Liver disorders Part 2

Question 1

Gallbladder functions

• Concentrates, stores & excretes bile.
• Bile= water, bile ………, pigments (bilirubin),
• Bile duct joins ……..,,,, duct.
• Food entry in GI tract -cholecy………… & secretin released into duodenum > Sti……. the release the release of ……. from gall bladder as well as ……….. enzymes are released into dued……….
• Bile salt e……. fats & pancreatic en……. digest foods.
• Bile salts em…… fats & pa………..enzymes digest f………
• Bile salts reab……….. in distal ileum.

Answer 1

Gallbladder functions

• Concentrates, stores & excretes bile.
• Bile= water, bile salts, pigments (bilirubin),
• Bile duct joins Pancreatic duct.
• Food entry in GI tract -cholecystokinin & secretin released into duodenum > Stimulates the release the release of Bile from gall bladder as well as pancreatic enzymes are released into duedenom.
• Bile salt emulsify fats & pancreatic enzymes digest foods.
• Bile salts emulsify fats & pancreatic enzymes digest foods
• Bile salts reabsorbed in distal ileum.

Question 2

Fatty liver:

Causes of Fatty liver

• Ov………
• Dia………..
• Illnesses such as tube……..
• Drugs such as cortico……..
• Heavy ……. ….

Diagnosis:

• En…….. liver
• El……. …… enzy…….. (AST, ALT, some cases also GGT and ALP)
• Liver ima….. (computed tomography, magnetic reson…… imaging, ultraso……..)
• Liver biopsy

IN ultraso….. fat… liv….. will produce a bright image in ri…… pattern
CT scan will show that liver is less dense than normal. Diagnosis must be con…… by liver biopsy

Answer 2

Fatty liver:

Causes of Fatty liver

• Overweight
• Diabetes
• Illnesses such as tuberculosis
• Drugs such as corticosteriods
• Heavy alcohol use

Diagnosis:

• Enlarged liver
• Elevated enzymes (AST, ALT, some cases also GGT and ALP)
• Liver imaging (computed tomography, magnetic resonance imaging, ultrasound)
• Liver biopsy

IN ultrasound fatty liver will produce a bright image in ripple pattern
CT scan will show that liver is less dense than normal. Diagnosis must be confirmed by liver biopsy

Question 3

Gallstones
Gallstones: Two main types of stones

• Cholesterol ……….. (-…0%) - Lithog……
• Pigment stone-bilirubin
  > brown Pigments (-..0% cholesterol)
  > Black pigment - no cholesterol
• Can also get mixed stones

Lithogenic bile is produced by the g………. ….. are formed in gall…………. due to crystallization of c……………

The prevalence of gall stones is found to in…… .with age and. body mass index

Most commonly in association with haem. or cir….. …………

Raised A… and G…., ja……., raised b..
……..
Method of dete…….: Ultras……… scan

Answer 3

Gallstones
Gallstones: Two main types of stones

• Cholesterol stones (-70%) - Lithogenic
• Pigment stone-bilirubin
  > brown Pigments (-30% cholesterol)
  > Black pigment - no cholesterol
• Can also get mixed stones

Lithogenic bile is produced by the gallstones are formed in gallbladder due to crystallization of cholesterol.

The prevalence of gall stones is found to increase with age and body mass index

Most commonly in association with haemolysis or cirrhosis

Raised ALP and GGT, jaundice, raised bilirubin.

Method of detection: Ultrasound scan

Question 4

Most common gallstones are c……….. stones and pigment stones.
Lithogenic b….. is super…………… bile contains excess cho………. relative to other components of mixed mic….. (bile salts, p………….. etc) due to either increased secr…….. of chol……… or a decrease in bile ac… pool size.. Cholesterol stones are usually ……..-green and are made primarily of hardened chol………… They account for about 70-…percent of gall………..
Pigment stones are small, dark stones made of bil………….
Bacteria are often found in high conce………..in brown pigm…… and less so in cholesterol gallstones. However a significant overlap exists between the two processes

Answer 4

Most common gallstones are cholesterol stones and pigment stones.
Lithogenic bile is supersaturated bile contains excess cholesterol relative to other components of mixed micelles (bile salts, phospholipids etc) due to either increased secretion of cholesterol or a decrease in bile acid pool size.. Cholesterol stones are usually yellow-green and are made primarily of hardened cholesterol. They account for about 70-80 percent of gallstones.
Pigment stones are small, dark stones made of bilirubin.
Bacteria are often found in high concentrations in brown pigment and less so in cholesterol gallstones. However a significant overlap exists between the two processes.