liver and gallbladder Flashcards
Three major types gallstones
cholesterol, pigment, mixed
risk factors for cholesterol stones:
fat, female, forty, fertile, flatulent
pain of gallstones is ___
peristaltic
pain of inflammation is ____
continuous ache
complications of gall stones?
obstruction of bile ducts, perforations of gallbladder
liver weighs about ___ grams
1200
symptoms of liver damage is ___
non specific
jaundice first appears :
eyes, creases of palms
jaundice is total serum bilirubin>____
35-51
pre-hepatic jaundice associated with:
hemolytic anemia
post hepatic jaundice associated with:
obstruction (gall stones, cancer in pancreas)
clinical features of acute liver disease:
jaundice, right upper quadrant pain, symptoms of liver failure, itching
why itching in acute liver disease>
bile duct compressed so bile salts go to blood and deposit in skin
chronic liver disease clinical features
asymptomatic, vague complaints, chronic elevation of liver enzymes in lab tests
what is hepatocellular?
damage to liver cells, transaminases leak out
what is cholestatic?
obstruction to bile flow, alkaline phosphatase released
most common reasons for liver disease?
drugs, alcohol, viruses thru sex or transfusion
<6mth is ___ damage
panlobular
> 6mth is ___ damage
periportal
this enzyme is elevated in chronic alcohol abuse
gamma glutamyl transpeptidase (GGT)
most important predictor of outcome in acute is ____
INR (prothrombin time)
most important predictor of outcome in chronic is ___
underlying cause
clinical effects of viral hepatitis divided into these phases:
preicteric and icteric
no cure for this type of hep
hep C
accumulation of fats in liver
steatosis
fatty liver mostly caused by:
alcohol
alcoholic liver disease characterized by appearance of:
mallory hyaline, neutrophils
similar changes outside of alcohol called:
NASH (non-alcoholic steatohepatitis)
NASH caused by:
obesity, rapid wt loss, diabetes, drugs
shrunken, hardened, bumpy liver referred to as
cirrhosis
complications of cirrhosis:
portal venous obstruction (hypertension), hepatic failure (splenomegaly), liver cell carcinoma
two types of hepatic failure
(rapid) massive necrosis, (slow) cirrhosis
this hepatitis by fecal oral spread, RNA
A
this hepatitis is DNA virus
B
most common metastatic site
liver
