Session 7 - Liver, Gallbladder + Pancreas 2

Question 1

What are some of the toxins that the GI is exposed to?

Answer 1

• Chemicals
• Bacteria
• Viruses
• Protozoa
• Nematodes, Cetsodes, Treamatodes

Question 2

What are some of the physical innate defences the GI tract has against toxins?

Answer 2

• Sight + Smell
• Memory (we don’t eat bad food again)
• Saliva
• Stomach acid
• SI secretions (Bile, proteolytic enzymes)
• Colonic Mucus

Question 3

What are some of the cellular innate defences the GI tract has against toxins?

Answer 3

• Neutrophils
• Macrophages (Kupffer cells in the liver)
• Natural Killer cells
• Tissue mast cells
• Eosinophils

Question 4

What are some of the adaptive cellular cellular defences that the GI tract has against toxins?

Answer 4

• B lymphocytes
• T lymphocytes
• Lymphatic tissue

Question 5

What are some of the issues with the failure or lessening of saliva production?

Answer 5

• dehydration
• microbial overgrowth in out and dental cavities
• can lead to parotitis (staph aureus)

Question 6

Name some organisms that are resistant to stomach acid?

Answer 6

• Mycobacterium TB
• Enteroviruses such as Hep A, polio, coxsackie
• H. Pylori

Question 7

Give some causes of liver failure

Answer 7

• Viral Hepatitis
• Alochol
• Drugs: paracetamol
• industrial solvents
• mushroom poisoning

Question 8

In terms of creating blood proteins, what are some of the liver functions?

Answer 8

• synthesise albumin
• synthesise clotting factors
• makes thrombopoietin
• AA synthesis

Question 9

What does jaundice refer to?

Answer 9

The build up of excess bilirubin in the blood

Question 10

What would be the lab findings for a pre-hepatic jaundice?

Answer 10

• Unconjugated hyperbilirubinaemia
• Anaemia
• High LDH
• Low haptoglobin

Question 11

Give some causes of Pre-Hepatic jaundice

Answer 11

• RBC defects (spherocytosis)
• Hb abnormalities
• Infection
• Acquired membrane defects
• burns

Question 12

What would be the lab findings for a hepatic jaundice?

Answer 12

• Mix of unconjugated and conjugated bilirubin
• High liver enzymes (ALT/AST)
• abnormal clotting

Question 13

What could cause hepatic jaundice?

Answer 13

• Viral Hepatitis
• alcohol
• Paracetamol
• Hepatocellular carcinoma
• Gilbert’s syndrome

Question 14

What would be the lab findings for post-hepatic jaundice?

Answer 14

• Conjugated hyperbilirubinaemia
• bilirubin in urine
• Rasied canalicular enzymes (ALP)

Question 15

What may cause a post-hepatic jaundice?

Answer 15

• Gall stones
• Carcinoma (Pancreas, bile duct, liver metastases)
• Pancreatitis
• Cirrhosis

Question 16

What effects on the liver may excessive alcohol intake have?

Answer 16

• Fatty Liver (less NAD+=FA and TAGs accumulate in liver)
• Alcholic hepatitis
• Cirrhosis

Question 17

What are some of the complications of alcoholic liver disease?

Answer 17

• Hepatocellular carcinoma
• Liver failure
• Dementia
• Epilepsy
• Encephalopathy

Question 18

What are some of the clinical features of cirrhosis?

Answer 18

• Liver dysfunction
• jaundice
• anaemia
• bruising
• palmer erythema

Question 19

What may portal hypertension lead to systemically?

Answer 19

• Ascites
• Splenomegaly
• Haemorrhoids, Oesophageal Varices, Caput Medusae

Question 20

What are some of the causes of pancreatitis?

Answer 20

Gall stones Ethanol Trauma
Steroids Mumps Autoimmune Scorpion bites Hyperlipidaemia ERCP/iatrogenic Drugs
(GET SMASHED)

Question 21

What is the likely presentation of someone with pancreatic carcinoma?

Answer 21

• initially asymptomatic then all symptoms at once

- Obstructive jaundice, pain, vomiting, malabsorption, diabetes