HEPATOBILIARY 2 Flashcards Preview

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Flashcards in HEPATOBILIARY 2 Deck (79)
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1

Jaundice, weight loss, epigastric pain

Pancreatic cancer

2

2 major risk factors for pancreatic cacner

Smoking
Chronic Pancreatitis

3

Unique findings in carcinoma of the HEAD of the pancreas
(also seen in periampullary cancer)

Conjugated hyperbilirubemia / Jaundice
Pale Stools
Dark urine (due to CB)
Itching

4

Serum marker for pancreatic cancer

CA 19-9

5

biliary atresia embryo defect

Failure to form the extrahepatic biliary tree

6

biliary atresia presentaion

conjugated hyperbilirubinemia/pale stool
Jaundice and cirrhosis in an INFANT

7

Risk factors for CHOLESTEROL stone formation

Supersaturation of bile
DECREASED bile acid, decreased phosphatidylcholine
GB Stasis, high estrogen, low cck, high progesterone

8

Cholesterol stone, gross and Xray

Radiolucent...may possibly be radiopaque
Yellow/faceted

9

Bilirubin stones, gross and Xray

Radio-opaque
Black (no infection)

10

Causes of brown pigmented stones

Biliary Tree infection

11

the causative organism of acute cholangitis

E.coli

12

RUQ pain radiating to the shoulder, Nausea and Vomiting

Acute Cholecystitis

13

Acalculous Cholecystitis causes

Critically ill patients (burns, sepsis) to develop cholecystitis w/o stones
Also in biliary sludge.

14

Which type of calcification causes porcelan gallbladder

Dystrophic- think carcinoma

15

Most common pathogens causing ascending cholangitis

gram negative enterics
Parasites that target the liver

16

Triad of symptoms for Acute ascending cholangitis

Sepsis
Jaundice
Abdominal pain

17

Biggest risk factor for ascending cholangitis

Choledocolithiasis

18

RLQ pain, SBO, Xray reveals air in the biliary tree

Gallstone illeus

19

Gallbladder carcinoma arises from

glandular epithleium --> Adenocarcinoma

20

Classic patient with gallbladder cancer is

Elderly female with cholecystitis

21

Unconjugated hyperbilirubinemia labs (hemolysis)

Increased UB
Increased urine Urobilinogen (more shunted during enterohepatic cycling)
No urine CB

22

Conjugated hyperbilirubinemia labs

Increased CB
no Urine urobilinogen (no CB made it to the gut to be converted)
Increased Urine CB and bile salts (CB refluxes backward into sinusoids)

23

Mixed hyperbilirubinemia is a result of

Hepatitis (viral or alcoholi)

24

Physiologic jaundice of newborn defect

low UDPgluconyltransferase levels --> high UCB

25

Physiologic jaundice of newborn tx and mechanism

Phototherapy --> converts UCB to CB

26

Gilbert syndrome

mildly low UDPgluconyltransferase levels

27

Crigler Najjar 1 syndrome

ABSENT UDPgluconyltransferase levels --> high UCB

28

Crigler najjar presentation

neonatal kernicterus

29

Gilbet inheritance

AR

30

Dubin Johnson and Rotor syndrome defect and inheritance

Bilirubin canalicular transport protein defect --> high CB

AR