Sorcha Shared "43 - Liver, Biliary Tract, and Pancreas Problems" - 14 Picmonics
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43 - Liver, Biliary Tract, and Pancreas Problems
Acute Pancreatitis Assessment
- Mechanism
- Heavy Alcohol Use and Gallstones
- Signs and Symptoms
- Abdominal Pain
- Nausea/Vomiting/Anorexia
- Abdominal Rigidity/Guarding
- Decreased or Absent Bowel Sounds
- Hypotension and Tachycardia
- Jaundice
- Increased White Blood Cells
2 mins
Acute Pancreatitis Causes
- "GET SMASHHED" Mnemonic
- Gallstones
- (Ethanol) Alcohol
- Trauma
- Steroids
- Mumps
- Autoimmune
- Scorpion Sting
- Hypercalcemia
- Hypertriglyceridemia > 1000
- ERCP
- Drugs
1 min
Acute Pancreatitis Interventions
- NPO with NG Tube to Suction
- Pain Management
- Albumin
- Lactated Ringers Solution
- Proton Pump Inhibitor (PPI)
- Antibiotics
- Surgery
- Nutrition
2 mins
Hepatitis A (HAV) Assessment
- Transmission
- Fecal-Oral
- Ingestion of Contaminated Food or Water
- Incubation
- 4 Weeks
- Assessment
- Fever
- General Malaise
- Hepatomegaly
- Considerations
- Self-Limiting
- Proper Hand Washing
2 mins
Hepatitis B (HBV) Assessment
- Transmission
- Bodily Fluids
- Blood Transmission
- People Who Use IV Drugs
- Incubation
- Variable 1-6 Months
- Assessment
- Fever
- Nausea and Vomiting
- Hepatomegaly
- Chronic Disease
- Cirrhosis
- Hepatocellular Carcinoma
- Considerations
- Vaccination
2 mins
Hepatitis C (HCV) Assessment
- Transmission
- Blood Transmission
- High Risk Sex (rare)
- IV Drug Users
- Incubation
- 7 Weeks
- Chronic Disease
- Cirrhosis
- Considerations
- Barrier Protection
2 mins
Cirrhosis Assessment
- Mechanism
- Degeneration and Destruction of Liver Cells
- Signs and Symptoms
- Jaundice
- Fatigue
- Palmar Erythema
- Spider Angiomas
- Hepatosplenomegaly
- Edema
- Gynecomastia
- Change in LOC
2 mins
Cirrhosis Interventions
- Interventions
- Maintain Nutrition
- Paracentesis
- Esophageal and Gastric Varices
- Drug Therapy
- Endoscopic Band Ligation or Sclerotherapy
- Balloon Tamponade
- Transjugular Intrahepatic Portosystemic Shunt (TIPS)
- Hepatic Encephalopathy
- Lactulose
- Antibiotics
2 mins
Complications of Cirrhosis
- Portal Hypertension
- Ascites
- Esophageal Varices
- Coagulation Defects
- Portal-Systemic Encephalopathy
- Hepatorenal Syndrome
1 min
Cholecystitis Assessment
- RUQ Pain
- Referred Shoulder Pain
- Clay Colored Stools
- Jaundice
- Nausea and Vomiting
- Dyspepsia (Indigestion)
- Fever
- Considerations
- Increased WBCs
- Fatty or Spicy Foods
- Ultrasound
2 mins
Cholecystitis Interventions
- Supportive Therapy
- Antibiotics
- Low Fat Diet
- NG Tube
- Analgesics
- Lithotripsy
- Cholecystectomy
- T Tube
2 mins
Nonalcoholic Fatty Liver Disease
- Characteristics
- Fat Infiltration of Hepatocytes in Absence of Alcohol Consumption
- Obesity
- Hyperlipidemia
- Type II Diabetes
- Diagnosis
- Often Found Incidentally
- Elevated Liver Enzymes
- Ultrasound
- Treatment
- Weight Loss
- Abstinence From Alcohol
3 mins
Cholecystitis Causes
- Gallbladder Inflammation
- 6 Fs
- Female
- Fair (Caucasian)
- Fat (Obese)
- Fertile (Pregnant)
- Forty (Advanced Age Over 40)
- Flatulence
2 mins
Gallstones, Cholecystitis, and Cholangitis
- Gallstones (cholelithiasis)
- Increased cholesterol and/or Increased bilirubin
- Decreased bile salts could cause stones
- Risk factors: Fat, Female, Fertile, Forty
- Estrogen: Induces cholesterol secretion
- Progesterone: Gallbladder hypomotility
- Cholesterol stones: Radiolucent
- Pigment stones: Radiopaque = Calcium bilirubinate or Hemolysis
- Pigment stone: Radiolucent (Brown) = Infection
- Biliary colic: Neurohormonal activation by CCK
- Painless in diabetes
- Cholesterol stones seen in: Obesity, Crohn's Advanced Age, Estrogen Therapy, Multiparity, Rapid Weight Loss, Native American
- Pigment stones caused by: Crohn's, Chronic hemolysis, Alcoholic cirrhosis, Advanced age, Biliary infections, TPN
- Cholecystitis
- Acute or chronic inflammation of gallbladder usually from cholelithiasis (stone at neck of gallbladder
- Gallbladder wall thickening (yellow arrows)
- Commonly block the cystic duct
- Can be caused by primary CMV infection
- Positive Murphy Sign (inspiratory arrest on RUQ palpation due to pain
- Diagnose with Ultrasound or Cholescintigraphy (HIDA - Hepatobiliary iminodiacetic acid scan)
- Cholecystitis can lead to porcelain gallbladder -> usually found on imaging -> must remove due to high rate of gallbladder cancer
- Cholangitis
- Cholangitis is infection of the biliary tract
- Charcot triad of cholangitis: Jaundice, Fever, RUQ pain
- Increased ALP
- Tx: ERCP
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