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CABS 3: GI > Liver and Gallbladder Pathology > Flashcards

Liver and Gallbladder Pathology Flashcards

1
Q

what is ammonia

A

nitrogen waste (primarily from protein break down)

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2
Q

what is the pH of ammonia

A

11

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3
Q

what makes aspartate aminotransferase (AST) increase

A

damage to hepatocytes

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4
Q

where is AST located

A

mitochondria of liver + other metabolically active tissues

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5
Q

where is ALT located

A

within the cytosol of the hepatocytes
more specific to liver - longer half life

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6
Q

when does ALt increase

A

damage/necrosis to hepatocytes

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7
Q

What is a AST/ALT ration > 1 mean

A

alcoholic cirrhosis

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8
Q

what is AST/ALT ration < 1 mean

A

acute hepatitis (viral, mono..)

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9
Q

when does alk phos increase

A

obstruction of biliary tree, cholestatis hepatitis
increased in pregnancy and kids

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10
Q

when does LDH increase

A

hypoxic and primary liver damage

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11
Q

what is LDH

A

lactate dehydrogenase

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12
Q

what indicates hyperbilirubinemia

A

jaundice

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13
Q

what is increased lipid deposition wtihin the liver

A

steatosis

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14
Q

where does steatosis begin

A

central vein and spread out

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15
Q

what is steatohepatitis

A

alcoholic hepatitis: next stage in advancing ETOH induced liver disease

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16
Q

what is inflamation and fibrosis of the liver

A

cirrhosis
irreversible

17
Q

what is non-alcoholic fatty liver disease

A

triglyceride infiltration into hepatocytes

18
Q

what are risk factors for non-alcoholic fatty liver disease

A

genetic predisposition, obesity, hypercholesterolemia, hypertriglyceridemia, change in gut microbiome

19
Q

what is portal hypertension

A

downstream effect of hepatocyte scaring and inflammation
-intrahepatic, posthepatic, prehepatic

20
Q

what is prehepatic portal hypertension

A

thrombosis of portal vein
causes: malignancy, hyper-coagulable state, septicemia, decreased flow 9cirrhosis), trauma/inflammation (pancreatitis, hepatitis)

21
Q

what are cause of intrahepatic portal hypertension

A

thrombosis
inflammation
fibrosis (cirrhosis)
infectious hepatitis
schistosomaiasis

22
Q

what is schistomaisis

A

parasite the lives in liver and causes intrahepatic portal HTN

23
Q

what is excess fluid within the peritoneal cavity

A

ascites
-increased portal pressure
- decreased albumin

24
Q

what is the presentation ascites

A

distended abdomen
weight gain
SOB b/c decreased diaphragmatic excursion
peripheral edema
hypoatremia

25
Q

what is the incubation period of hepatitis A

A

28 days

26
Q

what is the presentaiton of hepatitis A

A

fever/chills
N/V
clay-colored stools
arthralgias
abdominal discomfrot
jaundice
dark urine
hepatomegaly

27
Q

what is hepatitis B

A

double stranded DNA virus
transmitted via mucosal contact or blood born
can survive 7 days on fomites

28
Q

what is the presentation of hepatitis B

A

ascites, fatigue, anemia, encephalopathy
rarely cause fulminant hepatic failure
m/c subclinical infection

29
Q

what is hepatitis C

A

enveloped ssRNA virus
flavivirus high rate of chronic liver disease
bloodborn transmission
4-12 week incubation period

30
Q

what is the presentation of Hep C

A

abdominal discomfort, N/V, jaundice, fatigue
may develop chronic infection

31
Q

what is Hepatitis D

A

must have concomintant Hep B
increases pts risk of HCC

32
Q

what is the causes of hepatic failure

A

infectious (hepatitis)
toxins (meds, tylenol, ETOH)
ischemic

33
Q

what is the presentation of liver failure

A

jaundice
hepatomegaly/splenomegaly
encephalopathy
increased bleeding
asterixis

34
Q

what are liver abscess

A

m/c visceral abscess
associated with DM, transplant pts, on PPIs, hepatobiliary disease, pancreatic diease

35
Q

what is the cause of liver abscess

A

typically polymicrobial - anaerobic organisms, streptococci, staphylococcus

36
Q

what is the presentation of liver abscess

A

abdominal pain, fever, N/V, weight loss, transaminitis
consider in febrile neurtropenia

CABS 3: GI (7 decks)

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