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

Clinical- Liver Disorders Flashcards

(57 cards)

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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

Study These Flashcards
A
  • Isoniazid
  • Sulfonamides
  • Acetometaphen
24
Q

What is the treatment/therapy for acetaminophen poisoning

Study These Flashcards
A

Sulfhydryl compounds (N acetlycystine aka NAC)

*Use Rumack Matthew Nomogram

25
What is fulminant hepatitis
Massive hepatic necrosis with impaired consciousness occuring within 8 weeks of the onset of illness
26
What are the findings in the case of fulminant hepatitis
Rapidly shrinking liver Rapid rising bili Prolonged PT Hepatic failure encepephalopathy
27
What is a Maddrey’s discrimination function and what is the value with a poor prognosis
Looks as liver function: -PT and bilirubin are involved Values >32 are poor prognosis
28
Before giving glucose to a recovering alcoholic, what must absolutely be given first and what is the consequence if you do not
Folic acid, otherwise my lead to Wernicke-Korsakoff syndrome
29
What are som of the history factors that may lead to increase risk for PBC
-Smoking, UTI, Hormone replacement, hair dye
30
What are the clinical manifestations for PBC
-Pruritus, xanthelasma (cholesterol deposits in the eyelid), asymptomatic elevation of alkaline phosphatase
31
What is the antibody normally present in patients with autoimmune hepatitis
Antismooth muscle
32
What is the treatment for autoimmune hepatitis
Glucocorticoids
33
What are the common associations with hemochromatosis
Hepatic issues Cardiac issues Hypogonadism Arthritis
34
Patients with hemochromatosis are at an increased risk of infection with with organisms
- Vibrio vulnificus - Listeria monocytogenes - Yersinia enterocolitica
35
What are the laboratory findings in a patients with hemochromatosis
Elevated plasma iron greater than 45% transferrin
36
What is the treatment for hemochromatosis
Cheating agent deferoxamine
37
What is the genetic mutation in Wilson’s disease
ATP7B
38
What condition is considered for the following things in a young child: - Hepatitis - Splenomegaly with hypersplenism - Coombs- negative hemolytic anemia - portal hypertension - neuro abnormalities
Wilson disease
39
What is the cause of nutmeg liver
Right sided heart failure
40
In Budd chair I syndrome, what is the prominent in the liver
Prominent caudate liver lobe
41
What is the diagnostic test to look for hepatic vein obstruction or Budd chairing syndrome
- Contrast enhanced ultrasound | - Color or Doppler ultrasoundography
42
What pattern in imaging can lead to diagnosis with Budd chair I or hepatic vein obstruction
Spider Webb pattern with caval webs
43
What can Budd chiari or hepatic vein obstruction lead to
Nutmeg liver
44
What can anti-alpha 1 trypsin lead to in the lower lobes
Panacinar emphysema
45
What are the hallmark lab findings in ischemic hepatitis
- Elevation of the serum aminotransferases | - Early rise in the serum lactate dehydrogenase (LDH)
46
The presence of jaundice in ischemic hepatitis is associated with which outcomes
Poor outcomes
47
When there is ischemic hepatitis and there is passive congestion of the liver, what reflex is present and what is the result
The hepatojugular reflex, with tricuspid regurgitation of the liver that can be pulsitile
48
What are the three non-cirrhosis causes of portal hypertension
Portal vein thrombosis Portal vein obstruction Schistosomiasis
49
Pyogenic liver abscesses seem to be associated with which increased risk
GI malignancy
50
What is the most common cause of hepatic abcess formation
Ascending cholangitis
51
Liver abscesses can be secondary to which conditions
Appendicitis and diverticulitis
52
Which organisms are the most frequently causing liver abscesses
Ecoli Klebiella Proteus vulgaris Enterobactor aerogenes
53
Cavernous hemangiomas are commonly found in which patient population
Women on hormonal therapy
54
What is the characteristic of the vasculature on hepatocellular adenomas
Hypovascular
55
What is the protocol for focal modular hyperplasia and discontinuing the cause
The cause is seen in women with oral contraceptives leading to hepatocellular adenomas, but discontinuation is not necessary, just needs to be monitored
56
What condition can lead to Dupuytren’s contracture, aka bent finger with thickening of the skin on the palm and tenderness
Cirrhosis
57
During cirrhosis, what conditions are common due to vitamin deficiencies
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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