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jld15
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Fulminant Hepatica
- Rapidly progressing form Hepatic encephalopathy
- Rare
- Causes
- ---Acetaminophen hepatotoxicity
- ---Drug reaction
- ---Hepatitis A or B
- Treatment
- ---Supportive while liver goes into failure
- ---Transplantation is the best option
- --------80% mortality rate if no transplantation
- Prognosis
- ----Determined by cause
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Toxic (drug- induced) Hepatitis
- Chemical, drug induced, herbal preps -Usually caused by acetometaphin
- Mild symptoms to progression to fulminant
- Poor prognosis if jaundice, encephalopathy, impaired liver function present
- Factors that increase risk
- ----Age (Increased number of medications)
- ----Obesity
- ----DM
- ----Women
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Alcoholic Liver Disease
- Acute or chronic
- Chronic alcohol used leading to inflammation, scaring and fibrosis
- Late detection
- Diagnosis
- ----ALT/AST- mildly elevated
- Treatment
- ----Depends on cessation of drinking to stop damage to liver
- ----Nutritional support and education
- Prognosis
- ----How much liver damage is there
- ----If alcohol is cessated
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Pancreas
- endocrine
- ----Production of insulin and glucagon
- exocrine
- ----secretion of digestive enzymes
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Acute Pancreatitis
- Inflammation of pancreas bc digestive enzymes digest the pancreas (auto digestion)
- Acute
- ----Wide range of symptoms
- ----Weak severe (fluid collections around pancreas leading to sepsis)
- ----Abdominal pain
- ----N/V
- ----AMS
- Diagnosis
- ----CT
- ----labs
- Treatment
- ----Surgery to remove fluid
- ----NPO
- Prognosis
- ----Gallstones
- ---trauma
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Chronic Pancreatitis
- Can be caused by acute
- sometimes seen with ARDS
- in a lot of pain, may be back pain so may have problem mobilizing them
- Dietary limits
- Small frequent meals
- Not fatty
- fluids
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Pancreatic Cancer
- 4th leading cause of cancer death, worst 5 yr survival rate (1-5%)
- Risk factors
- ----Age >50
- ----Tobacco use
- ----women
- ----Peptic ulcer surgery
- ----Cholecystectomy
- ----DM
- Clinical signs and symptoms
- ----Vague
- ----Weight loss
- ----jaundice
- Metastasis
- ----Liver
- ----Lungs
- Diagnosis
- ----CT
- Treatment
- ----Palliative therapy (supportive comfort care)
- Therapist considerations
- ----Vague back pain
- ----Cervical lymphadenopathy
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Function of gallbladder
- reservoir of bile, which is important in digestion
- releases bile into small intestine
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Gallstones
- 80 cholestrol
- 20% bile salt
- main complaint: pain after eating
- Diagnosis
- ----Radiographs
- ----Ultrasound
- Treatment
- ----removing of the gall bladder but the bile goes directly into the small intestine instead of being released into the small intestine
- Therapist considerations
- ----Physical activity to prevent symptoms and after surgery which is laparoscopic
- ----Referred pain
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Cholecystitis
- Inflammation of the gallbladder
- Impaction of gallstones in the cystic duct
- complication of gallstones
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