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The GI System > Diseases of the Liver, pancreas, and gall bladder > Flashcards

Diseases of the Liver, pancreas, and gall bladder Flashcards

jaundice, fatty liver disease, liver cirrhosis and hepatic failure, gall stones, acute and chronic pancreatitis

1
Q

What is jaundice

A

Build up of bilirubin in blood and tissues in excess of 2mg/ml

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2
Q

Pre-hepatic causes of jaundice

A 
Increased haemolysis (RBC breakdown)
Gilbert's syndrome (mutation in Bilirubin UDP-­‐glucuronyl transferase 1 gene so ELEVATED UNCONJUGATED bilirubin)
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3
Q

If the cause of jaundice is pre-hepatic then what will the AST/ALT and ALP/gGT be like on a blood test?

A

Normal AST/ALT

Normal ALP/gGT

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4
Q

Hepatic causes of jaundice

A

Failure of cellular mechanisms of excretion of conjugated bilirubin
Acute hepatitis (Viral, Alcohol, Autoimmune, Toxic)
Or Chronic hepatitis and cirrhosis
Cholestasis (interruption of bile flow) as a result of damage to the liver
Cancer
Destruction of bile ductules (autoimmunity/drugs)
Cholestasis (secondary to systemic injury, pregnancy, drug toxicity)

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5
Q

Post-hepatic causes of jaundice

A

Gallstones

Disease of the ducts (cancer, inflammation) Compression of ducts (lymph nodes, pancreatic cancer)

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6
Q

Cholestasis=

A

reduction or stoppage of bile flow

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7
Q

What is liver cirrhosis

A

the final stage of chronic liver disease

characterised by fibrosis and abnormal ‘regenerative nodules’ in place of normal liver structure

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8
Q

What are the life-threatening complications of liver cirrhosis?

A

renal failure
portal hypertension
oesophageal varices
ascites

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9
Q

What is non-alcoholic fatty liver disease (NFLD)

A

a fatty liver (liver steatosis) in those who do not consume alcohol in amounts considered harmful to the liver

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10
Q

The most common causes of liver cirrhosis

A

alcoholic fatty liver disease
non-alcoholic fatty liver disease
viral hepatitis

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11
Q

What is the most widely held hypothesis for the pathology behind non-alcoholic fatty liver disease?

A

insulin resistance as the key mechanism leading to excessive triglyceride accumulation in the liver and subsequent hepatic steatosis

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12
Q

Risk factors for non-alcoholic fatty liver disease

A 
obesity 
insulin resistance (type II diabetes)
hypertension
metabolic syndrome
hyperlipidemia 
hepatotoxic medications (tamoxifen)
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13
Q

What is alcoholic fatty liver disease

A

liver damage caused by heavy chronic alcohol ingestion

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14
Q

Risk factors for alcoholic fatty liver disease

A 
being female (although more people with it are men)
prolonged and heavy alcohol exposure 
hepatitis C (will develop faster)
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15
Q

What is the (very basic) pathology of alcoholic fatty liver disease?

A

Excessive hepatic processing of alcohol means:

  • causes an increase in fatty acid oxidation promotes fatty acid infiltration to the liver
  • also generates more free radicals in the liver, damaging it
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16
Q

How is hepatitis B transmitted?

A

sex and blood

17
Q

How is hepatitis C transmitted?

A

blood

18
Q

How is hepatitis A and E transmitted?

A

faeces

19
Q

Symptoms of hepatitis C?

A

mostly asymptomatic

can present acutely in some - jaundice, fatigue

20
Q

Why does viral hepatitis damage the liver?

A

Viruses selectively infect hepatocytes (A-­‐E)
Very strong immune response causes severe hepatitis The immune system then kills the infected hepatocytes You wont necessarily see jaundice in all cases…….

21
Q

Liver function tests: Alanine aminotransferase (ALT) and aspartate aminotransferase (AST) - what are they?

A

ALT and AST are enzymes found in hepatocytes which leak into the blood stream when the liver cells are damaged. They indicate the degree of inflammation present in the liver

22
Q

Liver function tests: Alkaline phosphatase (ALP) and y-Glutamyltransferase (GGT) - what are they?

A

Enzymes found mainly in the bile ducts of the liver. Increases in ALP and GGT can indicate obstructive or cholestatic liver disease, where the flow of bile from the liver is blocked because of an obstruction of the bile duct.

23
Q

Symptoms of alcohol withdrawal syndrome

A 
tachycardia 
hypertension
irritability
insomnia 
anxiety
agitation
tremour 
severe/derilrium tremens - worsening AWD + 
tonic-clonic seizures 
confusion/delirium
hallucinations
hyperthermia

The GI System (13 decks)

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