6. Hepatobiliary and Pancreatic Disease Flashcards
Describe the features of jaundice
Yellowing of skin and mucosal surfaces - bilirubin >40umol/L
Can cause intense itch
Not always present in liver disease
What are the two types of jaundice
Unconjugated - water insoluble
Conjugated - water soluble, excreted in urine
Describe the prehepatic, intrahepatic and posthepatic causes of jaundice
Prehepatic - haemolysis : release of bilirubin from RBCs
Intrahepatic - liver disease: excess bilirubin in liver and bloodstream
Posthepatic - obstruction of bile outflow: dark urine and pale stools
What are some causes of cirrhosis
Alcohol Hepatitis B and C Iron overload Gallstones Autoimmune disease
Describe acute liver injury
Main causes: Viral infections ALCOHOL Adverse drug reactions Billary obstruction
Jaundice, malasie
Raised serum bilirubin and transaminases
Liver failure - decrease albumin, ascites, brusing, encephalopathy
Describe drug induced liver injury
Injury to hepatocytes - paracetamol overdose
Injury to bile production/secretion cells - methyl testosterone
Describe acute biliary obstruction
Usually due to gallstones
Causes colicky painand jaundice
Describe autoimmune chronic active hepatitis
Females > Males Usually present in mid-late teens Chronic hepatitis: Interface hepatitis Plasma cells and swollen hepatocytes Fibrosis
Describe primary bilary cirrhosis
Females > Males Stages: Autoimmune destruction of bile duct epithelium - dense lymphocytic infiltration Proliferation of small bile ducts Architectural disturbance Cirrhosis
Describe haemochromatosis
Iron deposition in the liver causing alteration of architecture - fibrosis - cirrhosis
Autosomal recessive - HFE gene
Describe a-1-antitrypsin deficiency
Autosomal recessive disorder Low levels of a-1-antitrypsin Proteins build up in hepatocytes Can lead to cirrhosis Associated with emphysema
Describe NASH/NAFLD
Non alcoholic steatohepatitis/non alcholic fatty liver disease
Associated with metabolic syndrome
Fat deposition in hepatocytes
Describe wilsons disease
Autosomal recessive disorder
Failure of liver to excrete copper in bile, builds up and leads to cirrhosis
Copper also deposits in brain tissue
Low caeruloplasmin
What are the causes of pancreatitis
Hypothermia Shock Alcohol Trauma Mumps virus Scorpoin bite Gallstones
