Liver and Gallbladder Pathology Flashcards
what is ammonia
nitrogen waste (primarily from protein break down)
what is the pH of ammonia
11
what makes aspartate aminotransferase (AST) increase
damage to hepatocytes
where is AST located
mitochondria of liver + other metabolically active tissues
where is ALT located
within the cytosol of the hepatocytes
more specific to liver - longer half life
when does ALt increase
damage/necrosis to hepatocytes
What is a AST/ALT ration > 1 mean
alcoholic cirrhosis
what is AST/ALT ration < 1 mean
acute hepatitis (viral, mono..)
when does alk phos increase
obstruction of biliary tree, cholestatis hepatitis
increased in pregnancy and kids
when does LDH increase
hypoxic and primary liver damage
what is LDH
lactate dehydrogenase
what indicates hyperbilirubinemia
jaundice
what is increased lipid deposition wtihin the liver
steatosis
where does steatosis begin
central vein and spread out
what is steatohepatitis
alcoholic hepatitis: next stage in advancing ETOH induced liver disease
what is inflamation and fibrosis of the liver
cirrhosis
irreversible
what is non-alcoholic fatty liver disease
triglyceride infiltration into hepatocytes
what are risk factors for non-alcoholic fatty liver disease
genetic predisposition, obesity, hypercholesterolemia, hypertriglyceridemia, change in gut microbiome
what is portal hypertension
downstream effect of hepatocyte scaring and inflammation
-intrahepatic, posthepatic, prehepatic
what is prehepatic portal hypertension
thrombosis of portal vein
causes: malignancy, hyper-coagulable state, septicemia, decreased flow 9cirrhosis), trauma/inflammation (pancreatitis, hepatitis)
what are cause of intrahepatic portal hypertension
thrombosis
inflammation
fibrosis (cirrhosis)
infectious hepatitis
schistosomaiasis
what is schistomaisis
parasite the lives in liver and causes intrahepatic portal HTN
what is excess fluid within the peritoneal cavity
ascites
-increased portal pressure
- decreased albumin
what is the presentation ascites
distended abdomen
weight gain
SOB b/c decreased diaphragmatic excursion
peripheral edema
hypoatremia
what is the incubation period of hepatitis A
28 days
what is the presentaiton of hepatitis A
fever/chills
N/V
clay-colored stools
arthralgias
abdominal discomfrot
jaundice
dark urine
hepatomegaly
what is hepatitis B
double stranded DNA virus
transmitted via mucosal contact or blood born
can survive 7 days on fomites
what is the presentation of hepatitis B
ascites, fatigue, anemia, encephalopathy
rarely cause fulminant hepatic failure
m/c subclinical infection
what is hepatitis C
enveloped ssRNA virus
flavivirus high rate of chronic liver disease
bloodborn transmission
4-12 week incubation period
what is the presentation of Hep C
abdominal discomfort, N/V, jaundice, fatigue
may develop chronic infection
what is Hepatitis D
must have concomintant Hep B
increases pts risk of HCC
what is the causes of hepatic failure
infectious (hepatitis)
toxins (meds, tylenol, ETOH)
ischemic
what is the presentation of liver failure
jaundice
hepatomegaly/splenomegaly
encephalopathy
increased bleeding
asterixis
what are liver abscess
m/c visceral abscess
associated with DM, transplant pts, on PPIs, hepatobiliary disease, pancreatic diease
what is the cause of liver abscess
typically polymicrobial - anaerobic organisms, streptococci, staphylococcus
what is the presentation of liver abscess
abdominal pain, fever, N/V, weight loss, transaminitis
consider in febrile neurtropenia
