Liver Biliary Pancreas Flashcards
Describe prehepatic
1-Caused by excessive hemolysis
The hemolysis being due to diseases that cause an abnormal RBCs
1-due to sickle cell anemia, or
2-hemolytic disease of the newborn
hemolysis mechanical factors
1-rbc’s breaking from hitting artificial heart valves
2-enlarged spleen
Jaundice
Cause and classifications (3)
Yellowed skin or sclera
Bilirubin build up to amount of hyperbilirubinemia
Classifications: prehepatic (before liver processes the bilirubin)
Hepatic (problem in the liver)
Post hepatic (problem occurs after the processing in the liver)
Hepatic disorders/diseases
define hepatic and name three hepatic disorders.
Bilirubin process gone wrong within the liver;not metabolized - not released into the bile.
Hepatitis
tumors
Cirrhosis
Posthepatic
Define and name four types of disorders
Posthepatic occurs after the file gets excreted from the liver. Blockages from gallstones and tumors can obstruct the flow of bile; the bile cannot leave the liver normally. 1-Gallstones 2-tumors of the biliary ducts 3-tumors of the ampulla of Vater 4-tumors of the pancreas
Define Hepatitis
name two types of hepatitis
Hepatitis is inflammation of liver tissue not referring to a bacterial problem
two types -viral forms, one is toxic such as alcohol
Viral hepatitis name the four different forms
Hepatitis A -hepatitis B - hepatitis C - hepatitis D - hepatitis E - etc. variable symptoms and the closer they are to the beginning of the alphabet the more common they are
Most common or A, B, C
What type of virus is hepatitis A ? how is it spread? what is the incubation? How prevalent? what are the symptoms and major complications?
hepatitis A. is an RNA virus. Spread via feces or oral. Short incubation 15 to 50 days. most prevalent children in undeveloped nations. symptoms mild fever vomiting jaundice. Major and rare complications cirrhosis. Disease can be tracked.
hepatitis B
what kind of virus is it? how is it spread? What is incubation period? What are the symptoms?
Hepatitis B is a DNA virus.
Spread infected blood body fluids
Incubation 40 to 180 days
symptoms in three phases
first preicteric - weakness, nausea, vomiting, tender liver
Second icteric - variable levels of jaundice (icteric or icteris is jaundice)
Third convalescent - not all patients recover. Can become chronic hepatitis or liver cancer. Cancer can be fatal
Hepatitis C.
what kind of a virus? How is it spread?
Who most commonly gets it? what is the incubation? What are the symptoms?
Hepatitis C
is an RNA virus
spread through blood body fluids
most cases drug abusers
incubation similar to hep B
symptoms similar to B but less severe but potential complications.
80% of infected will recover 20% will have chronic hepatitis C and die of liver failure or cancer. Previously spread through transfusions. Long incubation period.
Explain which hepatitis is least problematic and which hepatitis is worse. Which hepatitis has an immunization?
Hepatitis C is worse than hepatitis A and not as bad as hepatitis B. Hep C 80% of infected will recover and 20 will have chronic and then die of liver failure or cancer.
hepatitis B has an immunization. Hepatitis a has an immunization offered if you are going to a foreign country. No immunization for hepatitis C.
Toxic forms of hepatitis.
Alcoholic liver disease
Early symptoms are fatty liver which is called steatosis. Later in the disease is alcoholic hepatitis with similar symptoms without the viral changes.
Hemochromatosis
explain what kind of a disorder this is (meaning genetically)
what does it lead to?
Hereditary autosomal recessive disorder. The defect of iron absorption. Liver stores iron; the defect is in the storing which results in excessive amounts of iron. Iron damages liver cells if prolonged and scarring will develop which will lead to cirrhosis. Liver turns unnatural brown. Excessive accumulation of iron can be in the liver and in other organs.
Wilson’s disease what type of disease is this (genetic)?
Explain what it is and what it leads to.
Hereditary autosomal recessive disorder.
Defect in copper metabolism.
Lesions in the liver, brain and eye. Toxic to these organs.
In the eyes brownish discoloration of the iris called Kaiser Fleischer rings.
Alpha-1 antitrypsin deficiency
what type of disease is this
and what does it lead to?
A hereditary autosomal recessive disorder
Cholestasis which means the buildup of bile
most of these diseases are not diagnosed in children but it can lead to chronic hepatitis in young children.
Biliary system
immune disorders
name two diseases
Primary biliary cirrhosis
primary sclerosing cholangitis
Both diseases destroy biliary system in the cause obstruction. Antibodies attack the bile ducts then there is no way for the bile to get out of the liver.
Cirrhosis describe the process
Chronic liver disease also known as the end stage of any liver disease. All of the diseases discussed can advance and end in cirrhosis. Cirrhosis is irreversible. It is the loss of function caused by extensive scarring.
Name six causes of cirrhosis
1- alcohol
2- viral hepatitis
3- hereditary metabolic diseases such as hemachromatosis, Wilson’s disease, alpha-1 anti-trypsin deficiency
4-auto immune diseases such as primary biliary cirrhosis and primary sclerosing cholangitis
5-drugs
6-biliary obstruction such as cystic fibrosis or gallstones
Pathogenesis of cirrhosis
list three
Pathology of cirrhosis
List two modes of examination
1-necrosis of liver cells
2-repair by fibrosis
3-regeneration
Gross examination - firm liver tissue with a nodular appearance
Microscopically - extensive scarring
Clinical features of cirrhosis
list multiple complications to the disease
Coma - hepatic encephalopathy Jaundice Telangiectasias - facial and capture medusae v. (vessels engorged and broken peers on face and belly) Ascites Esophageal varices Purpura/edema of the lower extremities Splenomegaly Gynecomastia Absent or reduced pubic hair or small testes
Infections of the liver
Ascending: is the most prevalent in the United States
bacterial inflammation of the bile duct
bacteria is from the small bowel
bacterial ascends up to the liver
Gallbladder disease
Name two
Cholelithiasis and cholecystitis
gallstones from cholesterol (yellow green stones) or composed of bilirubinate (pigmentary) (Black from excessive bilirubin)
Cholecystitis often preceded by cholelithiasis because of the obstruction of the ducts bladder is inflamed
Neoplasms of the biliary system
name four types of cancers
Metastatic tumors are the most common liver tumors found in US
Hepatocellular carcinoma very malignant, and where hepatitis is prevalent
Bile duct cancer a.k.a. Colangiocarcinoma very malignant poor five-year survival
Carcinoma of the gallbladder caused by irritation of lining
Pancreatitis
Not usually infectious (Usually caused by obstruction)
sterile inflammation caused by tissue destruction of the pancreas itself
occurs in three forms
acute edematous
acute
chronic
Acute Edematous pancreatitis
describe
Mild form
symptoms do not usually require treatment
is usually evidenced in autopsy
Acute pancreatitis
describe
Tissue damage from: Obstruction of Main pancreatic duct
mechanical disruption
chemical injury
overstimulation of acinar cells leads to hemorrhagic reaction within the tissue and edema and necrosis
Complications are peritonitis and pseudocyst formation
pseudocyst is a hole in the tissue
Chronic pancreatitis
Inflammation slower and more progressive, leads to scarring, greater than 70% associated alcoholism/abuse.
Complications are pain, exocrine insufficiency due to malabsorption problems, endocrine insufficiency leads to diabetes mellitus.
Pancreatic neoplasms - adenocarcinoma
Name for important points
1-Most important tumor of the pancreas
2-fourth leading cause of cancer related deaths in males and fifth in females in US
3-risk factors not understood only smoking
4-clinically - weight loss, appetite loss, nausea, tumors invade locally and metastasize widely, less than 5% five-year survival prognosis.
Tumors of the endocrine cells -Islet cell tumors- uncommon
name the cells of islet of langorhans
Describe
Alpha cells
beta cells - insulinoma causes Hyperinsulinemia
Delta cells
Benign tumors
Diabetes mellitus
name where the disease originates
name two types
Type one diabetes younger onset sudden onset antibodies to islet cells can be demonstrated loss of beta cells Type two diabetes older onset gradual association with obesity normal number of beta cells
Describe diabetes clinically
name six points
1-Hyperglycemia
2-the 3P’s –polydipsia –polyurea –polyphagia
excessive thirst - urination - hunger
vascular changes -increased artheriosclerosis
susceptibility to infections -hyperglycemia encourages bacterial growth
Diabetes complications name five
Heart disease, stroke, gangrene kidney complications - renal failure Eye complications can lead to blindness
