Hepatobiliary/Pancreatic Flashcards
(109 cards)
1
Q
Do the trasaminases peak before or after the onset of acute hepatitis?
A
before
2
Q
What is almost the only way to observe a mixed hyperbilirubinemia?
A
viral hepatitis
3
Q
What type of drug can cause jaundice?
A
OCPs
4
Q
Other than LDH, what enzyme can increase in the blood during intravascular hemolysis?
A
AST
5
Q
Other than an obstruction, what else could elevate GGT?
A
induction of cytochrome enzymes
6
Q
Which immunoglobulin is increased during Primary Biliary Cirrhosis?
A
IgM
7
Q
What auto-antibody is present during Primary Biliary Cirrhosis?
A
anti-mitochondrial
8
Q
Which two auto-antibodies are present during Autoimmune Hepatitis?
A
anti-nuclear
anti-smooth muscle
9
Q
Is HAV spread by the blood?
A
NO
10
Q
Does HAV produce a carrier state?
A
no
11
Q
Is HAV an RNA or DNA virus?
A
RNA
12
Q
Is HBV an RNA or DNA virus?
A
DNA
13
Q
Is HBV carried by the blood?
A
yes
14
Q
Which hepatitis virus is known to produce Immune complex disease?
A
HBV
15
Q
Is HCV an RNA or DNA virus?
A
RNA
16
Q
Which specific kidney pathology does HCV cause?
A
Type I MPGN
17
Q
What two drugs are used to treat HBV?
A
Lamivudine
entecavir
18
Q
What two drugs are used to treat HCV?
A
ribavarin
Telaprevir
19
Q
Is HDV an RNA or DNA virus?
A
RNA
20
Q
Is HEV an RNA or DNA virus?
A
RNA
21
Q
Which specific part of HBV does HDV require to replicate?
A
HBsAg
22
Q
What causes fulminant hepatitis in pregnant women?
A
HBV and HDV superinfection
23
Q
What are the two hepatitis viruses not carried by the blood?
A
HAV
HEV
24
Q
What is the first marker for HBV infection?
A
appearance of HBsAg
25
How does the presence of HBsAg define chronic hepatitis?
longer than 6 months = chronic
26
What are the two markers for Hepatitis B infectivity?
HBeAG and HBV-DNA
27
Do HBeAG and HBV-DNA occur before or after HBsAg?
after
28
Do HBeAG and HBV-DNA disappear before or after HBsAg?
before
29
What is the marker for acute immune response against HBV?
anti-HBc IgM
30
Is anti-HBc IgM protective?
no
31
What are the only two markers of HBV infection during the window period?
IgM core
IgG core
32
What is the marker for HBV protection?
anti-HBs
33
What is the gold standard for detecting HCV?
HCV RNA
34
What is the hepatitis virus where IgG is not protective?
HDV
35
Mixed hyperbilirubinemia is indicative of what disease?
hepatitis
36
Which haplotypes are associated with Autoimmune Hepatitis?
HLA DR3 and DR4
37
Autoimmune hepatitis is associated with what two other autoimmune diseases?
Hashimoto and Graves
38
Other than the liver diseases, what virus can cause neonatal hepatitis?
CMV
39
What are the three symptoms of Reye Syndrome?
Encephalopathy
Microvascular Fatty change
increased transaminases
40
What two metabolic processes are mos likely to happen during Reye Syndrome?
urea cycle
β-oxidation
41
What defines Microvascular Fatty steatosis?
no displacement of nucleus
42
What is the metabolic abnormality present in Reye Syndrome?
hypoglycemia
43
What drug is used to treat Reye Syndrome?
Mannitol
44
What zone of the liver is affected during Pre-eclampsia?
zone 1
45
What is HELLP Syndrome?
Hemoltic anemia
Elevated liver enzymes
Low platelets
46
What is Pelios hepatis?
sinusodial dilation do to blood
47
What are the two causes of Pelios Hepatis?
B. henselae and anabolic steroids
48
What damages the hepatocyte during Alcoholic Hepatitis?
acetylaldehyde
49
What invades the cell during alcoholic hepatitis?
Neutrophils
50
Which is more elevated during Alcoholic Hepatitis, AST or GGT?
AST
51
Where is thorium dioxide found?
radiographic contrast
52
What molecule causes pruritis?
bile salt
53
What type of amino acids are increased during liver cirrhosis?
aromatic
54
Do loops and thiazides produce a metabolic acidosis or alkalosis?
alkalosis
55
Liver failure can produce an excess of what hormone?
aldosterone
56
What is the difference between serum albumin and ascites albumin during liver ascites or peritoneal ascites?
liver = > 1.1 g/dL
peritoneal =
57
What happens to the kidney during hepatorenal syndrome?
intense vasoconstriction
58
What type of drug is used to treat HRS?
vasopressors
59
Why does liver failure induced hyperestrogenism produce impotence?
increased synthesis of sex hormone binding protein binds free testosterone
60
What gets destroyed during Primary Biliary Cirrhosis? Where?
bile ducts
portal triads
61
What disease other than Wilsons disease can produce copper accumulation in the cornea?
Primary Biliary Cirrhosis
62
What are the two treatments for Primary Biliary Cirrhosis?
Ursodeoxycholic acid
Budesonide
63
Why does the skin get dark during hemochromatosis?
iron activates melanin
64
Transferrin saturation over what value requires investigation for hemochromatosis?
>45%
65
Destruction of what gland can occur during hemochromatosis? Which two values would go down?
anterior pituitary
LH and FSH
66
What is defective during Wilson disease?
defective transport of copper into bile
67
What protein carries copper in the absence of ceruloplasmin?
albumin
68
Where in the cornea does copper deposit during Wilson disease?
Descemet membrane
69
What other disease can produce copper in the cornea?
Primary Biliary Cirrhosis
70
What two specific structures of the brain does copper accumulate?
putamen
subthalamic nucleus
71
What type of movement does deposition of copper in the subthalamic nucleus produce?
hemiballismus
72
What specific kidney disease does excess copper produce?
fanconi syndrome
73
What type of emphysema does α1 anti-trypsin deficiency produce?
panacinar
74
What is the most common cause of cirrhosis in children?
α1 anti-trypsin deficiency
75
What does liver cirrhosis do to fasting glucose levels?
fasting hypoglycemia
76
What does liver failure do to breathing?
chronic pulmonary alkalosis
77
What type of blood pH abnormality do patients with liver failure clasically produce?
lactic acidosis
78
Do liver failure pt's present with hypernatremia or hyponatremia?
hyponatremia
poor CO leads to
79
Do liver failure pt's present with hyperkalemia or hypokalemia? Why?
hypokalemia
excess aldosterone secretion do to poor kidney perfusion
80
Hypoalbuminemia will produce what electrolyte disturbance?
hypocalcemia
81
Which hydroxylation reaction of vitamin D takes place in the liver?
25
82
What are the three causes of a liver adenoma?
OCPs
anabolic steroids
Von Gierke glycogenolysis
83
What amino acid disease can cause HCC?
tyrosinemia
84
Where can bile be found during HCC?
neoplastic cells
85
What three hormones can HCC secrete?
insulin-like factor
EPO
PTHrp
86
What type of cyst is the most common to find in children under the age of 10 in their liver?
Choledochal
87
Which liver cancer does Clonorchis sinesis cause?
Cholangiocarcinoma
88
What are the three mechanisms by which estrogen may contribute to formation of cholesterol stones?
increase HDL synthesis
upregulates LDL receptor
activates HMG-CoA reductase
89
Which virus can cause cholecystitis?
CMV
90
What is used for pain for a gall stone?
Meperidine
91
Why is morphine not used to treat a gall stone?
contracts sphincter of Oddi
92
What patient population most often develops gall bladder adenocarcinoma?
elderly women
93
What activates the pancreatic enzymes during a bile duct obstruction?
bile
94
Why can Acute Pancreatitis cause ARDS?
circulating pancreatic phosphoLipase can cleave surfactant
95
Why can acute pancreatitis cause DIC?
activate of prothrombin by trypsin
96
Why can acute pancreatitis cause tetany?
consumption of calcium during peripancreatic fet necrosis
97
Isolated increases in amylase are indicative of what?
pancreatic pseudocyst
98
What is secreted in the urine, amylase or liapse?
lipase
99
Which enzyme is increased during pancreatitis?
trypsin
100
What is the most sensitive marker for Acute Pancreatitis?
Serum Immunoreactive Trypsin
101
Does Serum Immunoreactive Trypsin increase or decrease during Acute Pancreatitis?
increase
102
Does Serum Immunoreactive Trypsin increase or decrease during Chronic Pancreatitis?
decrease
103
What does Bentiromide get converted into?
PABA
104
Where is PABA found?
urine
105
What is PABA in the urine indicative of?
Chronic Pancreatitis
106
Which gene is associated with Pancreatic Adenocarcinoma?
KRAF
107
Which two tumor suppressors are often mutated during Pancreatic Adenocarcinoma?
p16 and p53
108
What is the gold standard marker for pancreatic cancer?
CA 19-9
109
Which two cancers can produce a Sister Mary Joseph Nodule?
gastric and pancreatic
