hepatobiliary ?'s with Will Flashcards
liver functions tests (how well liver makes these things)
Bilirubin
PT/INR
albumin
tests of liver injury (components that get released by damaged liver cells)
ALT, AST
alk phos1
what other situation besides liver/biliary dz is alk phos raised? and what test to differentiate?
bone dz
measure GGT
why are platelets decreased in liver diseae?
liver makes thrombopoeitin –> platelet growth
spontaneous bacterial peritonitis happens how?
bacteria can enter more easily in ascites environment
what is INR?
ratio of vit K coag factors in patient to normal person
how well liver can use vit K to make clotting factors
3 types of acute liver injury
- hepatocellular (inc ALT, AST)
- cholestasis (inc alk phos)
- mixed
causes of ascites
- heart failure
- liver failure
- kidney failure
how to decipher between the etiologies of ascites? what lab?
SAG- serum ascites albumin gradient
nl 2.2-3.5
if >1.1 –>cardiac
if <1.1–> liver, kidney
what is S3?
heart failure sound
triplet sound
lots of blood hitting wall against floppy ventricle in diastole
S4?
atrial kick hits stiffened left ventricle wall
sounds like grace note
what dz does hepatic venous pressure gradient measure?
portal HTN
what dz does 24 hr urine total protein?
nephrotic syndrome
___% of patients with hep B will go on to develop cirrhosis
10%
is polyp in gallbaldder ever normal?
no- premalignant for cholangiocarcinoma
