This document discusses liver abscesses, including types (pyogenic, amoebic, fungal), causes, risk factors, symptoms, diagnostic tests, and treatment. Pyogenic liver abscess is most common, often caused by bacteria spreading from infections in other organs. Amoebic liver abscess is caused by a parasite and presents with thick pus. Imaging tests can identify abscesses, which are usually treated with antibiotics; drainage may be needed for large abscesses. With treatment, prognosis is generally good especially for amoebic liver abscess.
Gallstones are hardened deposits of bile that can form in your gallbladder. Bile is a digestive fluid produced in your liver and stored in your gallbladder. When you eat, your gallbladder contracts and empties bile into your small intestine (duodenum)
Gallstones are hardened deposits of bile that can form in your gallbladder. Bile is a digestive fluid produced in your liver and stored in your gallbladder. When you eat, your gallbladder contracts and empties bile into your small intestine (duodenum)
This PPT contains all necessary detail about cholecystitis and its management and covers all aspects of this disease according to nursing point of view. Helpful for studetns.
Hemorrhoids are swollen veins in the lowest part of your rectum and anus. Sometimes, the walls of these blood vessels stretch so thin that the veins bulge and get irritated, especially when you poop. Hemorrhoids are also called piles.
Definition
Type of Hernia
risk factor
pathophysiology
diagnostic procedure
physical assessment
management for hernia
Nursing Diagnosis
Health Education
Gastrointestinal bleeding (GI bleed), also known as gastrointestinal hemorrhage, is all forms of bleeding in the gastrointestinal tract, from the mouth to the rectum. When there is significant blood loss over a short time, symptoms may include vomiting red blood, vomiting black blood, bloody stool, or black stool.
Cirrhosis is a late stage of scarring (fibrosis) of the liver caused by many forms of liver diseases and conditions, such as hepatitis and chronic alcoholism.
Benign prostatic hyperplasia is an enlargement of the prostate gland resulting from an increase in the number of epithelial cells and stromal tissue and developing upward into the bladder and obstructing the outflow of urine.
Pyelonephritis
It is the inflammation of the kidney & upper urinary tract that usually results from the bacterial infection of the bladder.
Pyelonephritis can be classified in several different catagories:
-acute pyelonephritis
-chronic pyelonephritis
-xanthogranulomatous pyelonephritis
This PPT contains all necessary detail about cholecystitis and its management and covers all aspects of this disease according to nursing point of view. Helpful for studetns.
Hemorrhoids are swollen veins in the lowest part of your rectum and anus. Sometimes, the walls of these blood vessels stretch so thin that the veins bulge and get irritated, especially when you poop. Hemorrhoids are also called piles.
Definition
Type of Hernia
risk factor
pathophysiology
diagnostic procedure
physical assessment
management for hernia
Nursing Diagnosis
Health Education
Gastrointestinal bleeding (GI bleed), also known as gastrointestinal hemorrhage, is all forms of bleeding in the gastrointestinal tract, from the mouth to the rectum. When there is significant blood loss over a short time, symptoms may include vomiting red blood, vomiting black blood, bloody stool, or black stool.
Cirrhosis is a late stage of scarring (fibrosis) of the liver caused by many forms of liver diseases and conditions, such as hepatitis and chronic alcoholism.
Benign prostatic hyperplasia is an enlargement of the prostate gland resulting from an increase in the number of epithelial cells and stromal tissue and developing upward into the bladder and obstructing the outflow of urine.
Pyelonephritis
It is the inflammation of the kidney & upper urinary tract that usually results from the bacterial infection of the bladder.
Pyelonephritis can be classified in several different catagories:
-acute pyelonephritis
-chronic pyelonephritis
-xanthogranulomatous pyelonephritis
Anemia, Classification, Clinical Manifestations (General vs Specific Sign & Symptoms), Lab Investigations (Normal vs Abnormal Lab values) and Treatment
MANAGEMENT OF ATRIOVENTRICULAR CONDUCTION BLOCK.pdfJim Jacob Roy
Cardiac conduction defects can occur due to various causes.
Atrioventricular conduction blocks ( AV blocks ) are classified into 3 types.
This document describes the acute management of AV block.
Title: Sense of Taste
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the structure and function of taste buds.
Describe the relationship between the taste threshold and taste index of common substances.
Explain the chemical basis and signal transduction of taste perception for each type of primary taste sensation.
Recognize different abnormalities of taste perception and their causes.
Key Topics:
Significance of Taste Sensation:
Differentiation between pleasant and harmful food
Influence on behavior
Selection of food based on metabolic needs
Receptors of Taste:
Taste buds on the tongue
Influence of sense of smell, texture of food, and pain stimulation (e.g., by pepper)
Primary and Secondary Taste Sensations:
Primary taste sensations: Sweet, Sour, Salty, Bitter, Umami
Chemical basis and signal transduction mechanisms for each taste
Taste Threshold and Index:
Taste threshold values for Sweet (sucrose), Salty (NaCl), Sour (HCl), and Bitter (Quinine)
Taste index relationship: Inversely proportional to taste threshold
Taste Blindness:
Inability to taste certain substances, particularly thiourea compounds
Example: Phenylthiocarbamide
Structure and Function of Taste Buds:
Composition: Epithelial cells, Sustentacular/Supporting cells, Taste cells, Basal cells
Features: Taste pores, Taste hairs/microvilli, and Taste nerve fibers
Location of Taste Buds:
Found in papillae of the tongue (Fungiform, Circumvallate, Foliate)
Also present on the palate, tonsillar pillars, epiglottis, and proximal esophagus
Mechanism of Taste Stimulation:
Interaction of taste substances with receptors on microvilli
Signal transduction pathways for Umami, Sweet, Bitter, Sour, and Salty tastes
Taste Sensitivity and Adaptation:
Decrease in sensitivity with age
Rapid adaptation of taste sensation
Role of Saliva in Taste:
Dissolution of tastants to reach receptors
Washing away the stimulus
Taste Preferences and Aversions:
Mechanisms behind taste preference and aversion
Influence of receptors and neural pathways
Impact of Sensory Nerve Damage:
Degeneration of taste buds if the sensory nerve fiber is cut
Abnormalities of Taste Detection:
Conditions: Ageusia, Hypogeusia, Dysgeusia (parageusia)
Causes: Nerve damage, neurological disorders, infections, poor oral hygiene, adverse drug effects, deficiencies, aging, tobacco use, altered neurotransmitter levels
Neurotransmitters and Taste Threshold:
Effects of serotonin (5-HT) and norepinephrine (NE) on taste sensitivity
Supertasters:
25% of the population with heightened sensitivity to taste, especially bitterness
Increased number of fungiform papillae
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Ve...kevinkariuki227
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
Pulmonary Thromboembolism - etilogy, types, medical- Surgical and nursing man...VarunMahajani
Disruption of blood supply to lung alveoli due to blockage of one or more pulmonary blood vessels is called as Pulmonary thromboembolism. In this presentation we will discuss its causes, types and its management in depth.
Couples presenting to the infertility clinic- Do they really have infertility...Sujoy Dasgupta
Dr Sujoy Dasgupta presented the study on "Couples presenting to the infertility clinic- Do they really have infertility? – The unexplored stories of non-consummation" in the 13th Congress of the Asia Pacific Initiative on Reproduction (ASPIRE 2024) at Manila on 24 May, 2024.
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The prostate is an exocrine gland of the male mammalian reproductive system
It is a walnut-sized gland that forms part of the male reproductive system and is located in front of the rectum and just below the urinary bladder
Function is to store and secrete a clear, slightly alkaline fluid that constitutes 10-30% of the volume of the seminal fluid that along with the spermatozoa, constitutes semen
A healthy human prostate measures (4cm-vertical, by 3cm-horizontal, 2cm ant-post ).
It surrounds the urethra just below the urinary bladder. It has anterior, median, posterior and two lateral lobes
It’s work is regulated by androgens which are responsible for male sex characteristics
Generalised disease of the prostate due to hormonal derangement which leads to non malignant enlargement of the gland (increase in the number of epithelial cells and stromal tissue)to cause compression of the urethra leading to symptoms (LUTS
micro teaching on communication m.sc nursing.pdfAnurag Sharma
Microteaching is a unique model of practice teaching. It is a viable instrument for the. desired change in the teaching behavior or the behavior potential which, in specified types of real. classroom situations, tends to facilitate the achievement of specified types of objectives.
2. At the end of this presentation, student will know about:
Abscess
Liver Abscess
Types of Liver Abscess
Incidence Rate and Epidemic Data about Liver abscess
Who are at risk
Clinical Manifestations
Diagnosis
Treatment
Complication
Prognosis
3. What is Abscess
Abscess may be define as a collection of pus
(dead cells and neutrophils) that has
accumulated within a tissue because of an
inflammatory process in response to either
an infectious process (usually caused by
bacteria or parasites) or other foreign
materials
5. Liver abscess
A liver abscess is a collection of pus in the liver caused
by bacteria, fungi, or parasites. It may occur as a single
lesion or as multiple lesions of different sizes. The
abscess may contain thick, bad smelling pus or
reddish-brown anchovy paste-like fluid with no odor.
Occurs when bacteria/protozoa destroy hepatic tissue,
produces a cavity which fills up with infective
organisms, liquefied cells & leucocytes. Necrotic tissue
then falls off the cavity from rest of the liver.
7. Incidence & Epidemiology
Liver – organ most subject to the development of
abscesses
13% of total intraabdominal abscesses
48% of all visceral abscess
Mortality - 5-30% of cases
most common causes of death include sepsis,
multiorgan failure, and hepatic failure
Equal Male to female ratio. Males have poorer
prognosis
8. Types Of Liver Abscess
There are three major forms of liver abscess, classified
by etiology:
Pyogenic liver abscess, which is most often
polymicrobial, accounts for 80% of hepatic abscess cases
in the United States.
Amoebic liver abscess due to Entamoeba histolytica
accounts for 10% of cases.
Fungal abscess, most often due to Candida species,
accounts for less than 10% of cases.
10. Pyogenic Liver Abscess
A pyogenic liver abscess is a type of liver abscess
caused by bacteria, can be single or multiple.
The right lobe is affected twice as often as the left; 5%
have bilateral involvement.
No cause found in 15% cases. Most are secondary to
infection originating in the abdomen. Bacterial
endocarditis and dental infection are other causes.
More common in the immunocompromised and in
people with Liver cirrhosis.
12. Etiology
Disorders or bacterial infection of following origins
may invade liver to cause abscess:
Biliary disease (most common) e.g.: stones,
cholangiocarcinoma, infection
Colonic disease. e.g.: diverticulitis, appendicitis, Crohn's
disease
Pancreatitis
Infection of blood
Intra-abdominal sepsis
Endocarditic, Dental infection (with streptococci)
Traumatic, Iatrogenic
13. Common Causative Agents
Most common species invloved are
Streptococcus milleri
Pseudomonas
E. coli
Klebsiella pneumoniae
Proteus vulgaris
Bacteroides
Opportunistic Pathogens (Staphylococcus)`
14. Amoebic Liver Abscess
Amoebic liver abscess or amebiasis is a type of liver
abscess caused by Entamoeba Histolytica (Protozoa).
E. histolytica causes amoebic colitis and dysentery but
liver abscess is the most common extra-intestinal
manifestation of infection
Route of entry via oro-fecal roue by ingestion of
contaminated food or water. Amoebae invade
intestinal mucosa and can gain access to the portal
venous system.
15. Causes a large necrotic area which is liquefied into
thick reddish-brown pus (Anchovy sauce pus) due to
liquefied necrosis, thrombosis of blood vessels, lysis of
liver cells
It affects the right lobe in 80%.
This type is common in overcrowded areas with poor
sanitation and in alcoholics.
Amoebic Liver Abscess
17. Fungal Liver Abscess
Fungal abscesses is a less common type,
primarily due to Candida albicans and occur
in individuals with prolonged exposure to
antimicrobials, hematologic malignancies,
solid-organ transplants, and congenital and
acquired immunodeficiency.
18. Clinical Manifestation
1. Fever with Chills, (PUO in Amoebic Abscess)
2. Abdominal pain
3. Anorexia
4. Weight loss
5. Nausea, Vomiting
6. Right shoulder pain / irritable cough
7. Cough and Dyspnea
8. Hepatomegaly
9. Tenderness
10. Rebound tenderness
11. Jaundice (late)
20. People at Risk
Age: Advanced age, particularly in people older than 70 years.
Health: Having a long-term disease, (cancer, diabetes,
tuberculosis) or splenectomy, a weak immune system, AIDS.
Taking Drugs: Such as steroids, chemotherapy, prolong use of
antibiotics (fungal abscess).
Lifestyle: Drinking too much alcohol, too often. Living in over
crowding area, poor sanitation
Nutrition: Being malnourished (having poor nutrition).
Activity: Traveling to places where amebiasis is common.
Eating foods and drinking liquids that are sold in the street may
further increase risk.
21. Laboratory Studies
1. CBC
1. Increased WBC, usually Neutrophilic Leukocytosis.
2. Raised erythrocyte sedimentation rate (ESR).
3. Mild normochromic normocytic anaemia.
2. Liver function studies
1. Hypoalbuminemia
2. Elevation of alkaline phosphatase
3. Elevations of transaminase and bilirubin levels (variable)
22. 3. Blood cultures are positive in roughly 50% of cases.
4. Stool DR: Stools can contain cysts or trophozoites of E.
histolytica.
5. Serology should be carried out if E. histolytica is
suspected.
6. Culture of abscess fluid should be the goal in
establishing microbiologic diagnosis. Usually done
through Percutaneous needle aspiration (under CT or
Ultrasound Guidance)
Laboratory Studies
23. Imaging Study
1. Chest X-Ray: May show raised right hemi-diaphragm on.
2. Ultrasonography
a) Can show abscess and also allow guided percutaneous aspiration
and drainage and biliary tree examination. A Doppler ultrasound
study may be done to check for blood flow in your liver.
3. CT scanning
a) Can show the abscess, allow guided aspiration and drainage and
show other intra-abdominal abscesses or a possible cause such as
diverticular disease, appendicitis, etc. It is good for the detection
of small abscesses.
4. Liver Scan
5. MRI
26. Medical Management
Antibiotics
Pyogenic liver abscess: Broad spectrum antibiotics should
be started before waiting for culture results.
Usually start treatment with tri-therapy included the use of
penicillin, amino-glycoside and metronidazole.
A third-generation cephalosporin can be considered in the
elderly or if renal function is impaired.
Antibiotic therapy can be modified once culture results are
available.
Treatment may be needed for up to 12 weeks and should be
guided by the clinical picture and radiological monitoring.
27. Amoebic liver abscess:
Metronidazole is the treatment of choice. 95% of
patients with amoebic liver abscess recover with this
alone. Most patients show a response to treatment
within 72-96 hours.
Diloxanide furoate should be prescribed for 10 days to
eliminate intestinal amoebae after the abscess has been
successfully treated.
Antifungal agents such as amphotericin B are used if
fungal abscess is suspected.
Medical Management
28. Surgical Management or Drainage
Most patients with pyogenic liver abscess or with very large
amoebic abscesses, may not recover with antibiotics alone
need drainage guided by ultrasonography or CT.
Percutaneous aspiration can be carried out for small
abscesses although
Catheter drainage carried out for larger abscesses.
Open surgery may be necessary if
Abscess ruptured
Signs of peritonitis,
Abscess 5 cm
Appendicitis.
29.
30.
31. Nursing Management
Pain Management: Alleviation or reduction in pain
Nutrition Management: Assisting with or providing
a balanced dietary intake of foods and fluids.
Infection Protection: Infection Control, Prevention
and early detection of infection in a patient at risk.
32. Complications
1. Return of Abscess
2. Widespread infection in abdomen.
3. Overwhelming sepsis.
4. Rupture of the abscess into adjacent structures
(pleural, peritoneal and pericardial spaces).
5. Secondary infection of amoebic liver abscesses.
33. Prognosis
Pyogenic liver abscess
Mortality rate is 5-30%.
Condition such as Diabetes Mellitus, immunodeficiency,
malignancy, affect prognosis.
Amoebic liver abscess
Mortality rates have fallen to 1-3%.