EXTRAS Flashcards
what are the cells in the islets of langerhans and what do they produce?
beta cells - insulin
alpha cells - glucagon
delta cells - somatostatin
F cells - pancreatic polypeptide
how does somatostatin affect pancreatic secretions?
decrease them
how does cholecystokinin affect pancreatic secretions?
increases enzymatic secretions
how does secretin affect pancreatic secretions?
increases water and electrolyte secretions
what will not be absorbed in pancreatic insufficiency?
fats
fat soluble vitamins ADEK
vitamin B12
what do the acing cells of the pancreas secrete?
enzymatic secretions e.g. trypsinogen, procarboxylate, amylase and elastase
what do the ductal and centroacinar cells of the pancreas secrete?
aqueous secretions including Na+, HCO3-, K+, water and Cl-
whats the arterial supply to the pancreas?
head pancreaticoduodenal artery
tail splenic artery
whats the incubation time for hep A?
2-4 weeks
whats the incubation time for Hep E?
2-10 weeks
whats the incubation time for Hep C?
2 weeks - 6 months
whats the incubation time for hep B?
1-6 months
what type of virus is hep a?
ss+ RNA hepatovirus
what type of virus is hep B?
double stranded DNA virus
what type of virus is hep C?
SS+ RNA flavivirus
what type of virus is hep D?
ss - RNA delta virus
what type of virus is hep E?
ss + RNA picornavirus
what is fulminant hepatitis?
a clinical syndrome of severe liver function impairment which causes hepatic command the decrease in synthesising capacity of the liver. Develops within 8 weeks of the onset of hepatitis. i.e. acute liver failure
what are councilman bodies?
hepatocytes undergoing apoposis - seen in viral hepatitis
what will be higher in viral hepatitis, ALT or AST?
ALT
which viral hepatitis infections can you vaccinate against?
A and B
what type of vaccine is hep A?
inactivated preparation
what type of vaccine is for hep B?
subunit/conjugate vaccine
why can viral hepatitis lead to renal failure?
it can cause membranous glomerulonephropathy
what is HBsAg?
hepatitis B surface antigen
what is HBcAg?
hepatitis B core antigen
what does it mean if HBsAg is positive?
person is currently infected with hepatitis B and is able to pass the infection on to others.
what does it mean if HBcAg is positive?
an active infection with the hepatitis B virus, likely in someone with chronic hepatitis B
what is HBeAg?
Hepatitis B e-antigen
what does positive HBeAg mean?
marker of an actively replicating HBV virus infection
what does it mean if anti-HBc IgM is positive?
recent infection with hepatitis B virus (<6 mos).
what does it mean if anti-HBc IgG is positive?
chronic hep B infection
what are the 3 pathways in which alcohol can be broken down in hepatocytes?
CYP450 2E1
catalase in peroxisomes
alcohol dehydrogenase
whats an example of a reactive oxygen species?
hydrogen peroxide
what are mallory bodies?
damaged intermediate filaments
what typically causes mallory bodies?
alcoholic induced liver disease
what is perivenular fibrosis?
when scar tissue forms around the central veins in the liver
whats higher in alcoholic fatty liver disease, ALT or AST?
AST
what is the definition of metabolic syndrome?
3 of 5 of the following... obesity hypertension diabetes hypertriglyceridemia hyperlipidemia
whats the pathophysiology of non-alcoholic fatty liver disease?
insulin receptors become less responsive to insulin
more fat is taken up by cells and less fatty oxidation occurs
accumulation of fat droplets in the cells
reactive oxygen species form and cause breakdown of lipid membranes of hepatocytes
cell death
generates inflammation
stellate cells can the start to put down fibrous tissue
what will be higher in non-alcoholic fatty liver disease, ALT or AST?
ALT
what is a prehepatic cause of portal hypertension?
- Obstruction e.g. thrombus occluding the portal vein
what is an intrahepatic cause of portal hypertension
- Cirrhosis
- Shistosmiasis
- Sarcoidosis
what is a post hepatic cause of portal hypertension
- Budd chiari syndrome
- Right sided heart failure
- Constrictive pericarditis
what is schistosomiasis?
when fluke worms (trematode worms) invade the liver
what is sarcoidosis?
when granulomas form in the liver from inflammatory cells
what is Budd chiari syndrome?
When a thrombus or tumour obstructs the venous flow towards the inferior vena cava
what type of anaemia does liver disease usually cause?
macrocytic
which ligament connects the liver do the anterior abdominal wall?
falciform ligament
what is the volume of distribution?
theoretical volume that the total amount of administered drug would have to occupy to provide the same concentration as it currently is in blood plasma
