Exocrine Pancreas, GB and Liver Flashcards
What causes Acute pancreatitis
- Alcohol
- Gallstones
- Hypercalcemia
- Hyperlipidemia
- Drugs
- Scorpion sting
- Mumps
- Rupture of posterior duodenal ulcer
Pancreatic pseudocysts
Fibrous tissue surrounded liquefactive necrosis and pancreatic enzymes seen as late complication of Acute pancreatitis
What cuases Chronic Pancreatitis
Aduts: alcohol
Children: CF
Pancareatic carcinoma tumor marker is
CA 19-9
Pancreatic carcinoma is an
adenocarcinoma arising from the pancreatic ducts
Pancreatic carcinoma clinical
- Obstructive jaundice with pale stools and papable GB: because tumor normall in Head of pancreas causing obstruction
- Migratory thrombophlebitis (Trousseau sign)
Cholelithiasis is
Gallstones
Cholelithiasis arrise due to
- Saturation of Cholestrol or bilirubin
- Decrease phospholipds (Lecithin) or bile acids
- Stasis
Cholesterol stones are
Yellow
Radiolucent
Risk factors for cholesterol Gallstones
- Age
- Estrogen
- Clofibrate (increase cholesterol production)
- Crohn
- Cirrhosis
Bilirubin stones are
Pigmented Radiopaque
What two bugs increase Bilirubin Gallstones
Ascaris lumbricoides
Clonorchis sinensis
Acute cholecystits pain originates and radiates to where
Right upper quadrant pain that radiates to right scapula
Rokitansky-Aschoff sinus
Herniation of GB mucosa into muscular wall seein in chronic cholecystits
Ascending cholangitis is due to infection with
Ascending enteric gram-negative bacteria
What conjugates bilirubin in hepatocytes
Uridine glucuronyl transferase
Gilbert syndrome genetics
AR mutation causing mildly low UGT activity
Gilbert syndrome lab findings
Increase UCB
Gilbert syndrome clinical
Jaundice during stress
Crigler-Najjar defect
Absence of UGT
Crigler-Najjar clinical
Kernicterus
Fatal
Dubin-Johnson genetics
AR deficiency of bilirubin canalicular transport protein
Dubin-Johnson lab findings
Increased CB
Lab findings in Obstructive jaundice
- Increase CB
- Decrease urine Urobilinogen
- Increase Alkaline phosphate
Fibrosis in Cirrhosis is mediated by
TGF-β from Stellate cells
Mallory bodies are
Damaged cytokertain filaments seen in alcohol-related hepatitis
Primary hemochromatosis is due to an AR mutation in
HFE gene
Triad of Hemochromatosis
Cirrhosis
Secondary Diabetes mellitus
Bronze skin
Hemochromatosis lab findings
- Increase ferritin
- Decreased TIBC
- Increased Serum Iron
- Increased % saturation
Wilson disease genetics
AR defect in ATP7B that is an ATP-mediated hepatocyte Cu transport
Treat wilson disease with
D-pencillamine (chelates copper)
Primary Sclerosing Cholangitis is
Inflammation and fibrosis of intrahepatic and extrahepatic bile ducts
Primary Sclerosing Cholangitis is associated with
UC
p-ANCA
Reye syndrome is
Liver failure and encephalopathy in children with viral illness taking asprin
Aflatoxin is a risk factor for
Hepatocellular carcinoma
Hepatocellular Ca serum tumor marker is
Alpha-fetoprotein