post midterm: 1 Flashcards
How is the liver involved in bile production?
RBC breakdown > Bile > fat digestion
What kind of proteins does the liver make?
- transport: ex TBG transferrin, albumin
- coag factors
- makes proteins that help with fluid oncotic pressure
How does the liver play a role in immune system?
makes proteins for immune system
what role does liver play in storage?
glycogen, vit B12 and D
what is often the best Proteins made by liver are often the best measure of liver function?
Proteins made by liver are often the best measure of liver function
- Serum proteins: Albumin, globulins, total protein
- Coagulation protein function: Prothrombin time (protime or PT)
Give 3 examples of more “indirect” liver tests?
1) Transaminases “liver function tests” (LFT’s)
Monitor liver injury; exist in other cells as well (eg muscle)
-AST / SGOT
-ALT / SGPT
-GTT – most specific to liver
2) Bilirubin: colors bile, causes jaundice when elevated
-Increases with hemolysis, biliary obstruction, liver dysfunction
3) Alkaline phosphatase:
Increase with disease of bile ducts (w/ ↑ bilirubin), bone disorders
what are the 2 main categories of hepatitis?
1) biliary: Blockage of bile ducts e.g. gallstone
2) hepatocellular: Celluar injury from drug, toxin, virus, etc
how would biliary hepatitis show up on lab tests? hepatocellular hep?
biliary:
- Initial ↑ in bilirubin, alkaline phosphatase
- Later ↑ in transaminases (AST, ALT)
- Secondary liver injury
hepatocellular:
-Initial ↑ in transaminases (AST, ALT), bilirubin (causes jaundice)
May recover
Later ↑ in PT; ↓ protein levels (albumin, globulins, total serum protein)
Liver synthetic defects
T/F: peptic ulcer disease has a high rate of recurrence
True
stomach vs duodenal ulcers are more common in what age ranges?
Stomach (gastric) ulcer: 40 – 70
Duodenal ulcer: 25 – 55
T/F: peptic ulcer disease can be aggravated by meals or lack of meals
true
what kind of bleeding do you see with acute? subacute? chronic?
Acute: coffee ground emesis, Vomiting of gastric blood !EMERGENCY!
Acute/subacute: melena, Passing digested red blood in stool / black, tarry stool
Chronic: iron deficiency anemia
2 most common causes of peptic ulcer disease?
Helicobacter pylori infection
NSAID use
other: Stress ulcer (acute/severe illness) Gastrinoma (MEN I) Antral G-cell hyperfunction Tumors Oral corticosteroid use**
H pylori is what kind of pathogen and able to evade host defenses how?
Gram negative pathogen
1) Secretes Urease (permits survival in acid stomach)
2) sticks to epithelial cells to evade immune response
T/F: peptic ulcer disease is inc in US?
False, dec.
-developing nations have high inc.
T/F: H pylori is always harmful and should be eliminated?
false
what are 3 options to test for/dx peptic ulcer disease
1) Gastric/duodenal biopsy (endoscopy)
2) Breath test (C-Urea)
3) Serology (ELISA antibody test)
* *however, the ab is there whether or not infection is present!