Session 7 - Liver, Gallbladder + Pancreas 2 Flashcards
What are some of the toxins that the GI is exposed to?
- Chemicals
- Bacteria
- Viruses
- Protozoa
- Nematodes, Cetsodes, Treamatodes
What are some of the physical innate defences the GI tract has against toxins?
- Sight + Smell
- Memory (we don’t eat bad food again)
- Saliva
- Stomach acid
- SI secretions (Bile, proteolytic enzymes)
- Colonic Mucus
What are some of the cellular innate defences the GI tract has against toxins?
- Neutrophils
- Macrophages (Kupffer cells in the liver)
- Natural Killer cells
- Tissue mast cells
- Eosinophils
What are some of the adaptive cellular cellular defences that the GI tract has against toxins?
- B lymphocytes
- T lymphocytes
- Lymphatic tissue
What are some of the issues with the failure or lessening of saliva production?
- dehydration
- microbial overgrowth in out and dental cavities
- can lead to parotitis (staph aureus)
Name some organisms that are resistant to stomach acid?
- Mycobacterium TB
- Enteroviruses such as Hep A, polio, coxsackie
- H. Pylori
Give some causes of liver failure
- Viral Hepatitis
- Alochol
- Drugs: paracetamol
- industrial solvents
- mushroom poisoning
In terms of creating blood proteins, what are some of the liver functions?
- synthesise albumin
- synthesise clotting factors
- makes thrombopoietin
- AA synthesis
What does jaundice refer to?
The build up of excess bilirubin in the blood
What would be the lab findings for a pre-hepatic jaundice?
- Unconjugated hyperbilirubinaemia
- Anaemia
- High LDH
- Low haptoglobin
Give some causes of Pre-Hepatic jaundice
- RBC defects (spherocytosis)
- Hb abnormalities
- Infection
- Acquired membrane defects
- burns
What would be the lab findings for a hepatic jaundice?
- Mix of unconjugated and conjugated bilirubin
- High liver enzymes (ALT/AST)
- abnormal clotting
What could cause hepatic jaundice?
- Viral Hepatitis
- alcohol
- Paracetamol
- Hepatocellular carcinoma
- Gilbert’s syndrome
What would be the lab findings for post-hepatic jaundice?
- Conjugated hyperbilirubinaemia
- bilirubin in urine
- Rasied canalicular enzymes (ALP)
What may cause a post-hepatic jaundice?
- Gall stones
- Carcinoma (Pancreas, bile duct, liver metastases)
- Pancreatitis
- Cirrhosis
What effects on the liver may excessive alcohol intake have?
- Fatty Liver (less NAD+=FA and TAGs accumulate in liver)
- Alcholic hepatitis
- Cirrhosis
What are some of the complications of alcoholic liver disease?
- Hepatocellular carcinoma
- Liver failure
- Dementia
- Epilepsy
- Encephalopathy
What are some of the clinical features of cirrhosis?
- Liver dysfunction
- jaundice
- anaemia
- bruising
- palmer erythema
What may portal hypertension lead to systemically?
- Ascites
- Splenomegaly
- Haemorrhoids, Oesophageal Varices, Caput Medusae
What are some of the causes of pancreatitis?
Gall stones Ethanol Trauma
Steroids Mumps Autoimmune Scorpion bites Hyperlipidaemia ERCP/iatrogenic Drugs
(GET SMASHED)
What is the likely presentation of someone with pancreatic carcinoma?
- initially asymptomatic then all symptoms at once
- Obstructive jaundice, pain, vomiting, malabsorption, diabetes
