Biliary Tract Disease/Jaundice Flashcards
Things that the liver does.
1) Conjugates bilirubin
2) Makes prothrombin
3) Converts ammonia to urea
4) Makes albumin
Conditions where you have more unconjugated bilirubin in the blood.
Hemolysis
Conditions where you have more conjugated bilirubin in the blood.
Biliary tract obstruction.
What happens if the liver doesn’t work to make albumin.
There’s less protein (albumin) in the blood, and fluid goes into the extracellular space to cause edema.
What happens if the liver doesn’t work to make prothrombin.
You have longer clotting time.
What happens if the liver doesn’t work to make urea.
Toxic ammonia builds up in the blood.
Liver function tests that measure biliary tract obstruction.
GGT and ALP
What is biliary cirrhosis?
Autoimmune destruction of the bile ducts.
The liver and cholesterol.
The liver makes and gets rid of cholesterol.
What can you get from primary biliart cirrhosis?
Bile duct destruction, granulomas, autoimmune disease, anti-mitochondrial antibodies, xanthomas, jaundice.
What physical discomfort does a lot of bilirubin in the blood cause?
Pruritis.
Why is there a lot of bilirubin in the blood in PBC?
Bc the bile ducts are destroyed, and the bilirubin has no where else to go other than the blood.
Why are there xanthomas in ________ (a disease).
Xanthomas are in primary biliary cirrhosis bc the liver can’t get rid of the cholesterol, so it builds up and forms fatty deposits under the skin.
The liver normally makes and gets rid of cholesterol in the _______.
Bile - But if the bile ducts are destroyed, the cholesterol is deposited under the skin in xanthomas.
Difference between primary and secondary biliary cirrhosis.
Primary biliary cirrhosis causes destruction of the biliary tract due to an autoimmune problem. Secondary biliary cirrhosis is caused by obstructing the biliary tract with a stone, for example.
Seen in secondary biliary cirrhosis.
Bile duct proliferation and polys.
Cholestasis.
Bile moves slowly or not at all.
Evidence of cholestasis.
1) Bile duct proliferation
2) Pigmented hepatocytes
3) Distended canaliculi
Sclerosing cholangitis
Segmented, concentric fibrosis.
Quadrant with the gall bladder.
Right upper quadrant.
Cholecystitis
Ischemia and inflammation of the gall bladder.
Cholelithiasis
Gall stones.
People at risk to get cholelithiasis.
Fair (female), forty, full figure.
Contents of gall stones.
Cholesterol, Bilirubin, and Calcium carbonate
Hepatitis that can increase the risk of primary liver cancer.
Hep B and C.
Cancer of the bile ducts.
Cholangiocarcinoma
How is hepatocellular carcinoma different from bile duct cancer?
The tumor cells in hepatocellular carcinoma make bile, but the cells in bile duct cancer do not.
