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METHODOLOGY TEXT BOOK 2009 2010.doc
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Alcoholic Hepatitis

Ethanol, mostly in alcoholic beverages, (to be) ______ an important cause of hepatitis. Usually alcoholic hepatitis (to come) ________________ after a period of increased alcohol consumption. Alcoholic hepatitis (to characterize) _________________________________by a variable symptoms, which may (to include) _______________ feeling unwell, enlargement of the liver, development of fluid in the abdomen ascites, and modest elevation of liver blood tests. Alcoholic hepatitis can (to vary) _______________ from mild with only liver test elevation to severe liver inflammation with development of jaundice, prolonged prothrombin time, and liver failure. Severe cases (to characterize) __________________ by either dulled consciousness or the combination of elevated bilirubin levels and prolonged prothrombin time; the mortality rate in both categories (to be) ______50% within 30 days of onset.

Alcoholic hepatitis (to be) _____ distinct from cirrhosis caused by long term alcohol consumption. Alcoholic hepatitis can (to occur) ________________ in patients with chronic alcoholic liver disease and alcoholic cirrhosis. Alcoholic hepatitis by itself (not to lead) ____________________ to cirrhosis, but cirrhosis (to be) _______ more common in patients with long term alcohol consumption. Patients who (to drink) _________ alcohol to excess (to find) ______ also more often than others _____________ to have hepatitis C. The combination of hepatitis C and alcohol consumption (to accelerate) ________________________ the development of cirrhosis in Western countries.

Pancreas and diseases of the pancreas

The pancreas (to be) _____ an organ in the digestive and endocrine system. It (to serve) _______ two major functions: exocrine (producing pancreatic juice containing digestive enzymes) and endocrine (producing several important hormones, including insulin).

Anatomy

In humans, the pancreas (to be) ____ a 15-25 cm (6-10 inch) organ in the abdomen. It (to locate) _____________ posterior to the stomach and in close association with the duodenum.

It(to describe) _____ often ___________ as having three regions: a head, body and tail.

The pancreatic duct (to empty) ___________ into the second part of the duodenum. The common bile duct commonly (to join) ___________ the pancreatic duct at or near this point.

The pancreas (to supply) _________________ by the pancreaticoduodenal arteries.

Venous drainage [‘dreinidz] (to be) ______ via the pancreaticoduodenal veins which (to end up) _________ in the portal vein.

Acute pancreatitis (to be) _____ rapidly-onset inflammation of the pancreas. Depending on its severity, it can (to have) ___________ severe complications and high mortality despite treatment. While mild cases (to treat) _______often successfully _______________ with conservative measures or laparoscopy, severe cases (to require) _______________ invasive surgery (often more than one intervention.

Common symptoms (to include) _______________________:

  • Severe abdominal pain often radiating through to the back.

  • Nausea, vomiting, diarrhea and loss of appetite.

  • Fever

  • Shock, hemodynamic instability

Recovery may (to follow) _________________by development of pancreatic pseudocyst, pancreatic dysfunction or diabetes mellitus.

Common causes of pancreatitis spells may (to be) ______:

gallstones, alcohol, trauma, steroids, mumps and other viruses, autoimmune diseases, snake bites, hypercalcemia, hyperlipidemia/hypertriglyceridemia and hypothermia, drugs, duodenal ulcers

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