Liver/Biliary System/LI Flashcards

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1
Q

How does Alcoholic Cirrhosis differ from Biliary Cirrhosis?

A

Alcoholic: Hepatocyte Damage

Biliary: Bile canaliculu and Bile duct damage

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2
Q

What drains the gallbladder?

A

Cystic Duct

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3
Q

A Patient comes to clinic with liver damage and is found to have damage to cells which produce globulin proteins. What symptoms may he experience?

A
  • Hypocholeserolemia
  • Low level of testosterone
  • Reduced ability to clot
  • Hepatitis from Trypsin activation in liver
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4
Q

Obese Patient presents with peripheral insulin resistance, increases TGs, increased FAs, and blood tests reveal increase in LFT. Patient reports no past history of chronic alcoholism? What is likely diagnosis?

A

Non-alcoholic fatty liver

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5
Q

Describe pathology of Hepatic encephalopathy. How is it treated?

A

Liver damage —> DEC ammonia metabolism —> Ammonia in brain —> Encephalopathy

Treat with Lactulose or neomycin

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6
Q

What organs send blood through the liver before entering the IVC?

A

Colon, SI, pancreas, and stomach

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7
Q

What are the two stimulators of bile secretion?

A

Ach - Vagus

CCK - Duodenum

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8
Q

What is the rate limiting enzyme of bile acid synthesis?

A

Cholesterol 7 alpha hydroxylase

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9
Q

What percentage of cholesterol is in bile?

A

5%

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10
Q

What is a big risk factor for gall stones?

A

Lodging in sphincter of Oddi —> Pancreatitis

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11
Q

What is the effect of Ileal resection?

A
  • Resection removes the portion of intestine which normally transports bile acids into liver for recirculating
  • No bile acids —> No micelles —> Steatorrhea
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12
Q

Describe Gilbert’s syndrome

A
  • Abnormal conjugation Of Bilirubin due to familial bilirubin glucoronidation

*** Lab shoes everything is normal except unconjugated bilirubin

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13
Q

Describe Dublin-Johnson Syndrome

A
  • genetic Decreased hepatocyte excretion of conjugated bilirubin
  • LFT/ALK normal
  • Increase in conjugated bilirubin
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14
Q

What are the two main types of Gall Stones?

A

Pigmented: Dark Brown - Black; Calcium salts of unconjugated bilirubin; Hemolytic anemia

Brown pigment stones: Secondary to Bacterial infection of biliary tract —> Release of Beta-glucoronidase

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15
Q

What is the main causes of biliary sludge?

A
  • Gallbladder Hypomotility

- Prolonged TPN or Octreotide

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16
Q

What are the functions of different segments of LI?

A

Ascending colon: Absorption of Water and Ions

Transverse: Bacterial fermentation

Descending: Storage of waste

17
Q

What are the three secretions of the LI?

A
  1. Alkaline secretions foe bacterial acids
  2. Mucous secretions for protection
  3. Vitamin B and K absorption made from bacterial flora