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GI part 2 > icr: jaundice > Flashcards

icr: jaundice Flashcards

1
Q

cirhhosis causes

A

portal hypertension

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2
Q

final product of heme breakdown?

A

bilirubin

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3
Q

unconjugated bilirubin is water _____

A

insoluble — has to attach to albumin for transport

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4
Q

conjugation of bilirubin

A

unconjugated bilirubin is conjugated at the ER by the enzyme uridine diphosphate glucuronosyltransferase (UDP-GT)
after, bilirubin is water soluble

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5
Q

direct fraction =

A

conjugated bilirubin

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6
Q

indirect fraction =

A

u-bilirubin

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7
Q

PBC is more common in ___ and PSC in ___

A

females; males

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8
Q

pain radiating to the back indicates

A

pancreatic cancer or chronic pancreatitis

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9
Q

1-2 weeks before viral hepatitis you see

A

prodrome = anorexia, malaise, nausea, low grade fever, and arthritis

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10
Q

pruritis suggests

A

obstructive/cholestatic process

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11
Q

bilirubin binds to

A

elastin –> sclera is high in elastin so this causes scleral icterus

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12
Q

kayser Fleischer rings

A

copper deposit in lens of eye = wilsons disease

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13
Q

xanthoma

A

fat deposition = biliary sirrhosis

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14
Q

gynecomastia

A

chronic liver disease

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15
Q

caput medusa

A

superficial vein pattern near umbilicus –> portal hypertension

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16
Q

courvoisiers sign

A

distended gallbladder, nontender, and jaundice

NOT stones –> likely malignancy of gallbladder or pancreas

17
Q

telangiectasia

A

spider veins –> cirrhosis or oral contraceptives can cause them

18
Q

gilberts syndrome

A

AD, decreased activity of UDP-GT –> elevated u-bilirubin

evident jaundice in stress

19
Q

crigler najjar

A

absence of UDP-GT –> fatal!

20
Q

choledocolithiasis

A

stones in the common bile duct

21
Q

PSC

A 
primary sclerosing cholangitis
inflammatory thickening/fibrosis of larger bile ducts
immune system mediated
young males
associated with UC
risk for cholangiocarcinoma
22
Q

PBC

A 
primary biliary sirrhosis
autoimmune destruction of small bile ducts
mid age females
elevated alk phos
\+AMA
23
Q

ALT vs AST

A

AST is more sensitive for alcoholic cause

24
Q

alk phos

A

indicated cholestatic process

25
Q

three ddx for tea colored urine

A

bilirubinuria
myoglobinuria
hemoglobinuria

26
Q

k dependent clotting factors

A

2, 7, 9, 10

27
Q

low ceruloplasmin

A

wilsons disease = copper transport protein is low

28
Q

a1AT

A

protease inhibitor made in liver

deficiency of this leads to hepatitis and cirrhosis

29
Q

AFP

A

alpha fetoprotein is elevated with hepatocellular carcinoma

30
Q

HBsAg

A

active infection

31
Q

HBeAg

A

active replication/infective – can pass to others!

32
Q

Anti-HBs

A

protection/vaccinated

33
Q

Anti HBc IgM and IgG

A

core antibody cannot come from vaccination!!!

34
Q

ALT elevated

A

hepatocellular damage

35
Q

HEP A

A

travel - jaundice a week after prodrome

GI part 2 (8 decks)

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