Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

[AMS] Gastro-intestinal System > S7) Liver and Pancreatic Pathology > Flashcards

S7) Liver and Pancreatic Pathology Flashcards

1
Q

Describe the anatomical relationship of the liver with the gallbladder and duodenum

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Outline the transport and metabolism of bilirubin

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Identify 3 ways in which we can measure liver dysfunction

A
  • Failure of anabolism
  • Failure of catabolism and excretion
  • Markers of hepatocyte damage/dysfunction
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Identify 4 things produced by the liver (anabolism)

A
  • Albumin
  • Glycogen
  • Coagulation factors
  • Haematopoiesis (in foetus / adult with bone marrow failure)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

In terms of anabolism, identify 2 indicators of poor liver function

A
  • Hypoalbuminaemia due to failure to produce albumin
  • Prolonged prothrombin time (PT/INR) due to failure to produce coagulation factors
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Identify 5 things broken down by the liver (catabolism)

A
  • Drugs
  • Hormones
  • Haemoglobin
  • Poisons
  • Aged RBCs (after splenectomy)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Identify and describe 3 abnormalities of bilirubin production/excretion

A
  • Pre-hepatic jaundice: too much bilirubin e.g. haemolytic anemia
  • Intra-hepatic jaundice: failure of hepatocytes to conjugate and/or secrete bilirubin e.g hepatitis, cirrhosis
  • Post-hepatic jaundice: failure of the biliary tree to convey conjugated bilirubin to duodenum e.g. biliary tree obstruction
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

How can excess bilirubin be measured?

A

Conjugated bilirubin is water soluble so when elevated, serum levels can be measured with a dipstick (dark yellow)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Identify 3 signs of pre-hepatic jaundice

A
  • Raised serum bilirubin
  • Increased urinary urobilinogen
  • No conjugated bilirubin present in urine
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Identify 4 symptoms of pre-hepatic jaundice

A
  • Mild jaundice (lemon tinge)
  • Stools may be very dark
  • Normal urine colour
  • No pruritis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Identify 3 signs of intra-hepatic jaundice

A
  • Raised serum bilirubin
  • Normal urinary urobiliogen
  • Conjugated bilirubin present in urine
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Identify 4 symptoms of intra-hepatic jaundice

A
  • Moderate jaundice
  • Stools normal
  • Urine dark
  • No pruritis usually
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Identify 3 signs of post-hepatic jaundice

A
  • Raised serum bilirubin
  • Decreased urinary urobilinogen
  • Conjugated bilirubin present in urine
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Identify 4 symptoms of post-hepatic jaundice

A
  • Severe jaundice (green tinge!)
  • Stools pale
  • Urine dark
  • Pruritis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Identify 3 enzyme markers of hepatocyte damage/dysfunction

A
  • Alanine aminotransferase (ALT) is released by inflamed/damaged hepatocytes
  • Alkaline phosphatase (Alk Phos) is present in the liver canaliculi, bile ducts and bone
  • Gamma-glutamyl transferase (Gamma GT) is present in bile duct cells
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

A raised ALT is due to hepatitis.

Identify 4 causes of hepatitis

A
  • Viral (A, B, C etc.)
  • Acute alcohol intake
  • Fatty liver disease
  • Drugs/toxins
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Identify 2 main causes of a raised Alk Phos

A
  • Bile duct/liver disease with cholestasis
  • Bone disease
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Identify 4 conditions which lead to bile duct/liver disease presenting with a raised Alk Phos

A
  • Biliary obstruction
  • Cirrhosis
  • Liver metastases
  • Drugs
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Identify 4 conditions which lead to bone disease presenting with a raised Alk Phos

A
  • Bone metastases/fracture
  • Osteomalacia
  • Hyperparathyroidism
  • Paget’s disease of bone
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Identify 5 causes of a raised Gamma GT

A
  • Biliary duct obstruction/cholestasis
  • Cirrhosis
  • Liver metastases
  • Drugs
  • Alcoholism
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Identify 4 common liver and bile duct diseases

A
  • Hepatitis
  • Cirrhosis
  • Gallstones and biliary tract obstruction
  • Liver metastases
22
Q

How does liver failure present?

A
  • Increased susceptibility to infections
  • Increased susceptibility to toxins and drugs
  • Increased blood ammonia (failure to clear ammonia via urea cycle)
23
Q

Identify 6 symptoms of hepatitis

A
  • Malaise
  • Anorexia
  • Fever
  • Right upper quadrant pain
  • Dark urine
  • Jaundice
24
Q

What are the typical blood test findings in acute hepatitis?

A
  • Normal albumin and INR
  • High serum bilirubin
  • Very high serum ALT
  • Normal/slightly raised Alk Phos
  • Normal/slightly raised Gamma GT
25
What is cirrhosis?
**Cirrhosis** is a condition caused by liver fibrosis, producing a shrunken hard nodular liver
26
Identify 3 consequences of liver fibrosis
- **Portal hypertension** due to pressure and occlusion of the hepatic sinusoids - **Reduced excretion** due to pressure on the bile canaliculi **- Reduced albumin** and **clotting factor** production due to replacement of hepatocytes by fibrous tissue
27
Identify 4 main causes of liver cirrhosis
- Alcohol - Consequence of viral hepatitis (B,C) - Fatty liver disease - Idiopathic
28
Identify 3 sites of portosystemic anastomoses
- Anorectal junction - Ligamentum teres of falciform ligament - Oesophagogastric junction
29
In two steps, explain how oesophageal varices results from liver cirrhosis
- Pressure and occlusion of the hepatic sinusoids leads to **portal hypertension** - Portal hypertension leads to portosystemic shunting, including **oesophageal varices**
30
Identify 5 symptoms of cirrhosis
- Fatigue/weakness - Ascites - Swollen legs (hypoproteinaemia) - Weight loss - Jaundice
31
What are the typical blood test findings for cirrhosis?
- May all be normal - May show a low **albumin** and/or prolonged **INR** - May show a raised **bilirubin** - May be a slight rise in **ALT** (if ongoing inflammation) - May be very mild raise in **Alk Phos** (if cholestasis) - May show a raised **Gamma GT** (if alcoholism)
32
What is the treatment of cirrhosis?
- Fibrosis is irreversible so a **liver transplant** is needed - Treatment is aimed at managing the **complications**
33
What are the 2 main causes of gall bladder obstruction?
- **Gallstone migration** from the gallbladder into common bile duct - **Carcinoma** of the head of pancreas
34
What are the typical laboratory findings in post-hepatic/obstructive jaundice?
- Normal serum **albumin** and **INR** - Normal/slightly raised serum **ALT** - Very high **serum** **bilirubin** - **Conjugated bilirubin** present in the urine - Raised **Alk phos** and **Gamma GT**
35
What is cholangitis?
**Cholangitis** is an infection in the bile ducts and a life-threatening complication of bile duct obstruction, commonly caused by E. Coli
36
Why do gallstones develop?
Gallstones develop in the gallbladder due to **chemical imbalances** in the bile
37
Biliary colic is not true colic. What is it?
- **Biliary colic** is pain in the right upper quadrant that radiates to the tip of the right scapula/right shouder - It is often precipitated by eating a fatty meal and lasts up to 6 hours
38
What is acute cholecystitis?
**Acute cholecystitis** is inflammation of the gallbladder, occurring when a gallstone blocks the cystic duct and commonly caused by E.coli
39
Apart from severe gallbladder pain, how does a patient with acute cholecystitis present?
- Systemically unwell - Pyrexia - Tenderness over the gallbladder
40
Why is the liver a common site for metastases?
The liver is designed to filter the blood entering it and cancer cells can lodge in the filter
41
What are the laboratory findings in liver metastases?
- Raised **serum bilirubin** - **Conjugated bilirubin** present in the urine - Raised **Alk Phos** - Slightly raised **ALT** and **Gamma GT** - Normal **serum albumin** and **INR**
42
What are the two forms of pancreatitis?
- Acute - Chronic
43
What is acute pancreatitis?
**- Acute pancreatitis** is a common condition arising from the premature activation of pancreatic proteases in the pancreas itself rather than in the duodenum - These proteases then autodigest the pancreas and the retroperitoneum
44
Identify and describe the 2 main causes of acute pancreatitis
- **Alcohol** alters the balance between proteolytic enzymes and protease inhibitors, thus triggering enzyme activation - **Gallstone obstruction** causes pancreatic duct hypertension and the toxic effect of bile salts contribute to enzyme activation (biliary acute pancreatitis)
45
What is chronic pancreatitis?
**- Chronic pancreatitis** is rare condition caused by alcohol abuse where repeated low grade pancreatitis causes pancreatic fibrosis - The pancreas becomes calcified and patients suffer severe epigastric and back pain that leads to opiate addiction and not infrequently suicide
46
State 2 symptoms of acute pancreatitis
- Epigastric pain that goes through to the back - Vomiting
47
How can the diagnosis of acute pancreatitis be confirmed?
- Raised **serum amylase /** **serum lipase** - **CT scan** used to look for pancreatic necrosis/pseudocyst
48
Describe the treatment of acute pancreatitis
- Analgesia - Supportive treatment - Fluid resuscitation
49
What is pancreatic cancer?
- **Pancreatic carcinoma** is a condition resulting from the uncontrolled cell growth in the pancreas which metastasises to the rest of the body - Nearly all are ductal adenocarcinomas and most are in the head of the pancreas
50
Describe the clinical presentation of pancreatic carcinoma
- Anorexia, malaise, fatigue - Significant weight loss - Epigastric and/or back pain - Dark urine - Pale stools - Pruritis

[AMS] Gastro-intestinal System (18 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions