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block 15 anna > lecture 7 biliary and pancreatic pathology > Flashcards

lecture 7 biliary and pancreatic pathology Flashcards

1
Q

where does bile come from

A

hepatocytes

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2
Q

where is bile stored

A

gall bladder

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3
Q

what does eating stimulate

A

CCK

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4
Q

what does CCk secretion induce

A

bile release

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5
Q

how does the bile enter the bowel

A

ampulla of vater

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6
Q

what is the bile for

A

emulsification of fat

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7
Q

where is ile reabsorbed

A

terminal ileum

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8
Q

where is the gallbladder found

A

visceral surface

between right lobe and quadratic lobe

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9
Q

how are bile salts reabsorbed

A

active transport

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10
Q

how are bile salts returned to the liver

A

enterohepatic circulation

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11
Q

bile contains

A

bile acids

bilirubin

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12
Q

function of bile

A

absorbing fats
eliminate waste products
signalling molecules

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13
Q

what are the waste products bile helps to eliminate

A

excess cholesterol, bilirubin, non water soluble xenobiotics

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14
Q

what are the signalling molecules bile helps with

A

Activate MAPK pathway, ligands for receptor TGR5, activate hormone receptors

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15
Q

where is bilirubin conjugated

A

liver

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16
Q

what happens to the iron and globin from the RBC

A

recycled

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17
Q

where does the bilirubin go

A

excreted into bile then small intestine and travels to the large intestine

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18
Q

what happens to bilirubin in the large bowel

A

bacteria convert it to urobilligen

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19
Q

3 pathways of urobilligen

A

reabsorbed into blood
converted to urobilin and excreted in urine
converted to stercobillin and excreted in poo

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20
Q

jaudice patients wee

A

dark

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21
Q

jaundice patients poo

A

light

22
Q

what is jaundice

A

high billirubin in the blood

23
Q

what can occur with jaundice

A

pruritus - itching

24
Q

where might you look for jaundice

A

conjuctiva

25
Q

Prehepatic jaundice

A

Haemolysis, resorption from bleed, gilbert syndrome and ineffective erythropoesisis.

26
Q

gilbert syndrome

A

bilirubin struggles to get into the liver

27
Q

how would you know if someone had gilberts syndrome

A

in times of stress there may be visible jaundice

28
Q

what are post hepatic causes of jaundice

A

obstructed bile duct

29
Q

what can cause hepatic and post hepatic

A

primary sclerosing cholangiti

30
Q

Cholesterolosis

A

accumulation of cholesterol

31
Q

Cholecystitis

A

gallbladder infection

32
Q

Mucocoele

A

distension of gallbladder by accumulation of mucous

33
Q

gall stones risk factors

A

fat, female, forty, fertile, fair

34
Q

signs of gall stones

A

murphys sign

right upper quadrants pain

35
Q

Murphy’s sign

A

hypersensitivity to deep palpation in the subcostal area when a patient with gallbladder disease takes a deep breath

36
Q

causes of gall stones

A

stasis
haemolysis
rapid weight loss

37
Q

what are most of the stones

A

cholesterol

38
Q

empyema

A

collection of puss in the gallbladder

39
Q

pancreas exocrine gland arrangement

A

acini

40
Q

release of pancreas exocrine gland

A

trypsin, lipases, and amylases

41
Q

pancreas endocrine arrangement

A

islets of langerhans

42
Q

endocrine pancreas secretion

A

insulin and glucagon

43
Q

how does the pancreas form

A

pancreas develops in two halves one half swings round and joins the other half and fuses

44
Q

main causes of acute pancreatitis

A

alcohol
gallstones

surgery
virus

45
Q

Pseudocysts

A

inflammatory cysts

46
Q

treatment of Pseudocysts

A

draining them

47
Q

most common place for adenocarcinoma in the pancreas

A

head

48
Q

symptoms of pancreatic adenocarcinoma

A

weight loss, back pain and painless jaundice

49
Q

are pancreatic symptoms common

A

no

50
Q

pancreatic adenocarcinoma signs

A

trousseau’s sign

51
Q

causes of acute pancreatitis

A 
Idiopathic
gallstones, 
ethanol, 
trauma, 
steroids, 
malignancy/mumps, 
autoimmune, 
scorpion sting, 
hypertriglyceridemia/hypercalcemia, 
ERCP 
drugs
52
Q

pancreatitis symptoms

A

Acute abdominal pain - central, severe, and often radiates to back, vomiting and history of alcohol excess, gallstones, and certain drugs

block 15 anna (15 decks)

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