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HSC2008 Pathology & Pharmacology > Week 11 > Flashcards

Week 11 Flashcards

1
Q

liver function

A
  • bile production
  • clearing meds
  • metabolism
  • protein production
  • breakdown toxins
  • clotting factors
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2
Q

loss of bile production leads to

A

jaundice

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3
Q

loss of med clearance leads to

A

drug toxicity

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4
Q

loss of clotting factors leads to

A

coagulopathy

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5
Q

loss of toxin breakdown leads to

A

encephalopathy

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6
Q

loss of protein production leads to

A

low albumin > edema / ascites

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7
Q

loss of metabolism leads to

A

hypoglycemia, lethargy, cachexia

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8
Q

hepatitis

A

liver injury due to inflammation

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9
Q

what are acute hepatitis

A

hepatitis A / E

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10
Q

what are chronic hepatitis

A

hepatitis B / C

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11
Q

what leads to increased risk of liver cirrhosis / cancer

A

hepatitis B / C

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12
Q

what are the sources of hepatitis A / E

A

contaminated food & water, acute illness

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13
Q

what are the sources of hepatitis B / C

A

blood products / bodily fluids

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14
Q

those infected with acute hepatitis B present with __

A

lethargy, body-aches, fever, jaundice and dark tea-
colored urine

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15
Q

what is a rare complication of hepatitis A / E

A

liver failure; transplant is the only life saving option

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16
Q

risk of liver cancer increased in

A
  • males > 40 yrs, females > 50 yrs
  • liver cirrhosis
  • family history
  • high level of hep B
  • alcohol, smoking, obesity
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17
Q

what does lipogenesis result in

A
  • dyslipidemia
  • insulin resistance
  • obesity
  • metabolic syndrome
  • Type 2 diabetes
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18
Q

what does inflammation result in

A
  • lipid peroxidation
  • mitochondrial dysfunction
  • oxidative stress
  • apoptosis
  • pro-inflammatory cytokine activation
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19
Q

what does fibrosis result in

A
  • advanced cell damage
  • scarring
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20
Q

what are the 3 stages involved in fatty liver disease

A

lipogenesis, inflammation, fibrosis

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21
Q

what gene is associated with autoimmune hepatitis

A

human leukocyte antigen

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22
Q

gallbladder diseases

A

cholelithiasis, cholecystitis, biliary colic, choledocholithiasis, cholangitis

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23
Q

cholelithiasis

A

gallstones in gallbladder

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24
Q

cholecystitis

A

GB & cystic duct inflammation

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25
Q

biliary colic

A

abdominal pain due to gallstone in gallbladder neck

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26
Q

choledocholithiasis

A

gallstones in CBD

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27
Q

cholangitis

A

infected bile ducts

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28
Q

causes of cholelithiasis

A

bile saturated due to high cholesterol, obesity, estrogen

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29
Q

causes of biliary colic

A

Gallstone lodged in the neck of the gallbladder or cystic duct

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30
Q

causes of Cholecystitis

A

infected GB leading to inflammation

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31
Q

causes of choledocholithiasis

A

Obstruction of biliary flow into the duodenum due to gallstone stuck in CBD

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32
Q

causes of Cholangitis

A

biliary tract infected causing obstructed bile flow

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33
Q

cirrhosis

A

hardening of liver

34
Q

causes of cirrhosis

A

hepatitis B / C
excessive alcohol
autoimmune liver disease
fatty liver
iron build up
copper accumulation
repeated heart failure with liver congestion

35
Q

most common causes of liver cirrhosis in SG

A

chronic hepatitis B & alcoholic liver disease

36
Q

symptoms of compensated cirrhosis of the liver

A
  • abnormal function tests
  • low platelet count
  • spider like blood vessels
  • fatigue and weight loss
37
Q

symptoms of decompensated cirrhosis of the liver

A
  • abdominal swelling
  • leg swelling
  • jaundice
  • vomit blood
  • confusion
38
Q

how is cirrhosis diagnosed

A

US, MRI, CT

39
Q

complications of portal hypertension

A

dilated vessels > splenomegaly > fluid accumulation in abdomen

40
Q

complications of liver failure

A

low protein > easy bruising > jaundice

41
Q

complications of cirrhosis

A

ascites, varices, encephalopathy, jaundice, liver cancer

42
Q

ascites

A

fluid accumulation in abdomen due to low protein levels in body

43
Q

leg swelling

A

fluid accumulation in feet

44
Q

spider naevi

A

dilated blood vessels on upper chest wall

45
Q

palmar erythema

A

reddish discoloration of palms due to dilated blood vessels

46
Q

jaundice

A

yellowing of sclera of eyes due to bilirubin accumulation

47
Q

varices

A

swollen veins in esophagus & stomach leading to rupture and bleeding

48
Q

hematemesis

A

vomit blood

49
Q

malena

A

dark stool

50
Q

encephalopathy

A

confusion & drowsiness due to toxins in brain

51
Q

liver cirrhosis severity determined by

A
  • cirrhosis / child’s score A, B, C
  • MELD score
  • liver siffness / fibroscan
52
Q

liver cirrhosis treatment

A
  • treat hepatitis B / C
  • stop alcohol
  • treat autoimmune hepatitis
  • exercise / weight loss
53
Q

varices treatment

A

reduce variceal bleeding via
- non selective beta blockers for portal hypertension
- endoscopic banding / ligation

54
Q

mild ascites treatment

A

avoid development of ascites & leg swelling via
- low salt diet
- diuretics to increase water clearance

55
Q

severe ascites treatment

A

remove excess fluid to reduce abdominal swelling & breathlessness
- abdominal paracentesis
- TIPS shunt
- liver transplant

56
Q

hepatic encephalopathy treatment

A
  • clear bowels regularly to reduce toxins
  • lactulose to prevent constipation
  • fleet enema to clear retained stools
57
Q

types of liver transplant

A

cadaveric & living donor

58
Q

how is cirrhosis diagnosed

A

biopsy & fibroscan (measures stiffness)

59
Q

how should one survey for liver cancer

A

Ultrasound & AFP every 6 months; confirm using CT/MRI

60
Q

arterial phase characteristic is __

A

hypervascular

61
Q

delayed venous phase characteristic is __

A

washout

62
Q

what test is used for liver function

A

child pugh class & portal hypertension

63
Q

what test is used for physical status

A

ECOG, co-morbidities, symptoms

64
Q

what is the material used for selective internal radiation therapy

A

Yttrium-90

65
Q

TACE

A

transarterial chemoembolization

66
Q

systemic chemotherapy used for HCC is __

A

sorafenib

67
Q

when is RFA suitable for HCC

A

single nodules < 3cm & outcome similar to surgery for nodules < 2cm

68
Q

RFA

A

radiofrequency ablation

69
Q

TACE is recommended for __

A

BCLC B; multifocal HCC w/o PV invasion or metastasis

70
Q

SIRT w/ Y90 is suitable for __

A

multifocal HCC w/ PV invasion

71
Q

what hormones are inactivated in liver

A

aldosterone & estrogen

72
Q

gluconeogenesis

A

protein & fat > glucose

73
Q

glycogenolysis

A

glycogen > glucose

74
Q

hepatic artery function

A

supplies oxygenated blood from general circulation

75
Q

hepatic portal vein function

A

supplies nutrients

76
Q

what neutralizes HCl

A

bicarbonate ions

77
Q

endocrine hormones produced by islet of langerhans

A

insulin, glucagon

78
Q

where is vitamin K synthesized

A

resident normal flora

79
Q

what does congested spleen & varices lead to

A

hemolysis

80
Q

what is the most common primary tumor

A

hepatocellular carcinoma

HSC2008 Pathology & Pharmacology (14 decks)

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