Pathology of the GI Tract- Liver and Gallbladder (4) Flashcards
What is cholestasis?
bile inactivity; decrease in bile flow due to impaired secretion by hepatocytes or due to obstruction of bile flow
what are two hallmarks of cholestasis?
accumulation of green-brown plugs of bile pigment in hepatocytes and dilated canaliculi
what are the two main purposes of bile?
emulsification of dietary fat and elimination of bilirubin
what is bilirubin conjugated with?
glucuronic acid
what are two characteristic laboratory findings of cholestatic disease?
elevated serum alk phos and GGT
what causes physiologic jaundice of the newborn?
levels of UGT1A1 are low at birth
what is the role of UGT1A1?
it is the enzyme that is responsible for bilirubin glucironidation
what are 2 hereditary conjugated hyperbilirubinemias?
dubin johnson syndrome and Rotor syndrome
etiology of cholestasis in adults is usually large duct obstruction due to what 3 things?
stones (choledocholithiasis), tumors, or strictures
what can persistent obstruction of the common bile duct lead to?
fibrosis and biliary cirrhosis
biliary obstruction predisposes a patient to what?
ascending cholangitis- a bacterial infection of the biliary tree most commonly by enteric organisms such as coliforms and enterococci
what are the signs/symptoms/ presentation of acute cholangitis?
CHARCOT’S TRIAD: 1. jaundice 2. fever 3. RUQ pain
what is reynold’s pentad?
the presence of pus in the biliary ducts: charcot’s triad + hypotension and confusion
what are 2 additional settings associated with cholestasis?
sepsis and primary hepatolithiasis
what is primary hepatolithiasis?
stones in the intrahepatic bile ducts
