buzzwords - GI Flashcards

1
Q

red flags

A

dysphagia, GI blood loss, persistent vomiting, unexplained weight loss, upper abdominal mass

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2
Q

what things should you ask about diarrhoea

A

frequency, nocturnal diarrhoea, colour and consistency, blood

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3
Q

herbal and ‘food supplements’, possible toxins, alcohol

A

liver

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4
Q

what should be suspected in known liver, pancreas, small bowel disease

A

malabsorption

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5
Q

gynaecomastia ->

A

hyperoestrogenism (cirrhosis)

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6
Q

easy brusing is due to

A

vit c deficiency (scurvy)

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7
Q

major functions of liver

A

detoxification and degradation, excretion of cholesterol and bilirubin, production of hepatic bile

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8
Q

where does blood go to liver

A

from hepatic portal vein (75%), hep artery (25%)

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9
Q

where does venous and arterial blood mix in liver

A

sinusoids

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10
Q

what is the direction of blood in liver

A

flows inwards towards the central vein through the sinusoids

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11
Q

what is contained in the sinusoidal space

A

endothelial cells to form fenestrated structure
kuppfer cells - macrophages resident to sinuoidal vascular space (remove particulate matter eg bacteria and senescent RBCs)
stellate (ito) cells in space of disse - storage of vitA

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12
Q

what is phase 1 of drug oxidation

A

oxidation/reduction/hydrolysis

makes drug more polar, adds a chemically reactive group (a handle) permitting conjugation (functionalisation)

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13
Q

what is phase 2 of drug oxidation

A

conjugation

adds endogenous compunds increasing polarity eg glucuronyl, sulphate, methyl, acetyl, glycyl, glutathione groups

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14
Q

what are the 3 plasma proteins

A

albumin
alpha-globulins
beta-globulins

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15
Q

what does albumin do

A

transports fatty acids, bilirubin, thyroid, aspirin

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16
Q

what does alpha-globulin do

A

transport lipoproteins, lipids, hormones, and bilirubin

17
Q

what does beta-globulin do

A

transferrin (fe3+), fibrinogen

18
Q

what does liver store

A

vits A, D, B12, iron

19
Q

what is the livers nearest central vein

A

zone 1 = periportal

20
Q

the rapid developent of hepatic dysfunction without prior liver disease causing encephalopathy and prolonged coagulation (<6 months)

A

acute liver disease

21
Q

causes of acute liver disease

A

viral (hepA/B/C/D/E, CMV, EBV and toxoplasmosis)
drug, shock liver, cholangitis, alcohol, malignancy, chronic liver disease, paracetamol overdose, rare (budd chiari, AFLP, cholestasis of pregnancy)

22
Q

what investigations would you carry out for acute liver disease

A
LFT's (inc albumin, bilirubin)
prothrombin time
Hx
examination
U/S
virology
rarely liver biopsy