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Part 1 Pathophysiology > GI And liver > Flashcards

GI And liver Flashcards

1
Q

DNA hepatitis

A

B

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2
Q

Unenveloped hepatitis

A

A and E

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3
Q

IV hepatitis

A

BCD

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4
Q

Hep A diagnosis

A

Serum IgM ABs

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5
Q

Hep B diagnosis

A

HBsAg
AB to HBcAg
PCR for HBV DNA

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6
Q

Hep C diagnosis

A

3rd gen ELISA for AB detection
PCR for HCV RNA

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7
Q

Hep D Diagnosis

A

IgM and IgG ABs
Serum RNA
HDAg in liver

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8
Q

Hep E diagnosis

A

IgG and IgM ABs serum
PCR for RNA

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9
Q

Serology carrier hep B

A

HBsAg present
HBeAg not present
Anti HBeAB present
Normal transaminases
Low/ undetectable HBV DNA
Liver bx no inflamation or necrosis

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10
Q

UC

A

spreads prox from rectum
broad based shallow ulcers, mucosa only
no strictures
multiple pseudopolyps
toxic megacolon

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11
Q

Crohns

A

skip lesions
cobblestone
transmural
rik calcium oxalate stones
strictures, deep ulcers
non caseating granulomas

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12
Q

coeliac

A

tissue transglutaminase and gliadin blood tests
diffuse enteritis with flattened villi
assoc dermatitis herpetiform

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13
Q

Whipple disease

A

assoc HLA B27
tropherma whippeli infection
lamina propria SI laden macrophages
diarrhoea, statorrhoea, fever weight loss, migratory arthritis, brain involvement

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14
Q

Blood tests liver

A

hepatocyte - ALT AST LDH
bile canaliculi - ALP GGT

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15
Q

Scar formation liver

A

collagen release by stellate (Ida cells)

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16
Q

Cirrhosis morphology

A

proliferating hepatocyte surrounded by on going fibrosis
- fibrous septae
- parenchymal nodules
- disruption architecture

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17
Q

Acute liver failue

A

80% function lost
80% die without transplant

acute illness assoc encephalopathy and coagulopathy
within 26 weeks initial illness
absence pre existing liver disease

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18
Q

Ascites

A

85% due to cirrhosis
low protein fluid
amount of lymph thoracic cavity exceeds thoracic duct capacity

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19
Q

Mortality acute on chronic hepatic failure

A

50%

20
Q

HBV % acute and chronic

A

65% subclinical
25% acute
10% chronic

21
Q

HCV % chronic

A

80%, main cause IVDU

22
Q

HIV % with hepatitis

A

10% HBV
25% HCV

23
Q

Chronic hepatitis morphology

A

mononuclear portal infiltration
hepB ground glass hepatocytes
hepC lymphoid aggregates and bile duct injury

24
Q

Type 1 autoimmune hepatitis

A

middle aged/ old
ANA and anti smooth muscle actin ABs

plasma cells as infiltrate

25
Q

Type 2 autoimmune hepatitis

A

kids/ teenagers
anti liver kidney microsome 1 antibodies

plasma cells as infiltrate

26
Q

Hepatic cancer associations

A

hepatocellular adenoma - OCC and anabolic steroids
HCC - ETOH
angiosarcoma - vinyl chloride

27
Q

Stages alcoholic liver disease

A
  1. steatosis (reversible) fatty change and perivenular fibrosis
  2. hepatitis (reversible) hepatocyte swelling, mallory bodies, neutropilic infiltrate
  3. fibrosis and cirrhosis (non reversible) extensive fibrsosis with hyperplastic nodules
28
Q

NAFLD

A

> 5% hepatocytes invlved
less mallory bodies and more mononuclear cells tan ETOH
80% isolated fatty liver, 20% NASH which is progressive

29
Q

Unconjugated bilirubin

A

insoluble in water
highly albumin bound
unbound crosses BBB and icteric sclera
increased unbound in haaemolytic disease or when drugs displace

30
Q

Causes unconjugated bilirubinaemia

A

neonatal jaundice
criggler najar
gillbert syndrome

31
Q

Biliary atresia

A

conjugated
fetal/ perinatal (more common)
obstruction biliary tree viral/ autoimmune
hepatic or common bile duct

32
Q

Primary biliary cirrhosis

A

autoimmune cholangiopathy
destruction small medium bile ducts
female in 50s
assoc sjorgens
95% AMA
dx bx

33
Q

Primary sclering cholangitis

A

autoimmune cholangiopathy
intra and extrahepatic bile ducts with dilation and preserved segments
male 30s
assoc IBD
65% ANCA
radiology strictures and beading large bile ducts

34
Q

Gallstone types

A

cholesterol - most common, radiolucent unless contain calcium carbonate
pigment - insoluble calcium salts and unconjugated bilirubin
brown infected and radiolucent
black sterile and radioopaque

35
Q

Morphology chronic cholecystitis

A

suserosal fibrosis
outpouchings epithelium
porxelein gallbladder
hydrops gallbladder end stage

36
Q

Cirrhosis collagen

A

TI and III normally in portal tracts and around veins - deosited in lobules, neovascularisation
TIV in space of disse

37
Q

Pathogenesis acute pancreatitis

A

pancreatic duct obstruction
primary acinar cell injury
defective intrracellular release proenzymes

38
Q

Main cause acute panreatitis

A

80% alcohol and gallstones

39
Q

Hereditory pancreatitis

A

assoc 25% of pacreatitis
40% risk cancer
CFTR
SPINK1

40
Q

Blood tests pancreatitis (timing)

A

amylase in 24h
lipase in 72-96h
decreased Ca2+
10% glycosuria

41
Q

Cause and mortality chronic pancreatitis

A

Mainly alcohol
TGFbeta and PDGF fibrogenic factors
25y mortality 50%

42
Q

Autoimmune pancreatitis

A

IgG4 secreting plasma cells in pancreas
responsive to steroid therapy
similar symptoms to cancer

43
Q

Chronic hepatitis

A

Symptoms/biochemical/serological evidence for > 6m

44
Q

Hepatitis carrier

A

Harbours and can transmit
No symptoms

45
Q

Virus causing ischaemic gut

A

CMV

Part 1 Pathophysiology (15 decks)

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