Liver/GB/Pancreas

Question 1

Jaundice, Hepatitis, Cirrhosis, and tumors all effect the _______.

Answer 1

Liver

Question 2

What are the main functions of the liver?

Answer 2

Maintain metabolic homeostasis, synthesize proteins, detoxification

Question 3

The liver has an enormous functional reserve and regenerative capacity. What does this mean clinically for diagnosis?

Answer 3

Can mask early hepatic injury

Question 4

During injury, the liver will degenerate _______ or accumulate _______.

Answer 4

hepatocytes; toxic products

Question 5

T/F: Inflammation of the liver will constantly impede healing.

Answer 5

False

May facilitate or impede healing

Question 6

What is a top ten cause of death in adults, as well as the primary route of liver-related deaths?

Answer 6

Cirrhosis

Question 7

What are some causes of cirrhosis?

Answer 7

1. EtOH abuse
2. Viral hepatitis
3. Non-EtOH steatohepatitis
4. Biliary disease
5. Iron overload

Question 8

What is the end result of cirrhosis?

Answer 8

Loss of hepatic function

Question 9

Bridging septae and parenchymal nodules are associated with ________.

Answer 9

Cirrhosis

Question 10

What are some symptoms of the portal hypertension associated with cirrhosis?

Answer 10

1. Ascites
2. Collateral venous channels
3. Splenomegaly

Question 11

T/F: The conjugated version of jaundice is insoluble and toxic.

Answer 11

False

Unconjugated = insoluble, toxic

Question 12

T/F: Jaundice comes from excess bilirubin.

Answer 12

True

Question 13

What is the number 1 cause of jaundice?

Answer 13

Hemolytic anemia

Question 14

T/F: There will be a variety of patterns of liver injury depending on the agent causing the hepatitis.

Answer 14

False

Very similar patterns of injury for variety of agents

Question 15

Which hepatitis is a DNA virus?

Answer 15

Hep B

A and C are RNA viruses

Question 16

_______ causes a benign infection with no chronic disease or carrier state.

Answer 16

Hep A

Question 17

Which hepatitis is spread through fecal-oral transmission?

Answer 17

Hep A

Typically contaminated food/water

Question 18

_____ will cause a persistent infection and chronic hepatitis in 85% of patients.

Answer 18

Hep C

No vaccine!

Question 19

T/F: There is a vaccine for Hep B.

Answer 19

True

95% effective

Question 20

T/F: The majority of Hep B infections are self-limited.

Answer 20

True

90%

Question 21

Which viral hepatitis infections lead to an increased risk for hepatocellular carcinoma?

Answer 21

Hep B and C

Question 22

How is Hep C treated?

Answer 22

Protease and nucleoside inhibitors

Question 23

T/F: Often acute viral hepatitis will not have any serious symptoms.

Answer 23

True

Question 24

Acute viral hepatitis that transitions to a chronic state is often seen with _____ infections.

Answer 24

Hep C

Question 25

What are the three main features of alcohol liver disease?

Answer 25

1. Hepatic steatosis (fatty liver) 2. Alcoholic hepatitis 3. Cirrhosis

Question 26

What is the typical flow of liver injury with repeated severe exposures to alcohol?

Answer 26

1. Hepatitis - necrosis, inflammation, mallory bodies, fatty change 2. Cirrhosis - fibrosis, hyperplastic nodules

Question 27

What is the typical flow of liver injury with continued non-sever exposures to alcohol?

Answer 27

1. Steatosis - fatty change, perivenular fibrosis | 2. Cirrhosis - fibrosis, hyperplastic nodules

Question 28

T/F: Liver injury due to alcohol can reverse during abstinence.

Answer 28

True Except if cirrhosis is already occurring

Question 29

_________ is an autosomal recessive disorder which causes iron accumulation in the liver.

Answer 29

Hemochromatosis

Question 30

_________ is an autosomal recessive disorder that results in excess copper accumulation in the liver.

Answer 30

Wilson's Disease

Question 31

T/F: Bile duct carcinoma is very aggressive and shows symptoms very early.

Answer 31

False Very aggressive but does not show symptoms until late stage

Question 32

__________ is associated with oral contraceptives and may regress if discontinued.

Answer 32

Hepatocellular adenoma

Question 33

____________ is the third leading cause of cancer deaths in western countries.

Answer 33

Hepatocellular carcinoma

Question 34

T/F: Cirrhosis is seen in 90% of hepatocellular carcinomas.

Answer 34

True

Question 35

T/F: Liver cancers are unlikely to metastasize.

Answer 35

False Strong vascular supply = high likelihood of metastasis

Question 36

___________ is seen in younger patients and causes a "Scirrhous" tumor.

Answer 36

Fibrolamellar carcinoma

Question 37

T/F: It is more common to see a metastasis site in the liver than to have a primary tumor in the liver.

Answer 37

True

Question 38

What is a cholelithiasis?

Answer 38

Gallstone

Question 39

In the west most gallstones are made of ________, while a smaller amount are ________ stones.

Answer 39

cholesterol; pigment

Question 40

T/F: Most gallstones are silent.

Answer 40

True

Question 41

Cholesterol gallstones are mostly _________, while bilirubin is mostly _________.

Answer 41

radiolucent; radiopaque

Question 42

What are some risk factors for gallstones?

Answer 42

Cholesterol: white females; estrogen Pigment: hemolysis, GI disorder, biliary infection

Question 43

T/F: Cholecystitis is most common in women during the 4th-6th decade.

Answer 43

True

Question 44

During chronic cholecystitis, 90% of the patients will also experience _______.

Answer 44

gallstones

Question 45

Which type of cancer is 95% associated with gall stones?

Answer 45

Adenocarcinomas Only 5% 5 year survival

Question 46

T/F: The pancreas has both endocrine and exocrine function.

Answer 46

True Glucose homeostasis and food digestion

Question 47

What are the major risk factors associated with 80% of acute pancreatitis patients?

Answer 47

1. Cholelithiasis 2. Biliary tract disease 3. Alcoholism Trauma, drugs, and hypercalcemia

Question 48

During acute pancreatitis, _________ are released as well as inflammation ________.

Answer 48

lipases; proteolysis

Question 49

"Acute abdomen" is associated with _________.

Answer 49

acute pancreatitis

Question 50

Which two enzymes will be elevated in a patient with acute pancreatitis?

Answer 50

Amylase and lipase

Question 51

T/F: During chronic pancreatitis, the patient will lose endocrine function first.

Answer 51

False Exocrine then endocrine

Question 52

T/F: Chronic pancreatitis is irreversible.

Answer 52

True

Question 53

Adenocarcinomas are normally found in the _________ glands of the pancreas.

Answer 53

exocrine

Question 54

________ doubles pancreatic cancer risk.

Answer 54

Smoking

Question 55

T/F: Diabetes and chronic pancreatitis increase risk for pancreatic cancer.

Answer 55

True

Question 56

"Silent growth" is associated with ________.

Answer 56

pancreatic cancer