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GI > Week 6 Part 1 > Flashcards

Week 6 Part 1 Flashcards

1
Q

What is ketogenesis a sign of?

A

Starvation

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2
Q

What vitamins are stored in the liver?

A

Vit A, B12, E, D and K

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3
Q

Where is albumin synthesised?

A

Liver

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4
Q

What are Kupffer cells?

A

Liver phagocytes

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5
Q

Where is the sphincter of Oddi?

A

Between the duodenum and the common bile duct

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6
Q

What are the main components of bile acids?

A

Cholic and chenodeoxycholic acids

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7
Q

What is cholelithiasis?

A

The presence of gallstones

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8
Q

What is the treatment of choice for patients with unimpaired gall bladder function having small/medium-sized stones?

A

Uresodeoxycholic acid

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9
Q

What is the analgesia of choice for biliary colic?

What should not be used under any circumstances?

A

Buprenorphine

Morphine constricts the sphincter of Oddi

Atropine and GTN can relieve biliary spasm

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10
Q

What is the name of the process which describes the reabsorption of bile salts?

A

Enterohepatic recycling

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11
Q

What is enterohepatic recycling?

A

The reabsorption of bile salts

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12
Q

What does phase I of drug metabolism in the liver do?

A

Oxidation
Reduction
Hydrolysis

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13
Q

What does phase II of drug metabolism do in the liver?

A

Adds an endogenous compound

Increases polarity

Enables it’s solubility

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14
Q

What is electrophoresis?

A

Allows separation of proteins by size

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15
Q

What do plasma proteins do?

A

Maintenance of oncotic or colloid osmotic pressure

Transport of hydrophobic substances

pH buffering

Enzymatic

Immunity

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16
Q

What plasma protein transports vitamin A?

A

Alpha globulins

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17
Q

Deficiency in what vitamin causes visual impairment?

A

Vitamin A

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18
Q

What plasma protein transports iron?

A

Transferrin

beta-globulin

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19
Q

What does albumin transport?

A

Hydrophobic molecules

Fatty acids

Bilirubin

Thyroid hormones

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20
Q

Iron is stored in cells bound to what substance?

A

Ferritin

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21
Q

How is copper transported in the blood?

A

Bound to ceruloplasmin

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22
Q

What disease is associated with copper deficiency?

A

Wilson’s disease

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23
Q

What does HDL do?

A

Removes excess cholesterol from cells

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24
Q

What organ is the only organ capable of metabolising and excreting cholesterol?

A

The liver

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25
Q

What is the main component of gallstones?

A

Cholesterol

26
Q

Is cholesterol soluble in water?

A

No

27
Q

How is HMG-CoA reductase stimulated?

A

fasting

28
Q

What drug lowers cholesterol?

A

Statins

29
Q

What are some products of cholesterol?

A

Vitamin D
Steroid hormones
Bile salts

30
Q

What are antimicrobials?

A

All agents that act against microorganisms. namely bacteria, fungi, viruses and protozoa

31
Q

What are antibacterials?

A

Only act on bacteria including antibiotics

32
Q

What is an antibiotic?

A

A drug that kills or inhibits the growth of microorganisms

33
Q

What does MDR mean?

A

That bacteria is not susceptible to at least 1 agent in 3 or more antimicrobial categories

Multi drug resistant

34
Q

What does XDR mean?

A

A bacteria is not susceptible to at least 1 agent in all but 2 or fewer antibitcrobial categories (antibiotic only susceptible to 1/2 antibiotic categories)

Extremely drug resistant

35
Q

What does PDR mean?

A

Not susceptible to any antibmicrobial categories

Pandrug resisitant

36
Q

What are the four Ds of AMS(antimicrobial stewardship)?

A

Drug
Dose
Duration
De-escalation

37
Q

What are the 3 main factors of liver cirrhosis?

A

Reduced liver blood flow

Reduced metabolic function

Reduced plasma proteins

38
Q

What causes potassium loss, sodium retention and water retention?

A

Angiotensin II

Aldosterone

SNS

ADH

39
Q

What does aldosterone and endothelin do to the kidney?

A

Renal vasoconstrictor

Renal prostaglandin

Contributes to hepatorenal syndrome

40
Q

What are the consequences of moderate hepatic impairment?

A

Decreased renal clearance

Gut oedema

Liver and kidney congestion

Ascities

41
Q

What is the treatment for liver cirrhosis?

A

NSAIDs

Paracetamol

Opiate

42
Q

What should NSAIDs always be prescribed with?

A

PPIs

43
Q

For ascites due to the liver e.g. portal hypertension, what drug should be used?

A

Sprinolactone

44
Q

What antibiotic reduces drug metabolism?

A

Metronidazole

45
Q

What does renin do?

A

Converts angiotensinogen to angiotensin I

46
Q

What stimulates the release of renin?

A

Low albumin/low plasma volume

47
Q

What condition gives micronodular cirrhosis of the liver?

A

Alcoholism

48
Q

What condition causes

Caput medusa

Haemorrhoids

Oesophageal varices

A

Portal hypertension

49
Q

What causes spider naevi?

A

Hyperoestrogenism

50
Q

What hepatitis is transmitted through faecal to oral spread?

A

Hepatitis A

51
Q

Describe hepatitis A

A

Short incubation period

Patients make a full recovery

Faecal-oral spread

52
Q

Describe hepatitis B

A

Spread by blood, blood products, sexually, vertically (in utero)

Long incubation period

Liver damage is by antiviral immune response

Outcome is variable

53
Q

Describe hepatitis C

A

Spread by blood

Possibly spread sexually

Often assymptomatic

Short incubation period

Tends to become chronic

54
Q

What conditions can cause chronic hepatitis?

A

Hep B

Hep C

Primary biliary cirrhosis

Autoimmune hepatitis

Drug induced hepatitis

Primary sclerosing cholangitis

55
Q

What gender does primary biliary cirrhosis commonly occur in?

A

Females (90%)

56
Q

What test is used to stage primary biliary cirrhosis?

A

Biopsy

57
Q

What is primary sclerosing cholangitis and what population is it more common in?

A

Chronic inflammatory process affecting intra- and extra-hepatic bile ducts

Leads to periductal fibrosis, duct destruction, jaundice and fibrosis

Associated with UC

Males

Increased risk of malignancy

58
Q

What is haemochromatosis?

A

Excess iron within the liver

Genetic condition (inherited autosomal recessive condition)

Primary: Increased absorption of iron

Secondary: Iron overload from diet

59
Q

Describe Wilson’s disease?

A

Copper accumulates in liver and brain

Inherited autosomal recessive disorder of copper metabolism

Can cause chronic hepatitis and neurological deterioration

Low serum caeruloplasmin

KAYSER-FLEISCHER RINGS

60
Q

What are Kayser Fleischer rings a sign of?

A

Copper deposition in the liver

WILSON’S DISEASE

61
Q

What does alpha-1-antitrypsin deficiency cause?

A

Empysema and cirrhosis

62
Q

What is alpha-1-antitrypsin deficiency?

A

Inherited autosomal recessive disorder of production of an enzyme inhihbitor

GI (22 decks)

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