Rubin's Liver (2) Flashcards

1
Q

“dilation of collateral veins radiating about the umbilicus”

A

caput medusae

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2
Q

“dilated inferior hemorrhoidal veins”

A

Anorectal varices

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3
Q

“dilation of veins in the lower esophagus due to portal HTN”

A

esophageal varices

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4
Q

How does splenomegaly affect elements in blood?

A

Hypersplenism leads to a decreased lifespan of the formed elements (increased removal rate)

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5
Q

“fibrotic, Fe laden nodules caused by focal hemprrhages in the spleen”

A

Gamna- Gandy bodies

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6
Q

“accumulation of fluid in the peritoneal cavity”

A

ascites

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7
Q

“translocation of intestinal bacteria into the systemic circulation with secondary infection of ascites fluid”

A

spontanteous bacterial peritonitis

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8
Q

“renal hypoperfusion int he setting of cirrhosis due to systemic vasodilation, which prostaglandins are unable to counter”

A

hepatorenal syndrome

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9
Q

“creation of shunts of various sizes within the pulmonary vascular bed in the setting of portal hypertension”

A

Hepatopulmonary syndrome (HPS)

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10
Q

Pleural effusions, like ascites but in the chest”

A

hepatic hydrothorax

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11
Q

Most common cause of acute hepatitis?

A

hep A

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12
Q

Are Hep B/ Hep C directly cytopathic?

A

No! Mediated by CD8 T cell injury

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13
Q

“massive liver cell necrosis, hepatic failure, and high mortality”

A

fulminant hepatitis B

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14
Q

What are the common extrahepatic manifestatoins of acute hepatitis C?

A

mixed cryoglobulinemia–> vasculitis, sicca sundrome (salivary glands), mononeuritis, multiplex (nervous syndrome), MPGN (kidney

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15
Q

What is the hallmark of acute viral hepatitis?

A

Liver cell death

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16
Q

What are councilman bodies?

A

Apoptotic liver cells with pyknotic nuclei

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17
Q

What is confluent hepatic necrosis?

A

affects whole regions of the lobule, it is a severe form of acute viral hepatitis

18
Q

“chronic hepatitis of unknown cause that is associated with circulating autoantibdies and high levels of serum immunoglobulins”

A

Autoimmune hepatitis

19
Q

Which autoimmune hepatitis is associated with ANA(+) and anti- smooth muscle (+)?

A

Type 1

20
Q

Which HLA type is associated with Type 1 Autoimmune hepatitis?

A

HLA- DRB1

21
Q

Which autoimmune hepatitis is associated with anti LKM antibodies?

A

Type II

22
Q

Which autoimmune hepatitis is usually seen in children ages 2-14?

A

Tpye II

23
Q

“accumulation of fat in hepatocytes”

A

steatosis

24
Q

3 risk factors for nonalcoholic fatty liver?

A

Obesity, T2DM, hyperlipidemia

25
Q

“immune mediated chronic progressive cholestatic liver disease”

A

Primary biliary cirrhosis

26
Q

“chronic cholestatic liver disease of unknown cause”

A

primary sclerosing cholangitis

27
Q

“segmental disease associated with “beaded” intrahepatic biliary tree”

A

primary sclerosing cholangitis

28
Q

Immune findings in primary sclerosing cholangitis?

A

High Ig, p-ANCA, and T cell count

29
Q

“excessive accumulation of iron in the body”

A

siderosis

30
Q

“excess body Fe leading to deposition in tissues (hemosiderosis) and organ damage (hemochromatosis)”

A

hemochromatosis

31
Q

What causes the tissue damage in hemochromiatosis?

A

generation of free radicals

32
Q

Mutation in juvenile hemochromatosis?

A

HJV mutation

33
Q

Mutation in hemochromatosis?

A

AR mutation in HFE transmemebrane gene

34
Q

primary iron storage protein?

A

ferritin

35
Q

What results from ferritin degradation?

A

Hemosiderin

36
Q

What regulates plasma Fe by binding to ferroportin?

A

Hepcidin

37
Q

What controls hepcidin synthesis?

A

TfR2, HJV, HFE

38
Q

Pancreatic complications of hereditary hemochromatosis?

A

diabetes (bronze diabetes= pigmented skin + glucose intolerance)

39
Q

cause of hyperpigmentation in hereditary hemochromatisos?

A

increased melanin (Fe not always present in pigments)

40
Q

When does HH become symptomatic?

A

midlife

41
Q

Cirrhosis + HH can lead to….

A

hepatocellular carcinoma

42
Q

causes of secondary Fe overolad syndromes?

A

alcohol abuse, hemolytic anemia,s