxis? What are
some conditions or exogenous substances that might cause an increase in
bleeding time?
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What are the more common causes of nasal septum perforation?
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Differences between acute, chronic, allergic and hyperplastic sinusitis.
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Complications that can arise from untreated sinusitis.
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Physical exam findings (what is transillumination? Where might you find
tenderness to palpation - TTP?)
and more...
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what’s the difference between a nasal polyp and nasal papilloma?
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Where are adenoids located? What are some complications of adenoid
hyperplasia?
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Causes of acute vs. viral pharyngitis. Signs and symptoms of pharyngitis.
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What bacteria is most dangerous in tonsillitis? What are possible complications
from untreated tonsillitis?
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Location of peritonsillar vs. retropharyngeal abscess
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Causes of vocal cord nodules or polyps. Why would one opt for surgical removal?
What is larygneal web?
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Causes of laryngitis. Treatment? Worst case scenario of no treatment/treatment?
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Ddx Croup and Epiglottitis. Why do we care? Which is an emergent referral?
What do I need to know
about GI?
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it’ll be a good idea to know the general anatomy.
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What is necessary to absorb vitamin B12? Where is it produced? Where is B12
absorbed?
•
how would you clinically differentially diagnose duodenal vs. gastric ulcer? What
bacteria is commonly the infective agent in Peptic ulcer disease?
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What are GERD red flags?
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What are the types of hiatal hernia? What is a dangerous possible side effect of
paraesophageal hernia?
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What is the cause of Barrett’s esophagitis? What are the histologic changes? What
can Barrett’s esophagitis transform into?
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What causes esophageal varices? What is the danger present with esophageal
varices?
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Be able to distinguish the difference between acute and chronic gastritis:
histologically, causally, symptomatically.
More to know...
•
know what IBD is, know the two forms of IBD and how each is distinguished from the other
including presentation, labs and symptoms. Know methods of diagnosis eg. barium enema,
barium swallow study, x-ray, biopsy...
•
diverticulitis vs diverticulosis
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celiac disease presentation and histologic changes, the effects of the histologic changes on the
patient system as a whole
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Know IBS, causes and links between psychology and environment in relation to IBS.
Symptomatic presentation.
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gallbladder and pancreas anatomy. Know the difference between acute and chronic pancreatitis
presentation. The two most common causes and the systemic effects of pancreatitis. Why can
this be a medical emergency?
•
signs and symptoms of stomach cancer and what are thought to be causes/links to cause?
•
internal vs. external hemorrhoids
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causes of inactive colon - eg. over-use of laxatives
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symptoms of proctitis and contributing factors
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problems with pilonidal cysts
The eye
•
know internal and external anatomy as it relates to disease and disease
pathology/symptomatology
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blepharitis, stye(hordeolum), chalazion - how do they relate? How are they
treated? What are possible dangerous outcomes?
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two common causes of exophthalmos?
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orbital cellulitis - what is it? why is it dangerous? what is it the result of?
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common causes of conjunctivitis. What is a possible causative agent that would
need to be reported to public health? Treatment? Why treat quickly?
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what is a corneal abrasion? does it need to be treated quickly? why?
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signs and symptoms of retinal detachment? why is it an emergency?
• what is macular degeneration? what are the forms?
how is it treated? what happens to vision? who
usually is diagnosed with it?
• what causes cataracts? who is usually diagnosed
with cataracts?
• know the cranial nerves that innervate the eye
muscles and how they influence ocular movement so
that lesions on the “H in space” can be noted
• what are the two types of glaucoma? why is
glaucoma dangerous?
• know: myopia, hyperopia and astigmatism definitions
Lungs
•
know structure and function of lungs? How many lobes on each
lung? Whispered pectoriloqui? Egophony? Tactile fremitus? What
do they mean and what do positives indicate?
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How does the diaphragm work?
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Again - ddx croup and epiglottitis
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Two forms of COPD and how symptoms present differently?
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What physiologic changes occur to cause the physical symptoms
of COPD?
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Organism that causes TB? Diagnosis? Risk factors in developing.
Treatment?