کبد و مجاری صفراوی و پانکراس اگزوکرین

Question 1

سایز نرمال کبد

Answer 1

1200

تا 1400

Question 2

Acute Liver Failure؟

Answer 2

liver disease that produces encephalopathy within 6 months of the initial diagnosis & if encephalopathy
develops more rapidly, within 2 weeks, it is called fulminant liver failure

Question 3

علل

Acute liver failure

Answer 3

acetaminophen overdose - 50% of cases

autoimmune hepatitis, other drugs & toxins and acute hepatitis
A & B infections

Question 4

How does liver failure cause behavioral abnormalities to confusion to coma &
death?

Answer 4

detoxification is impaired because of loss of hepatocyte function
The accumulated ammonia enters the CNS, where it impairs neuronal function,
and causes cerebral edema
Symptoms : behavioral abnormalities to confusion to coma &
death

Question 5

Hepatic encephalopathy

clinical Test?

Answer 5

Asterixis
flapping tremorarms
are held in extension with dorsiflexed wrists

Question 6

Clinical manifestations of Acute liver failure

Answer 6

Jaundice and icterus

Coagulopathy:
reduced synthesis of coagulation factorsabnormal
coagulation tests (PT & PTT)PT is more sensitivebecause of the elevated levels of factor VIII
(secreted from endothelial cells

Hepatorenal syndrom
ekidney failure
decreases GFR
decrease in urine output
 rising BUN&creatinine levels

Question 7

Chronic liver failure & Cirrhosis

Answer 7

Is the result of prolonged liver injury, most often caused by alcoholic hepatitis,
nonalcoholic fatty liver disease (NAFLD), and chronic viral hepatitis B and C
- Cirrhosis is the morphologic change most often associated with chronic liver
disease & it is marked by diffuse distortion of the liver architecture resulting from
replacement by regenerative parenchymal nodules surrounded by fibrous bands
- The nodular nature of the process is evident both grossly & microscopically

Question 8

Clinical manifestations of Cirrhosis

Answer 8

The fibrosis obstructs blood flow through the liver and results in impaired drainage
of the portal vein, causing
portal hypertension
splenomegaly
ascites
periumbilical caput medusae
esophageal varices

excess estrogen : hypogonadism (testis atrophy)gynecomastia in malespalmar erythema as well as spider angioma in both sexes
hyperestrogenemia induces vascularization

Hypogonadism women disruption of
hypothalamic-pituitary axis

Chronic severe jaundice can lead to
pruritus or itching

Most chronic liver diseases predispose
to hepatocellular carcinoma (HCC)

Most of the clinical manifestations of
acute liver failure may also be seen
in chronic liver failure

Question 9

Hepatocyte integrity tests

نشان دهنده تمامیت هپاتوسیت

Answer 9

AST
ALT
LDH

Question 10

Biliary excretory function
عملکرد دفعی صفرا
تست ها

Answer 10

serum Bilirubin
serum alkaline phosphatase
GGT اختصاصی تر

Question 11

Hepatocyte function tests?

کبد چقدر میتونه تولید داشته باشه

Answer 11

serum albumin
PT
PTT
Serum ammonia

Question 12

بازه ای که هپاتیت
A
میتونه واگیر داشته باشه؟

Answer 12

Virus is shed in the stool for 2 to 3 weeks before and 1 week after the onset of
jaundice

Question 13

clinical manifestations of acute hepatit

Answer 13

anorexia, fever, jaundice,
hepatomegaly & abdominal pain in RUQ

elevation in AST & ALT
IgM anti-HAV antibody is detectable in the serum by the time symptoms appear
and is a reliable marker of acute infection

mmune response efficiently clears the virus and IgG Ab is produced for years,
providing lifelong protection (recover in a few months & cannot be re-infected)