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Phase 1 - S3 Gastrointestinal System > Liver and Pancreas Pathology > Flashcards

Liver and Pancreas Pathology Flashcards

1
Q

how is bilirubin carried in the blood

A

by being bound to albumin

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2
Q

describe bilirubin conjugation

A

bilirubin is conjugated with glucornic acid by the enzyme UDP glucuonyl transferase

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3
Q

what happens to conjugated bilirubin when it enters the duodenum

A

it is converted to urobiliogen and then stercobilin

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4
Q

what does urine high in conjugated bilirubin look like

A

dark

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5
Q

give some causes of hepatitis

A

viral, acute alcohol intake, fatty liver disease, drugs

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6
Q

give some signs of hepatitis

A

fatigue, weight loss, right upper quadrant pain, jaundice

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7
Q

what colour is the urine in hepatitis

A

dark

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8
Q

what do the blood tests show in hepatitis

A

normal albumin, high serum bilirubin, conjugated bilirubin in urine, high ALT, normal ALP/Gamma GT

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9
Q

how does hepatitis cause haptic encephalopathy

A

there is an increase in ammonia due to the urea cycle no longer occurring

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10
Q

how can you check to look at the anabolism of the liver

A

look at albumin and coagulation factors

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11
Q

how can you check to look at the catabolism of the liver

A

look at haemoglobin breakdown

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12
Q

what can be looked at to see for hepatocyte damage

A

ALT, ALP, Gamma GT

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13
Q

why does ALT increase

A

due to hepatocyte damage

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14
Q

give some examples of reasons why ALT might rise

A

hepatitis, fatty liver disease, drugs, viral disease

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15
Q

when is ALP high

A

due to bone disease, bile duct obstruction/damage and canalculi damage/obstruction

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16
Q

when is Gamma GT raised

A

due to bile duct obstruction or alcohol

17
Q

what happens in liver cirrhosis

A

there is fibrosis which causes pressure and occlusion of the sinusoids leading to portal hypertension

18
Q

what is the effect on the venous anatomises in portal hypertension

A

blood is shunted in the opposite direction in the portal veins, through the anatomises joining with the peripheral veins

19
Q

where are varices due to portal hypertension seen

A

anorectal junction, in ligametum teres in the falciform ligament, oesophagogastric junction

20
Q

what cases liver cirrhosis

A

alcohol, hepatitis, fatty liver disease

21
Q

what are symptoms of liver cirrhosis

A 
swollen legs and abdomen (ascites) - due to low albumin 
fatigue 
easily bleeding - low clotting factors 
jaundice - intra-hepatic 
weight loss
22
Q

what will blood tests show in liver cirrhosis

A

low albumin
prolonged INR
raised bilirubin
raised ALT

23
Q

what is pre-hepatic jaundice

A

where theres too much bilirubin due to an increase breakdown of RBCs

24
Q

give some causes of pre-hepatic jaundice

A

haemolytic anaemia, sickle cell anaemia, auto-immune

25
Q

what are the signs of pre-hepatic jaundice

A 
yellow tinge
raised serum bilirubin 
dark stool 
increased urobiligen in the urine 
no conjugated bilirubin in urine
26
Q

what is intra-hepatic jaundice

A

where there’re problems with the liver itself so bilirubin isn’t conjugated or secreted

27
Q

what causes intra-hepatic jaundice

A

hepatitis and cirrhosis

28
Q

what is cholestasis

A

where there is stasis in the liver

29
Q

in which type of jaundice is cholestasis seen in

A

intra-hepatic

30
Q

what are the signs of intra-hepatic jaundice

A

yellow/orange tinge
raised serum bilirubin
increased conjugated bilirubin in urine making it darker
normal stool/ urinary urobiligen

31
Q

what is post-hepatic jaundice

A

where there is bile duct blockage preventing conjugated bilirubin entering the duodenum

32
Q

what are the signs of post-hepatic jaundice

A

itching - due to bile salts not being secreted
pale stools (no stercobilin)
conjugated bilirubin in urine (dark urine)
increased serum bilirubin
decreased urobiligen in urine

33
Q

what can cause bile duct obstruction

A

gallstones, pancreatic cancer, liver metastases

34
Q

what are the signs of bile duct obstruction

A

normal albumin and INR
raised serum bilirubin
dark urine
ALP/Gamma GT raised

35
Q

what is a complication of bile duct obstruction

A

cholangitis - infection in the bile duct by E.coli due to obstruction

Phase 1 - S3 Gastrointestinal System (12 decks)

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