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Disease of hepatobiliary system > CP 61 - Disease of the Liver, Investigation of the liver > Flashcards

CP 61 - Disease of the Liver, Investigation of the liver Flashcards

1
Q

what is a sinusoid?

A

A sinusoid is a small blood vessel that is a type of capillary similar to a fenestrated endothelium

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2
Q

what within the liver cause conjugation of bilirubin, drug detoxification?

A

smooth endoplasmic reticulum

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3
Q

what are some functions of the liver?

A

Carbohydrates - glycogen storage & synthesis, glycolysis & gluconeogenesis

proteins - synthesis & catabolism - clotting factos, AA metabolism & urea synthesis

lipids - lipoproteins & cholesterol synthesis, fatty acid metabolism, bile acid synthesis

excretion & detoxification - bile acid& bilirubin excretion, drug detoxification & excretion , steroid hormone inactivation & excretion

miscellaneous - iron storage, Vit A, D, E & B12 storage & metabolism

CPLEM

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4
Q

what is LFT?

A

liver function test

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5
Q

what are some test for the liver?

A

alk phosph, ALT, bilirubin albumin, total protein, GGT (gemma glutamyl transferase)

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6
Q

what are some examples for liver disease?

A 
Poisoning
Drugs
Infection (viral & non-viral)
Alcohol
Inadequate perfusion – can be cardiac abnormality 
Fatty liver
Autoimmune
Metabolic
Tumours & metastases
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7
Q

what are aminotransferases

A

an enzyme that catalyzes a type of reaction between an amino acid and an α-keto acid. They are important in the synthesis of amino acids

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8
Q

what are the 2 examples of aminotransferases?

A

ALT, AST - only found within the cells and so only detected when cell damages

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9
Q

which of the 2 aminotransferases is more specific to liver test?

A

ALT as AST also found in muscle and blood cells

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10
Q

what is a tumour marker for the liver?

A

– α-fetoprotein (primary hepatocellular carcinoma)

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11
Q

what can indicate biliary tract damage?

A

increased conjugated bilirubin

Alk phosph - increased due to increase production from the cells lining the bile canaliculi and overflow in blood - for

cholestasis
infiltrative diseases
space-occupying lesions - tumours
cirrhosis

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12
Q

what can Gamma glutamyltransferase (γGT)

indicate?

A

elevated due to structural damage - for

alcohol
enzyme inducing agents 
fatty liver 
heart failure 
prostatic disease 
pancreatic disease
kidney damage
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13
Q

what can indicate hepatitis?

A

AST/ALT elevated & normal ALP

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14
Q

what can indicate obstructive jaundice

A

AST/ALT normal & elevated ALP

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15
Q

what can indicate post-hepatic jaundice?

A

dark urine & pale stool

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16
Q

what LFT can be used to detect viral hepatitis?

A

Serology:

Hep A,B,C,D & EB, CMV, HIV

17
Q

what LFT can be used to detect chronic active & autoimmune hepatitis?

A

Anti smooth muscle, anti liver/kidney, anti microsomal and anti nuclear antibodies

18
Q

what LFT can be used to detect primary biliary cirrhosis

A

anti-mitochondrial antibodies

19
Q

what LFT can be used to detect hereditary haemachoromatosis

A

Ferritin, transferrin saturation, liver biopsy, genetic testing

20
Q

what LFT can be used to detect hereditary Wilson’s Disease

A

urine copper, plasma copper, liver biopsy

21
Q

what LFT can be used to detect α1-antitrypsin deficiency

A

α1-antitrypsin, genetic testing

22
Q

what is AFP

A

AFP (alpha-fetoprotein): AFP is a plasma protein that is normally produced by the foetus.

23
Q

what LFT can be used to detect hepatocellular cancer

A

AFP

24
Q

what are some symptoms for acute pancreatitis?

A

Severe epigastic pain, sudden onset, radiating to the back

25
Q

what are some of the potential biochemical features for acute pancreatitis

A

uraemia, hypoalbuminaemia, hypocalcaemia - fatty acid binds to Ca2+
hyperglycaemia,
metabolic acidosis

26
Q

what test can be used to detect acute pancreatitis

A

amylase or lipase
imaging
clinical history

27
Q

what test can be used to detect chronic pancreatitis

A

Miscellaneous: Vitamin D, calcium, FBC, LFTs, glucose, lipids

Pancreatic Function test for investigating insufficiency
Direct
Indirect

28
Q

what is direct pancreatic function test?

A

invasive - Intubation to collect aspirates in the duodenum.

Secretin, CCK, Lundh Tests

29
Q

what is indirect pancreatic function test?

A

non-invasive

Pancreatic enzyme analysis in stools (Elastase)
Trypsinogen (IRT) measured in blood in CF screening
Pancreolauryl & NBT-PABA tests

Disease of hepatobiliary system (4 decks)

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