Gastrointestinal Pathology Flashcards
Describe the breakdown of billirubin
Heme metabolized by heme oxygenase to billiverdin
Reduced to bilirubin
Liver removes bilirubin from blood and conjugates it with glucuronate where its excreted into the bile.
Direct bilirubin is conjugated and soluble in water.
Indirect is unconjugated and water insoluble.
Conjugated gets converted in the intestines by bacteria and results in urobillinogen thats excreted as either stercobilin in the stool or urobillin in the kidney.
Why does achlasia occur?
Constriction of pyloric sphincter due to loss of myenteric plexus.
What is plummer vinson syndrome?
Triad of dysphagia, iron deficiency anemia and esophageal varices.
celiac disease
gluten intolerance decreasing mucosal absorption mostly effecting the duodenum and or jejunum.
How wuld pancreatic insufficiency present
Pt would not be able to absoarb fats!
Yu see foamy macropages in intestinal lamina propria with cardiac symptoms, arthralgias, and neurological symptoms.
Whipple disease
“Foamy whipped cream in a CAN”
Skip lesion with cobblestone mucosa, creeping fat and thickened bowel wall.
Crohns disease.
Ulcers in the large intestine that are continueous with crypt abcesses and risk of colorectal carcinoma. Extends proximally with bloody diarrhea and sclerosing cholangitis.
This is a sign of ulcerative colitis.
Hirschsprung disease
lack of ganglion cells/enteric plexus in the instestine leading to congenital megalo colon.
Increased risk with down syndrome.
Elevated ALP levels
Cholestatic and obstructive hepatobiliary disease HCC, Infiltrative disorders, bone disease.
Elevated ALT vs AST
Viral hepatitis
or metabolic syndromes
Elevated AST vs ALT
Alcoholic hepatitis
“Sippin”
Elevated amylase
acute pancreatitis/mumps
Decreased ceruloplasm
Wilson disease
Elevated lipase
pancreatitis.
Mallory bodies found in a swollen necrotic liver?
Alcoholic hepatitits.
Alcoholic cirrhosis
Final irreversible form of alcohol damage due to sclerosing around the zone 3 central vein.
Crigler Najjar syndrome type I
Absent UDP glucoronsyltransferase leading to the inability to conjugate bilirubin.
Dubin Johnson Syndrome
Conjugated hyperbilirubinemia due to defective liver excretion.
Causes a benign grosly black liver.
rotor syndrome is similar but doesnt cause blackened liver.
Wilsons disease
inadequate copper excretion leads to copper accumulation in the body.
Especially in the liver, brain, cornea and kidneys “Fancony syndrome”
It is an autosomal disorder
causing hemoytic anemia and kayser fleischer rings in the eyes “Golden brown Ring”
Diabetes with skin pigmentation causing a bronze color and cirrhosis.
Hemochromatosis: Excessive deposition of iron in the body. May be due to an autosomal recessive disorder or excessive transfusion. Identified with prussian blue staining.
