Clinical Correlations of the Upper GI System - Liver & Pancreas Flashcards
What is hepato-renal syndrome?
A functional form of renal failure due to liver cirrhosis. Patients will not respond to IV fluids. Liver transplant needed
Obstruction is most associated with (conjugated/unconjugated) hyperbilirubinemia.
Conjugated hyperbilirubinemia
Patients with primary sclerosing cholangitis are at higher risk of developing cholangiocarcinoma. What condition do most patients concurrently have?
Ulcerative colitis
This disease is characterized by progressive destruction of large bile ducts.
Primary sclerosing cholangitis
How is longterm ascites managed?
With diuretics (furosemide, spironolactone)
Patients with acute pancreatitis generally present with severe, sudden pain that radiates to the back. What abnormal lab findings may be present?
Amylase and lipase levels >3x normal
A patient undergoes Hepatitis B serology testing. What is their status?
HbsAg - negative
anti-HBc - positive
anti-HBs - positive
Immune due to natural infection. Immune, vaccinated patients do not have HBc antibodies.
What is hemochromatosis?
A genetic disorder that causes the deposition of iron in the liver
What is the treatment for acetaminophen overdose?
N-acetylcysteine antidote
A patient presents with liver dysfunction. Their transaminases are >1000 and blood testing confirms ANA and anti-smooth muscle antibodies. What is the diagnosis?
Autoimmune hepatitis
anti-LKM1 antibodies are seen in children
What would be the Hepatitis B serology results for a patient immune to the virus due to vaccination?
HbsAg - negative
anti-HBc - negative
anti-HBs - positive
What would be the Hepatitis B serology results for a patient chronically infected with the virus?
HBsAg - positive
anti-HBc - positive
IgM anti-HBc - negative
anti-HBs - negative
HBs antibodies are not generated until the virus is cleared.
What is the treatment for chronic pancreatitis?
Glucose control, small and frequent low-fat meals, pancreatic enzyme supplements, pain control
What would be the Hepatitis B serology results for a patient acutely infected with the virus?
HbsAg - positive
anti-HBc - positive
IgM anti-HBc - positive
anti-HBs - negative
HBs antibodies are not generated until the virus is cleared.
What is the most common cause of acute liver failure in the USA?
Acetaminophen
True/False. Most cases of Hepatitis C infection are acute.
False - acute cases are rarely seen. Most are chronic
What is the most common cause of unconjugated hyperbilirubinemia?
Gilbert’s disease - deficient functioning of UGT enzyme
What is the treatment for hepatic encephalopathy?
Lactulose, with rifaximin as prophylaxis
What is the most common complication of portal hypertension?
Ascites
What is the most common location of pancreatic adenocarcinoma?
Head of the pancreas
What is the cause of hepatic encephalopathy?
Decompensated liver cirrhosis - buildup of glutamine in the brain from increased ammonia that causes edema
Metabolic syndrome is most associated with what liver pathology?
Non-alcoholic fatty liver disease
This disease is characterized by progressive autoimmune destruction of small bile ducts.
Primary biliary cholangitis
What is the primary prophylaxis for esophageal varices?
Beta-blockers (nadolol, propanolol) and banding
Alkaline Phosphatase (ALP) is found in the liver, kidneys, and placenta. When ALP is elevated, what enzyme is checked to confirm liver dysfunction?
Gama-glutamyl transpeptidase (GGT) - when elevated with ALP indicates liver problem
What are the most common causes of acute pancreatitis?
Alcohol, cholelithiasis (gallstones)
Hepato-renal syndrome is caused by liver cirrhosis. What is the pathophysiology of the disorder?
Splanchnic vasodilation, renal vasodilation, activation of RAAS
What is a possible complication of acute pancreatitis?
Pseudocysts
What gene mutations are associated with hemochromatosis?
H63D andC282Y
This Hepatitis virus is spread via contaminated foods and water and never causes chronic infection.
Hepatitis A
Hepatocellular carcinoma is the most common type of hepatic tumor. What diagnostic finding may be found on imaging?
Arterial enhancement with rapid venous washout
A patient is diagnosed with Alcohol-Induced liver disease. What are the likely levels of their AST:ALT enzymes?
AST increased x2 that of ALT
