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GI Quiz 2 > Pathology > Flashcards

Pathology Flashcards

1
Q

treatment of alcoholic hepatitis

A

glucocorticoids and pentoxyfylline (if active infection and steroids are contraindicated)

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2
Q

3 major risk factors for non-alcoholic fatty liver disease

A

obesity, diabetes mellitus, hypertriglyceridemia

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3
Q

difference between NAFL and NASH

A

NASH has inflammation and ballooning of hepatocytes and can lead to liver failure

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4
Q

treatment for NAFLD

A

weight loss of 10% body weight

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5
Q

treatment or NASH

A

pioglitazone, vitamin E

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6
Q

vitamin E contraindication for NASH patients

A

diabetics

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7
Q

two mutations responsible for hereditary hemochromatosis

A

H282Y, H63D in HFE gene

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8
Q

role of HFE

A

downregulates transferrin when iron supplies are adequate

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9
Q

impotence in males

A

hereditary hemochromatosis

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10
Q

unique symptoms of hereditary hemochromatosis

A

skin hyperpigmentation, diabetes, impotence in males, ECG abnormalities

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11
Q

what hereditary hemochromatosis patients should you get a liver biopsy from?

A

homozygotes who are over 40 or if elevated ALT/AST

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12
Q

treatment for hereditary hemochromatosis

A

phlebotomy (goal ferritin <50)

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13
Q

role of ceruloplasmin

A

binds copper so that it does not deposit in tissues

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14
Q

unique symptoms of Wilson disease

A

dystonia, dysarthria, seizures, personality changes, psychosis, movement disorders

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15
Q

diagnosis of Wilson disease

A

low ceruloplasmin, copper in urine, kayser-fleischer rings

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16
Q

treatment of Wilson disease

A

trientine, zinc

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17
Q

role of alpha-1 antitrypsin

A

inhibits elastase

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18
Q

most common cause of genetic emphysema in adults

A

A1AT deficiency

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19
Q

A1AT deficiency: effects in lung vs. liver

A

lung: loss-of-function, unopposed elastases –> damage to lung parenchyma
liver: gain-of-function, accumulation of misfolded A1AT in ER –> hepatotoxic

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20
Q

stains red on PAS stain

A

A1AT globules

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21
Q

what autoantibodies are found in autoimmune hepatitis?

A

ANA, ASMA

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22
Q

most commonly associated condition with autoimmune hepatitis

A

thyroid disease

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23
Q

treatment for autoimmune hepatitis

A

prednisone and azathioprine

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24
Q

destruction of intrahepatic bile ducts (microscopic bile ducts)

A

primary biliary cirrhosis (PBC)

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25
Q

what autoantibodies are found in primary biliary cirrhosis?

A

AMA

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26
Q

target of AMAs in PBC

A

PDC-E2 (on membrane of biliary epithelial cells)

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27
Q

unique findings of PBC

A

AMA+, pruritis, xanthomas

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28
Q

ddx: steatorrhea

A

PBC, chronic pancreatitis, cancer in pancreatic head, somatostatinoma

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29
Q

ddx: prolonged PT

A

PBC

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30
Q

most commonly associated condition with PBC

A

Sjogren’s

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31
Q

3-4x normal alk phos, elevated cholesterol

A

PBC

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32
Q

florid duct lesion: diagnosis, what is it

A

PBC; inflammatory changes around bile ducts

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33
Q

treatment for PBC

A

ursodeoxycholic acid, cholestyramine

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34
Q

seroconversion in HepB infection

A

loss of HBeAg, development of HBeAb

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35
Q

treatment for chronic HepB

A

interferon, entecavir, tenofovir

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36
Q

sign of active hepC infection

A

hepC viral RNA

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37
Q

which hepatitis viruses cannot cause cirrhosis?

A

hepA&E

38
Q

prophylactic treatment for varices that haven’t bled yet

A

non-selective beta-blockers (propranolol, nadalol)

39
Q

treatment for actively bleeding varices

A

octreotide (somatostatin analog)

40
Q

pathophysiology of ascites

A

portal hypertension –> splanchnic arterial vasodilation –> decreased effective circulating volume –> activation of vasoconstrictor and antinatriuretic factors –> sodium and water retention

41
Q

treatment for ascites

A

sodium-restricted diet, diuretics

42
Q

fulminant liver failure

A

ACUTE liver failure characrerized by hepatocyte necrosis: coagulopathy, encephalopathy, cerebral edema

43
Q

treatment for hepatic encephalopathy

A

lactulose and rifaximin

44
Q

pregnant woman with pruritis during third trimester, jaundice: diagnosis and treatment

A

intrahepatic cholestasis of pregnancy (IHCP); cholestyramine and urso (same treatment as PBC)

45
Q

difference between pre-eclampsia and eclampsia

A

pre-eclampsia: HTN, proteinuria, edema

eclampsia: pre-eclampsia + seizures

46
Q

treatment for acute fatty liver of pregnancy

A

urgent delivery

47
Q

HELLP syndrome symptoms and treatment

A

hemolytic anemia, elevated liver tests, low platelets; urgent delivery

48
Q

liver lesion associated with oral contraceptives

A

hepatic adenoma

49
Q

liver lesion associated with history of primary sclerosing cholangitis (PSC)

A

cholangiocarcinoma

50
Q

most common benign liver lesion

A

hemangioma

51
Q

hemangioma: mechanism

A

congenital vascular malformations

52
Q

diagnose: small benign lesion in liver caused by intrahepatic anomolous artery leading to hyperperfusion

A

focal nodular hyperplasia

53
Q

only benign liver lesion with malignant potential

A

hepatic adenoma

54
Q

confirmation test for hepatocellular carcinoma (HCC)

A

alpha fetoprotein (AFP) >200

55
Q

leading cause of hepatocellular carcinoma worldwide vs. US

A

worldwide: hepB
US: hepC

56
Q

bile secretion decreases with ________________

A

splanchnic nerve stimulation

57
Q

diagnose: steady, right epigastric pain with fever, leukocytosis, tachycardic, normal liver panel, history of symptomatic gallstones

A

acute cholecystitis (inflammation of gallbladder)

58
Q

what is Charcot’s triad?

A

clinical syndrome of acute cholangitis consisting of fever, jaundice, and abdominal pain

59
Q

what is acute cholangitis?

A

infection/stasis in biliary tract

60
Q

what is primary sclerosing cholangitis (PSC)?

A

chronic progressive disorder characterized by inflammation, fibrosis, stricturing of medium/large ducts in intrahepatic/extrahepatic biliary tree –> liver failure

61
Q

condition most commonly associated with primary sclerosing cholangitis (PSC)

A

ulcerative colitis

62
Q

diagnose: severe, constant pain that begins in mid-epigastrium and radiates to right shoulder/scapular area

A

gallbladder problem

63
Q

where do cholangiocarcinomas usually develop?

A

perihilar region of biliary tree

64
Q

major risk factors for cholangiocarcinoma

A
  1. PSC
  2. biliary cysts
  3. biliary parasitosis
  4. thorotrast
65
Q

biliary condition most commonly associated with ulcerative colitis

A

primary sclerosing cholangitis (PSC)

66
Q

pruritis with cholangiocarcinoma: intrahepatic or extrahepatic?

A

extrahepatic

67
Q

jaundice with cholangiocarcinoma: intrahepatic or extrahepatic?

A

extrahepatic

68
Q

ddx: (CA) 19-9

A

cholangiocarcinoma, exocrine pancreatic cancer

69
Q

major risk factors for gallbladder cancer

A
  1. porcelain gallbladder
  2. gallbladder polyps/adenoma
  3. cholelithiasis (stones)
70
Q

causes of acute pancreatitis

A

gallstones, alcohol, hypertriglyceridemia, scorpion venom, mumps, seat belt injuries, pancreas divisum

71
Q

1 cause of acute pancreatitis

A

gallstones

72
Q

3 genetic causes of acute pancreatitis

A

PRSS1, CFTR, SPINK1

73
Q

systemic response to acute pancreatitis

A

SIRS, ARDS, myocardial depression, renal failure, infection

74
Q

treatment for acute pancreatitis

A

pain control, aggressive IV fluids

75
Q

1 cause of chronic pancreatitis

A

alcohol abuse

76
Q

distinguishing features of chronic pancreatitis (compared to acute)

A

can be asymptomatic, amylase and lipase may be normal, patchy, pancreatic duct calcification

77
Q

proteinaceous ductal plugs

A

chronic pancreatitis

78
Q

autoimmune pancreatitis: pathogenesis, treatment

A

IgG4-related disease; corticosteroids

79
Q

ddx: pancreatic mass

A

autoimmune pancreatitis, cancer

80
Q

major risk factors for exocrine pancreatic cancer

A

cigarette smoking, chronic pancreatitis

81
Q

symptoms of cancer in pancreatic head

A

painless jaundice, steatorrhea, weight loss

82
Q

ovarian-like stroma that secretes mucin in pancreatic body or tail: diagnosis and treatment

A

mucinous cystic neoplasm; surgical resection due to risk of malignancy

83
Q

what kind of intraductal papillary mucinous neoplasm (IPMN) has risk of malignancy?

A

main duct

84
Q

pancreatic lesion lined by glycogen-rich cells originating from acinar cells with central scar

A

serous cystadenoma

85
Q

pancreatic NET that can cause venous thrombosis

A

glucagonoma

86
Q

symptoms of somatostatinoma

A

diabetes mellitus, cholelithiasis, steatorrhea

87
Q

symptoms of VIPoma

A

“pancreatic cholera”=watery diarrhea, hypokalemia, achlorhydria

88
Q

anti-mitochondrial antibodies

A

PBC

89
Q

anti-smooth muscle antibodies

A

autoimmune hepatitis

90
Q

thorotrast-associated liver tumors

A

angiosarcoma and cholangiosarcoma

GI Quiz 2 (2 decks)

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