Liver/GB/Pancreas Flashcards
Jaundice, Hepatitis, Cirrhosis, and tumors all effect the _______.
Liver
What are the main functions of the liver?
Maintain metabolic homeostasis, synthesize proteins, detoxification
The liver has an enormous functional reserve and regenerative capacity. What does this mean clinically for diagnosis?
Can mask early hepatic injury
During injury, the liver will degenerate _______ or accumulate _______.
hepatocytes; toxic products
T/F: Inflammation of the liver will constantly impede healing.
False
May facilitate or impede healing
What is a top ten cause of death in adults, as well as the primary route of liver-related deaths?
Cirrhosis
What are some causes of cirrhosis?
- EtOH abuse
- Viral hepatitis
- Non-EtOH steatohepatitis
- Biliary disease
- Iron overload
What is the end result of cirrhosis?
Loss of hepatic function
Bridging septae and parenchymal nodules are associated with ________.
Cirrhosis
What are some symptoms of the portal hypertension associated with cirrhosis?
- Ascites
- Collateral venous channels
- Splenomegaly
T/F: The conjugated version of jaundice is insoluble and toxic.
False
Unconjugated = insoluble, toxic
T/F: Jaundice comes from excess bilirubin.
True
What is the number 1 cause of jaundice?
Hemolytic anemia
T/F: There will be a variety of patterns of liver injury depending on the agent causing the hepatitis.
False
Very similar patterns of injury for variety of agents
Which hepatitis is a DNA virus?
Hep B
A and C are RNA viruses
_______ causes a benign infection with no chronic disease or carrier state.
Hep A
Which hepatitis is spread through fecal-oral transmission?
Hep A
Typically contaminated food/water
_____ will cause a persistent infection and chronic hepatitis in 85% of patients.
Hep C
No vaccine!
T/F: There is a vaccine for Hep B.
True
95% effective
T/F: The majority of Hep B infections are self-limited.
True
90%
Which viral hepatitis infections lead to an increased risk for hepatocellular carcinoma?
Hep B and C
How is Hep C treated?
Protease and nucleoside inhibitors
T/F: Often acute viral hepatitis will not have any serious symptoms.
True
Acute viral hepatitis that transitions to a chronic state is often seen with _____ infections.
Hep C
What are the three main features of alcohol liver disease?
- Hepatic steatosis (fatty liver)
- Alcoholic hepatitis
- Cirrhosis
What is the typical flow of liver injury with repeated severe exposures to alcohol?
- Hepatitis - necrosis, inflammation, mallory bodies, fatty change
- Cirrhosis - fibrosis, hyperplastic nodules
What is the typical flow of liver injury with continued non-sever exposures to alcohol?
- Steatosis - fatty change, perivenular fibrosis
2. Cirrhosis - fibrosis, hyperplastic nodules
T/F: Liver injury due to alcohol can reverse during abstinence.
True
Except if cirrhosis is already occurring
_________ is an autosomal recessive disorder which causes iron accumulation in the liver.
Hemochromatosis
_________ is an autosomal recessive disorder that results in excess copper accumulation in the liver.
Wilson’s Disease
T/F: Bile duct carcinoma is very aggressive and shows symptoms very early.
False
Very aggressive but does not show symptoms until late stage
__________ is associated with oral contraceptives and may regress if discontinued.
Hepatocellular adenoma
____________ is the third leading cause of cancer deaths in western countries.
Hepatocellular carcinoma
T/F: Cirrhosis is seen in 90% of hepatocellular carcinomas.
True
T/F: Liver cancers are unlikely to metastasize.
False
Strong vascular supply = high likelihood of metastasis
___________ is seen in younger patients and causes a “Scirrhous” tumor.
Fibrolamellar carcinoma
T/F: It is more common to see a metastasis site in the liver than to have a primary tumor in the liver.
True
What is a cholelithiasis?
Gallstone
In the west most gallstones are made of ________, while a smaller amount are ________ stones.
cholesterol; pigment
T/F: Most gallstones are silent.
True
Cholesterol gallstones are mostly _________, while bilirubin is mostly _________.
radiolucent; radiopaque
What are some risk factors for gallstones?
Cholesterol: white females; estrogen
Pigment: hemolysis, GI disorder, biliary infection
T/F: Cholecystitis is most common in women during the 4th-6th decade.
True
During chronic cholecystitis, 90% of the patients will also experience _______.
gallstones
Which type of cancer is 95% associated with gall stones?
Adenocarcinomas
Only 5% 5 year survival
T/F: The pancreas has both endocrine and exocrine function.
True
Glucose homeostasis and food digestion
What are the major risk factors associated with 80% of acute pancreatitis patients?
- Cholelithiasis
- Biliary tract disease
- Alcoholism
Trauma, drugs, and hypercalcemia
During acute pancreatitis, _________ are released as well as inflammation ________.
lipases; proteolysis
“Acute abdomen” is associated with _________.
acute pancreatitis
Which two enzymes will be elevated in a patient with acute pancreatitis?
Amylase and lipase
T/F: During chronic pancreatitis, the patient will lose endocrine function first.
False
Exocrine then endocrine
T/F: Chronic pancreatitis is irreversible.
True
Adenocarcinomas are normally found in the _________ glands of the pancreas.
exocrine
________ doubles pancreatic cancer risk.
Smoking
T/F: Diabetes and chronic pancreatitis increase risk for pancreatic cancer.
True
“Silent growth” is associated with ________.
pancreatic cancer
