GIT 2 Flashcards
Cavernous hemangioma involves ____ structures and has _______ appearance
deep (liver, brain)
“Mulberry like”
Cavernous hemangioma histology:
Abnormal dilated blood vessels with single epithelial layer and thin adventitia lacking elastic fibers and smooth muscles
Focal nodular hyperplasia is most common in _____. it is a _______ lesion caused by hepatic vascular abnormality causing ______ with ________
young women. non-malignant
localized hyperperfusion, secondary hyperplasia
Focal nodular hyperplasia features indicating arterial origin is _____________________________
enhancement with contrast in arterial phase
Crigler Najjar syndrome type 1 treatment
plasmapheresis and phototherapy
Wilson disease lab findings:
↓ ceruloplasmin, ↓ bound copper, ↓ Total copper
↑ Free copper ( cause of all the symptoms)
(ATP7B gene; chromosome 13)
hepatocyte copper-transporting ATPase → loads Cu to apoceruloplasmin → it loads Cu to ceruloplasmin → secreted in blood
- Transports Cu to bile
Hemochromatosis effect on gonads and joints
hypogonadism (atrophy of testis)
arthropathy (calcium pyrophosphate deposition; especially metacarpophalangeal joints).
HFE protein found on
basolateral surface of hepatocyte and enterocyte
Ferroportin found on
macrophages and basolateral surface of enterocyte
Hemochromatosis
On ____ gene, located on chromosome ___; associated with ____. Leads to ______ and _________
HFE , 6
HLA-A3
abnormal iron sensing and ↑intestinal absorption
Primary sclerosing cholangitis
Unknown cause of concentric “onion skin” bile duct fibrosis alternating strictures and dilation with “beading”
of intra- and extrahepatic bile ducts
Primary biliary cholangitis
Autoimmune reaction lymphocytic infiltrate +/– granulomas destruction of ____
Treatment:
lobular bile ducts.
Ursodiol (ursodeoxycholic acid)
Estrogen increases the biosynthesis of cholesterol by___
upregulation of HMG-CoA reductase
Ursodeoxycholic acid is only used for____
cholesterol stones
Pigment stones (black =
brown =
radiopaque, Ca2+ bilirubinate, hemolysis
radiolucent, infection
Choledocholithiasis Presence of gallstone(s) in
common bile duct
Rigler triad:
radiographic findings of pneumobilia, small bowel obstruction, gallstone (usually in iliac fossa).
used for gallstone ileus
Charcot triad of cholangitis includes ____
Reynolds pentad is _____
JFR: jaundice, fever, RUQ pain.
Charcot triad plus altered mental status and shock (hypotension).
TPN causes bile stone by
↓CCK release → hypomobility of bile
Recurrent abdominal pain and jaundice in childhood (<10 y)
Choledochal cysts: Congenital dilatation of common bile duct
Abdominal pain, high fever 10 - 14 days after acute pancreatitis:
pancreatic abscess due to infection of pancreatic pseudocyst.
Pancreatic pseudocyst (lined by _____ , not _____
granulation tissue
epithelium
Chronic pancreatitis Complications include
pancreatic insufficiency and pseudocysts.
Pancreas lies below _____
splenic vein
Splenic vein thrombosis treatment:
splenectomy
Pancreatic adenocarcinoma
Very aggressive tumor arising from ______
pancreatic ducts
Pancreatic adenocarcinoma
Associated with tumor marker _______ (also _____, less specific).
CA 19-9,
CEA
——-, ———– and ———- genes are mutated in pancreatic carcinoma
BRCA-2, K-RAS, SMAD-4 (DPC-4)
Normally Fatty acids exist in the serum ___
bound to albumin
Effect of acute pancreatitis on sodium:
Hypernatremia (third spacing → hypovolemia → renal sodium retention
