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AU2017 Gen Path Exam 3 > Lecture 3- Liver, gall bladder, pancreas > Flashcards

Lecture 3- Liver, gall bladder, pancreas Flashcards

1
Q

the liver has an enormous …. and regenerative capacity can mask early hepatic injury

A

functional reserve

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2
Q

the liver maintains…. and synthesizes … and is the primary site for ….

A

metabolic hemostasis

serum proteins

detox of xenobiotics and waste products

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3
Q

causes of cirrhosis of the liver

A

EtOH abuse***

viral hepaitits

non-EtOH steatohepatitis

biliary disease

iron overload

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4
Q

morphologic changes of cirrhosis are….

end result?

A
  1. bridging fibrous septa
  2. parenchymal nodules
  3. fibrosis and parenchymal injury

decreased fxn

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5
Q

consequences of portal HTN

A

ascites

hepatic encephalophathy

esophageal varices

splenomegaly

hypogonadism

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6
Q

excess bilirubin is greater than … mg/dl

A

2

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7
Q

Is unconjugated bilirubin solube and/or toxic?

A

insoluble

toxic

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8
Q

Is conjugated bilirubin soluble or toxic?

A

soluble

nontoxic

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9
Q

1 cause of jaundice

A

hemolytic anemias

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10
Q

other causes of jaundice

A

bilirubin overproduction

hepatitis

obstruction of bile flow

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11
Q

T/F patterns of liver injury are usually the same regardless of causative agent

A

true

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12
Q

Hepatitis …. is a benign self limiting disease caused by an RNA virus and is a transient viremia

A

A

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13
Q

transmission of hep A?

A

fecal-oral which is seen with overcrowding/ unsanitary conditions. Ingestion of contaminated water and food

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14
Q

incubation of Hep A?

A

2-6 weeks

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15
Q

T/F Hepatitis A has a carrier state

A

false

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16
Q

T/F Hep A can be a chronic disease

A

false

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17
Q

…. induced liver disease is an important precursor for hepatocellular carcinoma

A

hepatitis B

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18
Q

Hep B transmission?

A

parenteral/sexual

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19
Q

incubation period of hep B?

A

4-6 weeks

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20
Q

hep B is caused by a … virus

A

DNA

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21
Q

… is excessive accumulation of body iron

A

hemochromatosis

22
Q

classic triad of hemochromatosis

A

cirrhosis wuth hepatomegaly

DM

skin pigmentation

23
Q

…. results from a failure to incorporate copper into ceruloplasmin– consequently getting accumulation of toxic copper levels in liver, brain and eye

A

wilsons disease

24
Q

… arises in bile ducts inside and outside of liver it is very aggressive but asymptomatic until late stage

A

cholangiocarcinoma (bile duct carcinoma)

25
Q

… is benign and is associated with increased exposure to estrogens (oral contraceptives / pregnancy)

A

hepatocellular adenoma

26
Q

… is distinct from HCC and occurs in younger patients (20s-40s) and there are no known risk factors. “Scirrhous tumor”

A

fibrolamellar carcinoma

27
Q

which is more common? primary tumors in the liver or mets?

A

mets

28
Q

…% of people have a common orifice between the gall bladder and pancreas

A

60-70%

29
Q

… stones of the gall bladder are usually radiolucent

A

cholesterol

30
Q

… stones of the gall bladder are usually radiopaque

A

bilirubin

31
Q

risk factors of cholesterol gall stones?

A

older, female, caucasian, estrogens

32
Q

risk factors for pigment gall stones

A

hemolysis
GI disorders
biliary infection

33
Q

… is almost always associated with gallstones and it can be acute or chronic, more common in females and occurs in the 4th-6th decades

A

cholecystitis

34
Q

Actue cholecystitis presents with …. pain, fever, anorexia, tachycardia, nausea, vomiting

A

severe RUQ

35
Q

Chronic cholecystitis presents with … symptoms, fibrosis/inflammation and stones in 90%

A

vague

36
Q

The endocrine function of the pancreas regulates glucose homeostasis via .. and ..

A

insulin

glucagon

37
Q

The exocrine function of the pancreas arise from … cells that produce enzymes (primarily released as proenzymes) used in digestion

A

acinar

38
Q

iron overload can lead to hepatocyte death and inflammation. complications involve…

A

reduced liver fxn

portal HTN

increased risk for hepatocellular ca

39
Q

liver responses to injury

A

degeneration of hepatocytes or accumulation of toxic products

necrosis

inflammation

regeneration

fibrosis

40
Q

clinical manifestations of cirrhosis of the liver

A

nonspecific: weight loss, weakness (reserve may mask symptoms)

liver failure

portal HTN

41
Q

portal HTN can occur 3 ways:

A
  1. prehepatic (obstructive thrombi)
  2. intrahepatic (cirrhosis)
  3. posthepatic (R. sided heart failure)
42
Q

4 possible results of Hep B infection

A

acute hepatitis with recovery and clearance (self limited in 90% of cases)

nonprog. chronic hepatitis

progressive dz ending in cirrhosis

asymptomatic carrier state

43
Q

Hep C is caused by a … virus and is transmitted by…

A

RNA

parenteral contact/sexual spread

44
Q

is there a vaccine for hep C?

A

no b/c of genomic instability

45
Q

incubation phase of hep C is … weeks

A

7-8

46
Q

3 overlapping forms in alcohol liver disease

A

hepatic steatosis (fatty liver)

alcoholic hepatitis

cirrhosis

47
Q

tx of hemochromatosis

A

phlebotomy, Fe chelators

48
Q

Wilsons disease is autosomal…. and occurs between ages of ….

A

recessive

6-40

49
Q

morphology of wilsons disease

A

acute/chronic
steatosis
necrosis
cirrhosis

50
Q

screening test for wilsons?

A

copper levels in urine
or
copper levels in liver (definitive diagnosis)

51
Q

T/F serum testing is best for wilsons disease

A

false

AU2017 Gen Path Exam 3 (12 decks)

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