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.