Liver Dysfunction/Gallbladder Disease Flashcards
Gilbert’s syndrome
inheritance
autosomal dominant
Gilbert’s syndrome
pathology
increase in unconjugated (indirect) bili
Hypervolemia in chronic liver disease
due to increased aldosterone
treat w/ spironolactone
Hormones in chronic liver disease
high estrogen
- testicular atrophy
- gynecomastia
Palmer erythema in chronic liver disease
due to peripheral vasodilation
just like spider hemangiomas (may blanch)
TIPPS procedure
go through jugular
create tract and stent from IVC to portal vein
decrease portal HTN
complication: encephalopathy, putting toxins up to brain
Lactulose in encephalopathy
acidify stool –> trap ammonia from bacteria
Abx in encephalopathy
decrease amount of gut bacteria
decrease ammonia production
Where does ammonia come from?
urea cycle
bacteria in gut
Hepatorenal syndrome types
type 1: acute hepatorenal syndrome
type 2: slow onset
SAAG test
serum-ascites albumin gradient
if high, then transudate from portal HTN
if low, then exudate from infection
How to test for chronic cholycystitis
HIDA scan
put in radiomarked bile precursor
watch for it go into gallbladder
watch for galbladder to squeeze when you give CCK
if either fails –> chronic cholycystitis
Acalculous cholecystitis
in setting of
acutely ill patients
Murphy sign in acute cholecystitis
RUQ tenderness on inspiration, inspiratory arrest
Choledocholithiasis
stones in common bile duct
