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GI > Session 7 - Liver And Pancreas Pathology > Flashcards

Session 7 - Liver And Pancreas Pathology Flashcards

1
Q

Where are red cells broken down?

A

In the spleen

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2
Q

What happens when a red cell is broken down?

A

Bilirubin is released from haem breakdown
Bilirubin is hydrophobic and binds albumin to be carried to the liver
In the liver bilirubin is conjugated - which is water soluble nd is secreted by hepatocytes into the bile canaliculli

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3
Q

What products of the liver can you measure to check liver function?

A

Albumin

Prothrombin time - coagulation factors

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4
Q

What are the types of jaundice ?

Give an example of each?

A

Pre-hepatic: haemolytic anaemia

Intra-hepatic: cirrhosis

Post-hepatic: biliary tree blockage

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5
Q

What skin condition would post-hepatic jaundice cause?

A

Pruritis - itching

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6
Q

what are the symptoms of pre-hepatic jaundice ?

A

Mild jaundice
Dark stools
Urine - normal colour
No pruritis

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7
Q

What happens to the levels of

  1. Serum bilirubin
  2. Urinary urobiliogen
  3. Urinary conjugated bilirubin

In PRE-HEPATIC JAUNDICE

A
  1. Serum bilirubin is raised
  2. Urinary urobiliogen is raised
  3. No conjugated bilirubin in the urine
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8
Q

Symptoms of intra-hepatic jaundice?

A

MOderate jaundice
Normal stools
Dark urine
No pruritis

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9
Q

What would be seen on the blood test of a patient with intra-hepatic jaundice?

  1. serum bilirubin
  2. urinary urobiliogen
  3. Conjugated bilirubin in urine
A

Raised serum bilirubin
Normal urinary urobiliogen
Presence of conjugated bilirubin in urine

(Why? Conjugated bilirubin does not go into the bile duct - into blood instead)

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10
Q

what are the symptoms of post-hepatic jaundice?

A

Pale stools
Dark urine
Itching
Severe jaundice

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11
Q

what would be the blood results of a patient with post-hepatic jaundice?

  1. Serum bilirubin
  2. Urinary urobiliogen
  3. Conjugated bilirubin in urine?
A
  1. Serum bilirubin raised
  2. Urinary urobiliogen - decreased
  3. Presence of conjugated bilirubin in urine
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12
Q

What does ALT stand for ?

A

Alanine aminotrasferase

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13
Q

When is ALT released?

A

It is released by damaged or inflamed hepatocytes

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14
Q

When may Alkaline phosphatase be raised?

A

Liver disease - especially cholestasis or biliary obstruction
Bone disease

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15
Q

What is raised gamma-glutamyl transferase a marker of?

A

Bile duct obstruction

Specifically induced by alcohol

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16
Q

Causes of raised ALT?

A

Hepatitis

  • viral
  • alcohol intake
  • fatty liver disease
  • toxins
17
Q

Causes of raised Alk Phosphate?

A

Bile duct obstruction
Liver Mets

Bone disease

  • bone mets, fracture
  • hyperparathyroidism
  • Paget’s disease
18
Q

what are the causes of a raised gamma-GT?

A

Alcohol

Liver mets
Cirrhosis
Biliary duct obstruction

19
Q

What blood results would you find in someone with acute hepatitis ?

A 
VERY HIGH ALT
High serum bilirubin 
Normal Gamma GT
Normal ALP/alk phos
Normal albumin
Normal INR
20
Q

What does the liver look like if there is cirrhosis?

A

Shrunken, hard and fibrotic

21
Q

What signs/symptoms are there of portal hypertension ?

A

Caput medusa
Haemorrhoids
Oesophageal varices
Ascites

22
Q

Symptoms of Cirrhosis

A 
Fatigue 
Bleeding and bruising easily 
Jaundice 
Ascites 
Swollen legs (hypoproteinaemia)
23
Q

How is liver cirrhosis treated?

A

Liver transplant

24
Q

what are the 2 main causes of biliary tree obstruction?

A

Gall stone

Carcinoma of the head of the pancreas

25
Q

What is cholangitis?

A

Infection in the bile ducts

26
Q

What is the most common bacterial agent which causes cholangitis?

A

E. Coli

27
Q

What are the symptoms of cholangitis?

A

Charcots triad
RUQ pain
Jaundice
Fever

28
Q

What is biliary colic?

A

A constant pain which lasts up to 6 hours

In the RUQ - may radiate to the tip of the right scapula / shoulder

29
Q

What is cholecystitis?

A

Infection of the gall bladder - due to a gall stone obstructing the cystic duct.

30
Q

What symptoms would someone with cheolecystitis present with?

A

RUQ pain
Systemically unwell
Fever

31
Q

What is the cardinal sign in the blood test of a pateint with liver cancer?

A

Raised Alk Phos.

32
Q

How do you diagnose acute pancreatitis?

A

Serum amylase or serum lipase

GI (13 decks)

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