GI- pathoma Flashcards
(61 cards)
What pancreatic enzyme is responsible for acute pancreatitis?
trypsin: which degrades protein, and also activates other enzymes as well
What two lab abnormalites can be seen in acute pancreatitis? (hint: one is enzyme, the other is electrolyte)
- increased lipase (specific)
- hypocalcemia: calcium used up for saponification
Is increased lipase a good indicator for chronic pancreatitis? why or why not?
No. In chronic pancreatitis, pancreatic cells that excrete lipase are mostly destructed
Two major risk factors for developing pancreatic cancer?
- chronic pancreatitis
- smoking
Thin old patient come into clinic and presents with diabetes. what possible GI complication should I think about?
pancreatic cancer. mass at body/tail of pancreas can compress/disrupts beta-islet cells
-> decreased insulin release -> new onset of type 1 diabetes
type of necrosis in acute pancreatitis
fat necrosis
: saponification of fat around pancreas by released lipase
Association between estrogen and cholesterol gall stone. why?
more estrogen, more chance to cholesterol stone
estrogen stimulates HMG-CoA reductase
- Fertile in 5Fs
Alternating pain (pain comes and goes) @ RUQ after meal. diagnosis?
biliary colic
- gallstone in the gallbladder is moving due to action of cholecystokinin after meal
Describe how patient presents pain in acute cholecystitis
RUQ patin that often radiates to right scapula
What is Rokitansky-Aschoff sinus? describe this histology. what disease is associated with it?
abnormal histologic finding of chronic cholecystitis
prolonged inflammation at gall bladder -> gall bladder mucosa is found in muscular wall
- check image: pathoma p. 117
What is the serious late complication of chronic cholecystitis? what is treatment? why?
porecelain gallbladder, which can lead to gall bladder cancer
*porecelain gall bladder and PSC are the only association with gallbladder cancer
What molecule is responsible for dark urine with extravascular hemolysis?
urobilinogen
- Don’t pick unconjugated bilirubin (which is not water soluble)
Etiology of physiologic jaundice of newborn? treatment? What does this treatment exactly do?
new born: low UDP-glucoronosyl-transferase activity
treatment is phototherapy, which makes unconjugated bilirubin more water soluble
Difference between Dubin-Johnson syndrome & Rotor syndrome?
Dubin-Johnson: black liver (accumulated conjugated bilirubin)
Rotor: milder form of Dubin-Johnson, no black liver
Viral hepatitis: findings in terms of conjugated and unconjugated bilirubin?
BOTH
conjugated due to disrupted bile duct
unconjugated due to disrupted hepatocytes
Hepatitis B serologic marker: resolved vs. immunized
resolved: anti-HBs + Hbc-IgG
immunized: only anti-HBs
HepB and HepD infection: what are two types of infection? which one has worse prognosis? incubation period?
coinfection: HepB and HepD infected at the same time, better prognosis, long incubation period
suprainfection: HepD infection after underlying HepB infection, worse prognosis, short incubation period
* way to remember: existing dirty environment (prior HepB infection) -> gets more dirty (worse prognosis) and short: short and strong
Describe histologic finding of liver cirrhosis
hepatic parenchyma dirsruption and fibrosis + regenerative nodules
What cell mediates fibrosis in liver cirrhosis? through what mediator? what is another function of this cell?
stellate cells -> TGF-beta
What lab test can be done to check severity of coagulopathy in liver cirrhosis?
PT
liver cirrhosis -> vitamin K dependent coagulation factors are messed up -> similar mechanism with respect to warfarin -> PT to follow up
What is specific histologic finding in alcoholic liver disease? What does this contain?
mallory bodies
- damaged cytokeratin fillaments
*red eosinophilic inclusion: kinda look like keratin.
What mediates hepatocyte damage in hemochromatosis?
radical ion
Two conditions that can give brown pigments in hepatocytes?
- lopofuscin
- hemochromatosis
serum marker for PBC (primary biliary cholangitis)?
anti-mitochondria muscle
