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38. RESEARCH, OBJECTIVE RESEARCH, LABORATORY AND INSTRUMENTAL METHODS OF RESEARCH IN DISEASES OF THE Pancreas

Patients with diseases of the pancreas (pancreas) may complain of abdominal pain, as well as dyspeptic symptoms and general weakness. Pain is most often localized in the upper abdomen, mainly in the epigastric region or left hypochondrium, radiating to the back, left shoulder. They can be acute, intense, herpes zoster, with irradiation to the lumbar region, which in acute pancreatitis is associated with a violation of the outflow of secretion from the pancreas and exposure to their own proteolytic enzymes. Prolonged and intense pain is characteristic of tumors; often they are strengthened in the position of the patient on the back, which forces patients to occupy a half-bent position. Dyspeptic phenomena often occur as a result of a change in the enzymatic activity of the pancreas or reflexively. In case of insufficiency of exocrine pancreatic function, in addition to dyspepsia, steatorrhea (an increased content of neutral fat, fatty acids or soaps in the feces) is possible. Feces with steatorrhea have a golden yellow color, a greasy consistency and are poorly washed off the walls of the toilet. Obstructive jaundice with itching of the skin is characteristic for lesions of the pancreatic head with a violation of the outflow of bile. Research Methods. On examination, it is possible to identify exhaustion, jaundice. Only with a marked enlargement of the gland due to tumor damage with deep sliding palpation is it possible to detect a neoplasm. X-ray examination: a survey radiograph of the abdominal cavity allows you to detect calcifications in the gland. Ultrasound of the abdomen. This is the most commonly used pancreatic imaging technique. It allows you to assess the state of the parenchyma of the gland, detect cysts and neoplasms in the pancreas, and also determine its increase as a result of edema or compaction (fibrosis).
CT: in patients with obesity and intestinal obstruction, ultrasound usually causes difficulties, therefore, CT is more appropriate. Arterial angiography: Selective angiography of arteries supplying blood to the pancreas is important in the diagnosis of tumors. Endoscopic retrograde cholangiopancreatography. This study is considered one of the most valuable imaging methods for pancreatic and bile ducts. An iodine-containing contrast agent is introduced into the common bile duct through an endoscope and then X-ray is performed, which allows not only to establish the cause of obstructive jaundice, but also to identify pancreatic changes characteristic of inflammatory and neoplastic processes. In chronic pancreatitis, the duct may be deformed, areas of narrowing and expansion are visible. In the presence of a tumor, isolated duct stenosis or its complete obstruction is possible. Radioisotope study: this is a pancreatic study using methionine labeled with the radioactive isotope of selenium, in general, less accurate than the above research methods. Laboratory methods. Necrosis of pancreatic tissue as a result of obstruction of its duct can be estimated by increasing the concentration of pancreatic enzymes in the blood, urine, and other body fluids. The most widespread determination of the activity of amylase and lipase. Using a radioimmunoassay, the activity in the blood serum of other enzymes — trypsin, lipase, elastase — is evaluated. Symptoms of acute pancreatitis can be leukocytosis, hyperglycemia, hypocalcemia, sometimes hyperbilirubinemia.
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38. RESEARCH, OBJECTIVE RESEARCH, LABORATORY AND INSTRUMENTAL METHODS OF RESEARCH IN DISEASES OF THE Pancreas

  1. QUESTION, INSPECTION OF PATIENTS WITH DISEASES OF THE ENDOCRINE SYSTEM. BASIC LABORATORY AND INSTRUMENTAL METHODS. DIAGNOSTIC VALUE
    Diseases: diffuse thyrotoxic goiter, myxedema, acromegaly, gigantism, nanism, Itsenko-Cushing syndrome, impaired fat metabolism. Demand: complaints of increased mental irritability, intermittent shallow sleep, decreased memory, irritability, lethargy, sweating, palpitations, tinnitus, itchy skin, increased thirst, significant weight loss. From the anamnesis: severe unrest,
  2. 44. QUESTION, INSPECTION, PALPATION IN DISEASES OF THE BLOOD SYSTEM. RESEARCH OF SPLEEN, DIAGNOSTIC VALUE. PRINCIPLES OF EARLY DIAGNOSIS OF BLOOD DISEASES.
    Questioning: complaints of weakness, light fatigue, dizziness, shortness of breath during physical exertion, palpitations in case of anemia, leukemia, myeloid hypoplasia. Many diseases of the blood system are accompanied by fever, fever, loss of appetite and weight loss. With B12 anemia, a burning tip of the tongue and its edges is characteristic. With Fe anemia, a perversion of taste (the use of chalk,
  3. Pancreatic examination
    Organocomplex again put the convex surface of the liver on the table, and the stomach is discarded on the liver. In this situation, the pancreas becomes available for research. It is released by fingers from the surrounding fiber, its shape and size are noted, the consistency of the head, body, tail is measured and determined. A transverse section is made at the boundary between the head and the body. Moreover, on
  4. Patient interrogation and physical research methods
    The fundamentals of modern clinical diagnosis of cardiac arrhythmias and conduction disorders were developed by K. Wenckebach before the creation of the electrocardiographic method. The reason for the examination is the patient's complaints, which are compatible with ideas about arrhythmias. Patients are concerned about palpitations, accompanied by weakness, dizziness, shortness of breath, polyuria, pain in the heart,
  5. NUTRITION FOR DISEASES OF THE Pancreas (Pancreatitis)
    NUTRITION FOR DISEASES OF THE Pancreas
  6. RESEARCH METHODS FOR DISEASES OF THE URINOIDAL SYSTEM
    RESEARCH METHODS FOR DISEASES OF THE URINAL
  7. Laboratory research methods
    1) The use of skin allergy tests. They are based on the ability of an infected or allergic organism to respond with a local focal or general reaction to the administration of certain doses of an allergen. There are application (epicutane), scarification and intradermal tests. They are used to confirm the allergic or occupational nature of dermatosis. 2) Bacterioscopic and
  8. DATA OF LABORATORY, INSTRUMENTAL METHODS OF RESEARCH
    General blood test 03/17/2011 General urine analysis 03/17/2011 Biochemical blood test 03/17/2011 norm. X-ray examination of the chest. There are no focal and infiltrative changes on the chest radiograph. Pulmonary pattern
  9. Laboratory research methods in the diagnosis of heart failure
    Determination of the content of NPs in blood plasma It was shown that an increase in the concentration of circulating NPs - atrial, so-called MNUP and its N-terminal fragment (NT-MNUP) is an early marker of LV dysfunction - both systolic and diastolic. In recent years, this approach has received the status of a diagnostic standard. High sensitivity of increasing the concentration of circulating MNUP
  10. DATA OF LABORATORY AND INSTRUMENTAL METHODS OF RESEARCH
    Complete blood count: Нb - 138 g / l, Er - 4, Зх10 at 12 step / l, ESR - 12 mm / h, L -7.4х10 at 9 step / l, stab neutrophils - 2%, segmented neutrophils - 56 %, eosinophils - 4%, basophils - 1%, monocytes - 6%, lymphocytes - 31%. General urine analysis: specific gravity - 1020, straw yellow, transparent, urine reaction - acidic, negative protein, white blood cells - 1-2, epithelium
  11. DATA OF LABORATORY AND INSTRUMENTAL METHODS OF RESEARCH
    General blood test: Нb - 142 g / l, Er - 5.4x10 in 12 step / l. CEC - 0.8. ESR - 5 mm / h. L - 6.4x10 in 9 step / l, stab neutrophils - 4%, segmented neutrophils - 56%, eosinophils - 4%. basophils - 1%, monocytes - 6%. lymphocytes - 29%. General analysis of urine: specific gravity - 1022. straw-yellow color, transparent, urine reaction - acidic, protein
  12. Laboratory and instrumental research methods. Resolution
    In outpatient practice, screening methods of the 1st, less often 2nd level are used. The significance of the method is evaluated by two parameters: sensitivity and specificity. Sensitivity (CV) of the method - the probability of a positive result in people with the presence of diseases. correct positive conclusions Chv = - - х100% number of patients The more sensitive the method, the higher the probability
  13. LABORATORY METHODS OF RESEARCH IN HEMATOLOGY
    LABORATORY METHODS OF RESEARCH IN
  14. Laboratory and functional research methods in the acute period of ischemic stroke
    An ischemic stroke is a clinical syndrome, manifested by an acute violation of local brain functions that lasts more than 24 hours, or leads to death, can be caused either by insufficient blood supply in a certain area of ​​the brain as a result of a decrease in cerebral blood flow, thrombosis or embolism associated with vascular diseases, heart or blood. Decision on the need
  15. 40. INSTRUMENTAL AND LABORATORY METHODS OF RESEARCH OF THE URINARY SYSTEM. DIAGNOSTIC VALUE.
    Special, including instrumental, research methods reinforce the data of a general clinical examination of the patient and make it possible, first of all, to reveal latent forms of kidney diseases, and also to assess the degree of activity of the process, anatomical features (size), which is important to know with a long-existing disease, asymmetry of size and shape kidneys that may be due
  16. Laboratory and instrumental studies that are used to diagnose bone and muscle diseases.
    Most often, X-ray research methods are used to diagnose bone diseases. In recent years, ultrasound densitometry has been used to detect osteoporosis (a decrease in bone density). For the study of muscles, electromyography methods are used to determine the threshold of muscle electric excitability and the duration of the reaction, as well as specific biochemical
  17. Biochemical methods for the study of biological fluids in clinical laboratory diagnostics
    Biochemical methods for the study of biological fluids in a clinical laboratory
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