HTHSCI 2F03 Lecture Notes - Lecture 2: Carcinoid, Octreotide, Pulmonic Stenosis
26 Dec 2020
School
Department
Course
Professor
Document Summary
Jaundice from biliary obstruction or liver mets. Diverse group of neuroendocrine tumours of enterochromaffin cell origin capable of producing 5ht. May secrete: 5-ht, vip, gastrin, glucagon, insulin, acth. Carcinoid syndrome suggest bypass of first-pass metabolism and is strongly assoc. c metastatic disease. Valve fibrosis: tricuspid regurg and pulmonary stenosis. Tumour outgrows blood supply or is handled too much massive mediator release. Median survival is 5-8yrs (~3yrs if mets present) Inflammation of the vermiform appendix ranging from oedema to ischaemic necrosis and perforation. Age: rare <2yrs, maximal peak during child, thereafter. Oedema ischaemia necrosis perforation. Visceral pain is not well localised cf. somatic pain. Nociceptive info travels in the sympathetic afferent fibres that supply the viscus. Pain referred to the dermatome corresponding to the spinal cord entry level of these sympathetic fibres. Append = midgut = lesser splanch (t10/11) = umb. Appendix mass may be palpable in rif. Pressure in lif more pain in rif.
