Liver/Biliary System/LI Flashcards
How does Alcoholic Cirrhosis differ from Biliary Cirrhosis?
Alcoholic: Hepatocyte Damage
Biliary: Bile canaliculu and Bile duct damage
What drains the gallbladder?
Cystic Duct
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?
- Hypocholeserolemia
- Low level of testosterone
- Reduced ability to clot
- Hepatitis from Trypsin activation in liver
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?
Non-alcoholic fatty liver
Describe pathology of Hepatic encephalopathy. How is it treated?
Liver damage —> DEC ammonia metabolism —> Ammonia in brain —> Encephalopathy
Treat with Lactulose or neomycin
What organs send blood through the liver before entering the IVC?
Colon, SI, pancreas, and stomach
What are the two stimulators of bile secretion?
Ach - Vagus
CCK - Duodenum
What is the rate limiting enzyme of bile acid synthesis?
Cholesterol 7 alpha hydroxylase
What percentage of cholesterol is in bile?
5%
What is a big risk factor for gall stones?
Lodging in sphincter of Oddi —> Pancreatitis
What is the effect of Ileal resection?
- Resection removes the portion of intestine which normally transports bile acids into liver for recirculating
- No bile acids —> No micelles —> Steatorrhea
Describe Gilbert’s syndrome
- Abnormal conjugation Of Bilirubin due to familial bilirubin glucoronidation
*** Lab shoes everything is normal except unconjugated bilirubin
Describe Dublin-Johnson Syndrome
- genetic Decreased hepatocyte excretion of conjugated bilirubin
- LFT/ALK normal
- Increase in conjugated bilirubin
What are the two main types of Gall Stones?
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
What is the main causes of biliary sludge?
- Gallbladder Hypomotility
- Prolonged TPN or Octreotide