Week 2: Cirrhosis + Hepatitis

Question 1

Cirrhosis

Answer 1

Chronic irreversible scarring of the liver.

patho: Hepatic Stellate Cells (HSC) found within Space of Disse become activated due to injury. Activated HSC turn into fibrogenic myofibroblast and produce TGF-B which produce collagen.
Features: Hyperestrognemia, HCC, Jaundice, Anorexia, Encephalopathy

Question 2

Portal Hypertension

Answer 2

Normal: 5-10mmHg.

Sinusoidal Endothelial Cells (SEC) (found b/w sinusoids and parenchyma) synthesize NO and Endothelin-1 (ET-1). Dysfunction results in:
- Increased ET-1 production & receptor activity INTRAHEPATICALLY initiates portal HTN.
- Increased SYSTEMIC NO > RAAS activation > hyperdynamic circulation.

Formation of Porto-systemic shunt from collateral vessels.

Portal vein fed by Superior Mesenteric V (sm. intest) + L gastric +

Portal vein fed by Superior Mesenteric V (sm. intest) + L gastric + splenic (inf. mesenteric (large intestine) drains into splenic).

Question 3

Causes of Acute Pancreatitis

I GET SMASHED

Answer 3

Idiopathic

Gallstones
Ethanol
Trauma

Scorpion sting
Mumps
Autoimmune
Steroids
Hyperlipidemia
ERCP
Drugs

Question 4

Pancreatic Carcinoma

Answer 4

Associated with Trousseau’s Sign (Migratory thrombophlebitis)