First Aid 373-375 GI last of it Flashcards Preview

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Flashcards in First Aid 373-375 GI last of it Deck (30):
1

recessive mutation in an ATPase leads to which GI disease?

Wilson disease - hepatocyte CU transporting ATPase

2

Chromosome # of Wilson's

13

3

Chromosome # and HLA # of Hemochromatosis?

chr 6, HLA A3

4

Which mem of cornea is CU deposition?

Descemet membrane

5

Tx of Wilsons?

penacillamine, trientine, oral zinc

6

Blood and urine signs of Wilson's

 serum ceruloplasmin,  urine copper

7

Presentation of Wilson's

Presents before age 40 with liver disease (eg, hepatitis, acute liver failure, cirrhosis), neurologic
disease (eg, dysarthria, dystonia, tremor, parkinsonism), psychiatric disease, Kayser-Fleischer rings
(deposits in Descemet membrane of cornea) A , hemolytic anemia, renal disease (eg, Fanconi
syndrome).

8

How can one detect Hemochromatosis? (tests)

Hemosiderin (iron) can be identified on liver MRI or
biopsy with Prussian blue stain

9

What cardiac and reproductive issues with Hemochromatosis?

dilated cardiomyopathy (reversible), hypogonadism

10

In terms of hemochromatosis, what is the arthropathy caused by? which joints in particular?

Calcium pyrophosphate deposition especially metacarpophalangeal joints

11

Most common cause of death in hemochromatosis?

HCC

12

Sx of biliary tract disease?

May present with pruritus, jaundice, dark urine, light-colored stool, hepatosplenomegaly

13

Which biliary disease is associated with UC?

PSC

14

Complication of PSC?

Can lead to 2° biliary cirrhosis.  risk of cholangiocarcinoma and gallbladder cancer.

15

alternating strictures and dilation with
“beading” of intra- and extrahepatic bile ducts on ERCP

Primary sclerosing
cholangitis

16

Which biliary disease assoc with inc IgM?

PSC and PBC

17

What disease can make secondary biliary cirrhosis worse?

May be complicated by
ascending cholangitis.

18

Which ducts are involved in each biliary tract disease?

PSC - intra and extra hepatic bile ducts
PBC - intralobular bile ducts
SBC - intrahepatic bile ducts

19

Which biliary disease involves fibrosis of intrahepatic ducts?

Both PSC and SBC

20

Which biliary disease = granulomas?

PBC

21

Radioluscent gallstones?

Cholesterol stones and Brown pigemnt stones

22

Most common type of gallstone?

Chol stones

23

Patients assoc with pigment stones?

seen in patients with Crohn
disease, chronic hemolysis, alcoholic
cirrhosis, advanced age, biliary infections,
total parenteral nutrition (TPN).

24

Most common complication of cholecystitis?

acute pancreatitis, ascending cholangitis.

25

What hormone can trigger biliary colic?

CCK

26

Explain how illeus can happen with gallstones?

Can cause fistula between gallbladder and
gastrointestinal tract Ž air in biliary tree
(pneumobilia) Ž passage of gallstones into
intestinal tract Ž obstruction of ileocecal valve
(gallstone ileus).

27

What viral infection assoc with cholecystitis?

CMV

28

When can cholecystitis present with inc ALP?

 ALP if bile duct becomes involved (eg, ascending cholangitis).

29

Drugs that increase risk of gallstones?

Fibrates

30

Diseases that increase risk of gallstones?

Acute pancreatitis, Clonorchis sinensis, Somatostatinoma, crohn's