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A_First Aid Random Memorizing > Pancreas, Gallbladder, Liver > Flashcards

Pancreas, Gallbladder, Liver Flashcards

1
Q

first enzyme activated in acute pancreas

A

trypsin

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2
Q

what types of necrosis seen in acute pancreas

A

liquefactive necrosis of pancreas itself

fat necrosis of peripancreatic fat

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3
Q

how does alcohol effect sphincter of Oddi

A

causes contraction -> blocks pancreas drainiage = pancreatitis!

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4
Q

what can trigger pancreatitis

A

hypercalcemia, hyperlipidemia (drugs, scorpin stings, mumps), rupture of posterior ulcer

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5
Q

lab values in acute panc

A

elevated lipase amylase

HYPOCALCEMIA (from fat necrosis and soponification)

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6
Q

persistently elevaed amylase with fever infection

A

pancreatic abscess (usu. e coli)

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7
Q

two devastating complications of pancreatitis

A

DIC and ARDS

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8
Q

MCC chronic panc in adults and hcildren

A

adult - alcohol

children - cystic fibrosis

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9
Q

how does pancreatic insufficiecy present

A

fat malabsorption (steatorrhea), vitamin deficiency (ADEK), dystrophic calcifcation
secondary DM!!! alte complication
increase risk of pancreatic arcinoma

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10
Q

major risk factors pancreatic carcinoma

A

smoking

chronic pancreatitis

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11
Q

how does pancreas head tumors present

A

obstructive jaundice with nontender gallbladder (Courvoisier)

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12
Q

tumor marker pancreatic cancer

A

CA 19 9

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13
Q

migratory thrombophelibitis

A

red flag for pancreas cancer!

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14
Q

thin elderly person suddenly develops DM….

A

suspicious for pancreatic cancer…(this is not the demographic of people who get DM!!!)

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15
Q

decreasd phospholipids and bile acids

A

increase risk of cholesterol stone (increased risk of preciptating)

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16
Q

what lipid lowering agent can increase risk for cholesterol stones

A

bile acid resins (cholestyramine, colestipol, colestivam)

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17
Q

where does reuptake of bile acids and bile salts occur

A

terminal ileum (crohns disease here increase risk of stone)

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18
Q

risk factor for BILIRUBIN/pigented stone

A

extravascular hemoylsis

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19
Q

where does acute cholecystitis pain occur

A

RUQ radiating to RIGHT SCAPULA

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20
Q

porcelain gallbladder

A

chronic cholecystitis causes this….take out gallbaldder for increased risk of cancer

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21
Q

very old woman with cholecytitis (past age dmographic)

A

gallbladder carcinoma

22
Q

pitch black liver…discolored

A

dubinjohnson (problem with transport of conjugated bili)

23
Q

Gilbert and Crigler Najar

A 
AR deficiency in UGT (uglucouronlytransferase)
gilbert is mild
crigler najar (EVIL NAME) is almost absent UGT...usually fatal
24
Q

biliary tract obstruction what will beelevated in blood

A

conjbili, plasma bile acids, alk phos, dark urine claycolored stool

25
Q

how are hepatocytes destroyed in hepatitis

A

cd8 t cell killing

26
Q

HEV in pregnantwoman?

A

may progress to fulminant hep (very bad)

27
Q

what’s worse superinfection of hpD on previous hepb or concurrentinfection of HBV HDV

A

superimpoed superinfection

28
Q

what cell mediates fibrosis in liver

A

TGF beta form stellate cells which lie beneath endothelial cells that line sinusoids

29
Q

signs and symptoms of excess estrogen

A

gynecomastia
spider angioma
palmar erythema

30
Q

histologic hallmark of alcoholic hepatitis

A

Mallory bodies (intracytoplasmic eosinophilic inclusions of DAMAGED INTERMEDIATE FILAMENTS, KERATIN FILAMENTS)

31
Q

non alcoholic fatty liver disease associated with…

A

obesity…ALT>AST

32
Q

how is hemochromotasis causing damge?

A

generation of free radicals from iron from fentin reaction

deposits in tissues as hemosiderosis

33
Q

primary hemochromatosis gene mechanism

A

HFE gene (c282y) recessive leads to abnormal iron sensing in enterocytes leading to increasd absorption (increased ferriton, increased iron, decreased TIBC, INCREASED TRANSFERRIN, high percent sat)

34
Q

how can secondary hemochromatosis happen

A

from transfusions multiple

35
Q

how to differentiate between iron an lipofuscin in liver

A

Prussian blue stain!

36
Q

autosomal recessive defeect in ATP7B gene (ATP mediated hepatocyte copper transport)

A

wilson dx

lack of copper transport into bile and ceruloplasmin leading to tissue deposition

37
Q

how does copper cause damage

A

free fradicals by production of hydroxyl free radicals

38
Q

rx wilsons

A

copper chelation with d penicillamine or zinc or trientine

39
Q

labs on wilsons

A

increased urinary iron
LOW CERULOPLASMIN
increaed copper in liver

40
Q

antibody for PBC

A

antimitochondrial

41
Q

obstructive jaundice, with late cirrhosis associated with other autoimmune disease, woman

A

PBC damage to intrahepatic ducts

42
Q

histology of PSC

A

concentric “onion skin” bile duct fibrosis with alternating stricture and dilation with “string and bead” apeparnts of both INTRA AND EXTRA hepatic ducts

43
Q

PSC associated with what disease and what marker

A

UC

p-anca

44
Q

child has viral illness and takes asprin…

A

reye syndrome

fulminant liver failure and encephalopathy… via MITOCHONDRIA DAMAGEL

45
Q

mitochondria abnormalities, fatty liver, HYPOGLYCEMIA, vomiting, hepatomegaly, coma in child

A

REY syndrome

decerased b oxidation off reversible inhibition of mitochondrial enzymes

46
Q

only time u give child aspirin

A

KAWASAKIS

47
Q

hepatic adenomas (benign) are assocaited with what medication

A

oral contracept

48
Q

what fungus can increase risk of HCC

A

aflatoxins form aspergillus by inducing p53 mutations

49
Q

liver infarction secoondary hepatic vein obstruction

A

budd chairi

presents wiht painful hepatoegaly and ascites

50
Q

serum tumor marker for HCC

A

AFP

51
Q

sources of liver mets

A

colon pancreas lung, breast

RESULTS IN MULTIPEL NODULES IN LIVER…can feel noduels on physical

52
Q

MOA duodenal atresia vs jejunal/ileal atresia

A

duodenal - failure of recanalization at 8-10 weeks gestation, aw Downs
jejunal/ileal - vascular occlusion = ischemia and narrowing/obliteration, apple peel deformity

A_First Aid Random Memorizing (17 decks)

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