Small group GB + Panc Flashcards
Lipase
made by pancreas
- high sensitivity and specificity for acute pancreatitis
- rises within 4-8 hours
- elevated for 8-14 days
Amylase
also made in pancreas (lipase), but also in small bowel and salivary glands
- lower sensitivity
- rises 6-24 hours/elevated for 3-7 days
Why would you have reduced vitamin K in chronic pancreatitis?
Fat soluble vitamins like vit K are poorly absorbed bc they have greater affinity for non-absorbed fat in intestinal lumen than for their muscosal receptors leading to steatorrhea
Salt and pepper chromatin patter and moderate amt of cytoplasm surrounded by fibrovascular core
Neuroendocrine neoplasm
painless jaundice
very concerning for pancreatic neoplasm
Advantages of EUS guided FNA
less invasive
- pot dx, lower incidence of bleeding
- lower risk of seeding cancer cells than w/ percutaneous biopsy
- more effective staging of cancer
Ca19-9
can be associated with pancreatic carcinoma tumor marker (if combined with other findings)
acute bacterial cholangitis
- presentation
charcots triad
- pain
- jaundic
- fever
PLus
- hypotension
- altered mental status
Which type of gallstones are visible by x ray?
Pigment stones (50-75%)
Cholesterol (20%)
AST can indicate what in:
Skeletal muscle -
Cardiac muscle -
RBCs -
Skeletal muscle - rhabdomyolysis
Cardiac muscle - MI
RBCs - Hemolysis
Alk phos can indicate what in
Bone -
PLacenta -
Intestine -
Bone - metastatic dis, fracture
PLacenta - pregnancy
Intestine - bowel perforation
abnormalities assoc with prolonged PTT or INR
Malabsorption: no correction with subcut. vit K
Synthetic dysfxn:
correction with subcu vit K
Cholestatic patttern of injury shows elevation of what levels?
Alk phos
hepatocellular injury or necrosis is predom AST & ALT elevation
Which Hep is assoc. with shellfish?
Hep A
ground glass
suggestive of HBV surface antigen storage.
AST>ALT (ratio 2)
Elevated GGT
likely alcohol use causing liver injury
Mallory bodies
aggregates of keratin
strongly associated with Alcoholic liver disease
- steatohepatitis
fatigue
pruritus
scleral icterus
RA
Primary biliary cirrhosis
- AMA strongly suggestive of PBC
tx and test for PBC
Ursodiol, liver transplant
AMA +
onion skin fibrosis
PSC
- scant inflammatory cells
- no granulomas/duct lesions
PSC or PBC assoc with IBD?
Primary sclerosing cholangitis:
PSC - associated with IBD - UC
do more pts with UC get PSC or more pts with PSC have UC?
70-80% of PSC pts have or develop UC
Benign neoplasm +
Malignant neoplasm assoc w/
- Hepatocyte
Benign: Focal nodular hyperplasia adenoma
Malignant: Hepatocellular Carcinoma
(adenoma benign, carcinoma not)
Benign neoplasm +
Malignant neoplasm assoc w/
- Biliary Duct epithelial cell
Benign:
- Bile duct adenoma
Malignant
- Cholangiocarcinoma
(Adenoma benign, carcinoma not)
Benign neoplasm +
Malignant neoplasm assoc w/
Benign:
Hemangioma
Malignant:
Angiosarcoma,
Kaposi sarcoma
SAAG
serum albumin - ascites albumin