Gastroenterology Flashcards
what are the GI red flags
dysphagia, GI blood loss, persistent vomiting, unexplained weight loss, upper abdominal mass
GI gynaecomastia
hyperoestrogenism (cirrhosis)
decreased androgen, loss of testosterone (alcoholic liver disease)
major functions of the liver
detoxification and degradation, excretion of cholesterol and bilirubin, production of hepatic bile
liver blood supply ratio
hepatic portal vein 75%
hepatic artery 25%
what do sinusoidal spaces contain
endothelial cells (form fenestrated structure), kuppfer cells (macrophages resistant to sinosoidal vascular space that remove particulate matter), stellate cells (store vit a)
what happens in phase I drug metabolism
oxidation, reduction, hydrolysis makes drug more polar, adds a reactive group permitting conjugation
what happens in phase II drug metabolism
conjugation- addition of endogenous compounds increasing polarity then excretion (renal)
most abundant plasma protein that controls oncotic pressure and doesnt exit isnt interstitial fluid
albumin
what does albumin transport
fatty acids, bilirubin, thyroid, aspirin
plasma protein that transports lipoproteins, lipids, hormones and bilirubin, caeruloplasmin, retinol binding hormone
alpha globulins
plasma protein that transports transferrin (Fe3+) and fibrinogen
beta globulins
what vitamins + minerals does the liver store
Vit A, D, B12 and iron
what is acute liver disease
rapid development of hepatic dysfunction without prior liver disease causing encephalopathy and prolonged coagulation
what are the symptoms of acute liver disease
none, jaundice, lethargy, nausea, anorexia pain, itch, arthralgia, abnormal LFTs
causes of acute liver disease
viral (hep, cmv, ebv, toxoplasmosis), drugs, shock liver, cholangitis, alcohol, malignancy, chronic liver disease, paracetamol
rare: budd chiari, AFLP, cholestasis of pregnancy
