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Flashcards in EXAM #2: REVIEW Deck (90)
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1

What is causing the dark urine seen in patients with extravascular hemolysis?

Urobilinogen

2

What labs differentiate Dubin-Johnson Syndrome and Rotor Syndrome?

Dubin-Johnson=
- Normal urine coproporphyrinogen
- Elevated isomer I

Rotor Syndrome=
- Elevated urine coproporphyrinogen
- Normal isomer I

3

What are the five normal components of bile?

1) Bile salts
2) Bilirubin
3) Bicarbonate
4) Cholesterol
5) Lecithin

4

What defect is seen in PFIC-1?

Defect in the canalicular ATPase

5

What defect is seen in PFIC-2?

Defect in the Bile Salt Export Pump

6

What defect is seen in PFIC-3?

Defect in the MDR-3 transporter, impairing phosphatidylcholine transport

7

List five clinical features of the PFICs.

1) Cholestasis
2) Fat malabsorption
3) Fat soluble vitamin deficiency
4) Osteopenia
5) Liver failure

8

List seven clinical manifestations of bile duct obstruction.

1) Jaundice
2) Steatorrhea
3) Dark urine
4) Xanthomas
5) Pruritis
6) Osteoporosis
7) Bleeding

9

List the lab findings in bile duct obstruction.

1) Elevated conjugated bilirubin
2) Decreased urine urobilinogen
3) Elevated: ALP, 5'-NT, and GGT
4) Hyperlipidemia

10

What diseases is macronodular cirrhosis associated with?

Viral hepatitis
Alpha-1 antitrypsin
Wilson's Disease

11

What are the three general manifestations of portal HTN?

1) Ascites
2) Congestive splenomegaly
3) Portosystemic shunts

12

What is acute liver failure?

Liver failure that occurs within 4 weeks of initial symptoms of liver dysfunction

13

List four clinical signs of hepatorenal syndrome.

1) Oliguria/anuria
2) Increased BUN/Creatinine
3) Low urinary Na+
4) Normal urinary sediment

14

What are the extrahepatic manifestations of Hepatitis C?

1) Cryoglobulinemia
2) Thyroiditis
3) Glomerulonephritis
4) Thrombocytopenia

15

What four factors will increase the likelihood of HCV infection leading to HCC?

1) Alcoholism
2) Cirrhosis
3) Male
4) Old age

16

What are the microscopic features of acute viral hepatitis?

- Swelling of hepatocytes
- Cholestasis
- Lobular disarray

17

What are the microscopic features of chronic viral hepatitis?

- Piecemeal necrosis
- Bridging fibrosis
- Nodular cirrhosis

18

What microscopic feature is associated with HCV infection?

Lymphoid aggregates in portal tracts

19

List the clinical manifestations of acute hepatitis.

- Mixed jaundice
- Dark urine
- Fever
- Malaise
- Nausea
- Elevated liver enzymes

I.e. flu-like illness with mixed jaundice, dark urine, and elevated liver enzymes.

20

What is an alternate name for Primary Biliary Cirrhosis?

Granulomatous cholangitis

21

What antibody is associated with PBC?

Anti-mitochondrial antibody (AMA)

22

List all of the lab findings associated with PBC.

1) Elevated antibodies: AMA, anti-M2, and anti PDH-E2
2) Elevated IgM
3) Elevated ALP/ 5'-NT, and GGT
4) Elevated cholesterol

23

What are the lab findings associated with PSC?

1) Elevated transaminases
2) Elevated ALP, 5'NT, and GGT

24

What antibody is most specific to PSC?

p-ANCA

25

What antibodies are specific to autoimmune hepatitis?

ANA
ASMA
ALKM

26

What are the features of Type I autoimmune hepatitis?

- Most common
- 10 y/o to elderly affected
- SMA and ANA positive

27

What are the features of Type II autoimmune hepatitis?

- Less common
- 2-14 y/o effected
- ALKM antibody
- Poor prognosis

28

What is Type III autoimmune hepatitis?

- Less common
- Effects 30-50 year olds
- Anti-SLA positive

29

What type of liver injury is seen with Tetracycline?

Microsteatosis

30

What type of liver injury is seen with Amiodarone?

Fibrosis