Dr. Atchley Flashcards
hepatic lobule zone 3
least oxygenated -> ischemia and fat accumulation
hepatic lobule zone 1
most oxygenated -> toxins and viral hepatitis
urine glucuronyl transferase (UGT)
converts unconjugated bili to water soluble conjugated bili
Crigler Najarr syndrome
- build up unconjugated bili
- ABSENT UGT -> deadly
- BOTH UGT1A1 mutations
- type 1 -> more severe (no ability to conj. bili)
- type 2 -> some ability to conj. bili
Gilbert Syndrome
- build up unconj. bili
- REDUCED UGT -> benign
- SINGLE UGT1A1 mutation
- stress or fasting
- no Tx: reassure
Dubin Johnson syndrome
- build up conjugated bili
- benign but has BLACK liver
- bile transport deficiency
Rotor syndrome
-similar to Dubin Johnson but NORMAL liver
ALT > AST
VIRAL hepatitis
AST > ALT
ALCOHOLIC hepatitis
GGT (gamma glutamyl transferase)
most sensitive for recent EtOH use
-found in bile ducts
hemolytic disease of the newborn (HDN)
-caused by anti-A or Anti-B Abs (NOT Rh Abs)
primary biliary cirrhosis (PBC)
-anti-mitochondrial Abs (AMA)
primary sclerosing cholangitis (PSC)
- p-ANCA+ Abs
- beads on a string (dilation and strictures)
- ulcerative colitis
- onion skin fibrosis
- increase risk for cholangiosarcoma
cirrhosis
- liver failure
- decreased estrogen metabolism -> build up estrogen -> gynecomastia, spider angiomata, PALMAR ERYTHEMA
Alcoholic hepatitis
- AST»_space; ALT
- acinus zone 3 affected -> accumulate fat
- hepatocyte BALLOONING
- MALLORY BODIES
