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Robbins Pathology GI (Chptr 16,17,18,19) > Clinical- Liver Disorders > Flashcards

Clinical- Liver Disorders Flashcards

1
Q

What are true liver function testing for

A
  • Cholestrol
  • Albumin
  • PT/INR
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2
Q

What is a nonhepatic source of bilirubin

A

RBCs

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3
Q

What is a nonhepatic source of AST

A

Skeletal muscle, cardiac muscle, RBCs

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4
Q

What is a nonhepatic source of ALT

A
  • Skeletal muscle
  • cardiac muscle
  • Kidneys
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5
Q

What is the nonhepatic source of LDH

A

Heart, RBC

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6
Q

What is a nonhepatic source of alkaline phosphatase

A

Bone, first trimester placenta, kidneys, intestines

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7
Q

Which amino transferase is more specific for liver injury

A

ALT

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8
Q

What are the characteristic symptoms of hepatitis A

A

Anorexia, nausea, vomiting, malaise, eversion to smoking

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9
Q

What are the lab values for Hep A

A
  • Very high ALT/AST
  • elevated bilirubin and alkaline phosphatase
  • Antibodies to hep A (anti-HAV)
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10
Q

What is the antibody that is mostly used in the diagnosis of acute hepatitis A

A

-IgM anti HAV

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11
Q

Which conditions are associated with HBV infections

A

Glomerulonephritis, serum sickness, polyarteritis nodosa

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12
Q

What are the lab values seen in HBV infection

A

Highly elevated ALT/AST

-normal alkaline phosphatase and bilirubin

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13
Q

When is the HBV surface antigen present

A

Infection, whether acute or chronic

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14
Q

What are antibodies to HBV surface antigen present

A

When immune, so if cleared a prior infection, or immunization

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15
Q

When are IgM against HBV core antigen present

A

Window period, acute and chronic infection

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16
Q

When are IgG against HBV core protein antigen present

A

Chronic infection and if had a prior infection

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17
Q

When is the HBV e antigen present

A

Only sure acute and chronic infection as it is a sign of viral replication

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18
Q

What is the HBV DNA present.

A

Acute and chronic infection, as it means the virus is present

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19
Q

What are some complications with Hepatitis C infection

A

Cirrhosis, HCC, mixed cyroglobulemia, lichen planus, autoimmune thyroiditis, decreased cholesterol levels

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20
Q

Which hepatitis infection is associated with polyarteritis nodosa

A

HBV

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21
Q

Which hepatitis infection is assocaited with mixed cyroglobulemia

A

HCV

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22
Q

What diagnostic method is used to check for presenc eor absence of fibrosis in chronic hepatitis

A

Serum FibroSure or ultrasound

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23
Q

Which drugs can elicit toxic hepatitis

A
  • Isoniazid
  • Sulfonamides
  • Acetometaphen
24
Q

What is the treatment/therapy for acetaminophen poisoning

A

Sulfhydryl compounds (N acetlycystine aka NAC)

*Use Rumack Matthew Nomogram

25
Q

What is fulminant hepatitis

A

Massive hepatic necrosis with impaired consciousness occuring within 8 weeks of the onset of illness

26
Q

What are the findings in the case of fulminant hepatitis

A

Rapidly shrinking liver
Rapid rising bili
Prolonged PT
Hepatic failure encepephalopathy

27
Q

What is a Maddrey’s discrimination function and what is the value with a poor prognosis

A

Looks as liver function:
-PT and bilirubin are involved
Values >32 are poor prognosis

28
Q

Before giving glucose to a recovering alcoholic, what must absolutely be given first and what is the consequence if you do not

A

Folic acid, otherwise my lead to Wernicke-Korsakoff syndrome

29
Q

What are som of the history factors that may lead to increase risk for PBC

A

-Smoking, UTI, Hormone replacement, hair dye

30
Q

What are the clinical manifestations for PBC

A

-Pruritus, xanthelasma (cholesterol deposits in the eyelid), asymptomatic elevation of alkaline phosphatase

31
Q

What is the antibody normally present in patients with autoimmune hepatitis

A

Antismooth muscle

32
Q

What is the treatment for autoimmune hepatitis

A

Glucocorticoids

33
Q

What are the common associations with hemochromatosis

A

Hepatic issues
Cardiac issues
Hypogonadism
Arthritis

34
Q

Patients with hemochromatosis are at an increased risk of infection with with organisms

A
  • Vibrio vulnificus
  • Listeria monocytogenes
  • Yersinia enterocolitica
35
Q

What are the laboratory findings in a patients with hemochromatosis

A

Elevated plasma iron greater than 45% transferrin

36
Q

What is the treatment for hemochromatosis

A

Cheating agent deferoxamine

37
Q

What is the genetic mutation in Wilson’s disease

A

ATP7B

38
Q

What condition is considered for the following things in a young child:

  • Hepatitis
  • Splenomegaly with hypersplenism
  • Coombs- negative hemolytic anemia
  • portal hypertension
  • neuro abnormalities
A

Wilson disease

39
Q

What is the cause of nutmeg liver

A

Right sided heart failure

40
Q

In Budd chair I syndrome, what is the prominent in the liver

A

Prominent caudate liver lobe

41
Q

What is the diagnostic test to look for hepatic vein obstruction or Budd chairing syndrome

A
  • Contrast enhanced ultrasound

- Color or Doppler ultrasoundography

42
Q

What pattern in imaging can lead to diagnosis with Budd chair I or hepatic vein obstruction

A

Spider Webb pattern with caval webs

43
Q

What can Budd chiari or hepatic vein obstruction lead to

A

Nutmeg liver

44
Q

What can anti-alpha 1 trypsin lead to in the lower lobes

A

Panacinar emphysema

45
Q

What are the hallmark lab findings in ischemic hepatitis

A
  • Elevation of the serum aminotransferases

- Early rise in the serum lactate dehydrogenase (LDH)

46
Q

The presence of jaundice in ischemic hepatitis is associated with which outcomes

A

Poor outcomes

47
Q

When there is ischemic hepatitis and there is passive congestion of the liver, what reflex is present and what is the result

A

The hepatojugular reflex, with tricuspid regurgitation of the liver that can be pulsitile

48
Q

What are the three non-cirrhosis causes of portal hypertension

A

Portal vein thrombosis
Portal vein obstruction
Schistosomiasis

49
Q

Pyogenic liver abscesses seem to be associated with which increased risk

A

GI malignancy

50
Q

What is the most common cause of hepatic abcess formation

A

Ascending cholangitis

51
Q

Liver abscesses can be secondary to which conditions

A

Appendicitis and diverticulitis

52
Q

Which organisms are the most frequently causing liver abscesses

A

Ecoli
Klebiella
Proteus vulgaris
Enterobactor aerogenes

53
Q

Cavernous hemangiomas are commonly found in which patient population

A

Women on hormonal therapy

54
Q

What is the characteristic of the vasculature on hepatocellular adenomas

A

Hypovascular

55
Q

What is the protocol for focal modular hyperplasia and discontinuing the cause

A

The cause is seen in women with oral contraceptives leading to hepatocellular adenomas, but discontinuation is not necessary, just needs to be monitored

56
Q

What condition can lead to Dupuytren’s contracture, aka bent finger with thickening of the skin on the palm and tenderness

A

Cirrhosis

57
Q

During cirrhosis, what conditions are common due to vitamin deficiencies

A

Glossitis and cheliosis (swollen patches at the corner of the mouth )

Robbins Pathology GI (Chptr 16,17,18,19) (32 decks)

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