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Path Final > Liver, GB, Pancreas > Flashcards

Liver, GB, Pancreas Flashcards

(48 cards)

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1
Q
  1. What is Jaundice?
A

Patient with excess bilirubin, >2-3mg/dl

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2
Q
  1. What are 4 possible causes of jaundice?
A

. Decreased conjugation in hepatocyte (hepatitis, neonatal jaundice)

ii. Impaired uptake by liver disease
iii. Over production of bilirubin due to increased RBC (sepsis, drug toxicity)
iv. Impaired secretion or excretion
a. Intrahepatic : Dubi-Johnson, Recurrent, Jaundice of pregnancy

b. Extrahepatic: Obstructive gallstone

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3
Q
  1. What is Cholecystitis?
A

Inflammation of gall bladder

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4
Q
  1. What is the most common form of Cholecystitis?
A 
Acute Cholecystitis (90% due to obstructive gall stone)
	* Caused by Gram-Negative infection
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5
Q
  1. What are 2 most common causes of Acute Pancreatitis?
A

i. Alcohol

ii. Gall Stone (aka Cholelithiasis is cholesterol type)

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6
Q
  1. What are 3 clinical manifestations associated with Acute Pancreatitis?
A

i. Increased Calcium and Lipid
ii. Necrosis results (chalky)
iii. Elevated amylase and lipase

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7
Q
  1. What are 2 most possible causes of Chronic Pancreatitis?
A

i. Alcohol

ii. Biliary disease

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8
Q
  1. T/F : Colorectal Polyps are usually benign hyperplastic polyps (90% of the time)
A

True

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9
Q
  1. What are 7 clinical manifestations of Chronic Pancreatitis?
A

i. Pain
ii. Weight Loss
iii. Jaundice
iv. Diabetes Mellitus
v. Inflammation
vi. Fibrosis
vii. Fatty Liver (aka Steatohepatitis; Hepatic Steatosis)
* Patient With Jaundice and Diabetes (experience)
Inflammation (from) Fibrosis and Fatty Liver

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10
Q
  1. What segment of the population are affected by Colorectal Polyps?
A

Older adults (25-50%)

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11
Q
  1. What is the histologic characteristic of Colorectal Polyps?
A

Proliferation of mucosal glandular and surface epithelium

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12
Q
  1. What is histopathologic characteristic of Cirrhosis?
A

Fibrosis (Hepatocellular carcinoma is most common primary tumor)

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13
Q
  1. What is the main cause of Cirrhosis?
A 
Fatty Liver	(Steatohepatitis)(Hepatic Steatosis)
	* Others include : Alcohol, Biliary Disease, Iron Overload
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14
Q
  1. What are 3 risk factors associated with Adenocarcinoma?
A

i. High meat and animal fat consumption
ii. Low fiber consumption
iii. Familial Adenomatous Polyposis (FAP)
* FAP is 2nd most common type of cancer in the U.S.

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15
Q
  1. T/F : Pancreatic neoplasms include Exocrine (adenocarcinoma) and Endocrine part of the pancreas.
A

True.

Exocrine : Pancreatitis (head of pancreas, older patient, die in 6 mo.)

Endocrine : Diabetes Mellitus (decreased glucose, confused, treat w/ glucose)

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16
Q
  1. T/F : Hepatocellular Adenoma is not associated with female hormones.
A

True (No bile ducts; bleeding)

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17
Q
  1. What are 3 characteristics of Hepatocellular Carcinoma?
A

i. Malignant
ii. Caused by Aflatoxin, Hepatitis A and C and Cirrhosis
iii. Most common primary tumor

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18
Q
  1. What is most commonly affected organ when cancer metastasizes?
A

Liver

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19
Q
  1. What demographics are most commonly affected by Carcinoma of Gall Bladder?
A

i. Whites

ii. Females

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20
Q
  1. What causes Wilson’s Disease?
Study These Flashcards
A

Accumulation of Copper in brain, liver and eyes

21
Q
  1. Why is Hepatitis A rarely screened during blood donation?
Study These Flashcards
A

Hepatitis A is a benign, self-limiting infection so the virus does not stay in the system for it to be detected.
* So there is no carrier state

22
Q
  1. What are 4 possible clinical manifestations associated with Hepatitis B infection?
Study These Flashcards
A

i. Acute hepatitis with recovery and clearance
ii. Non-progressive chronic hepatitis
iii. Progressive disease ending in cirrhosis
iv. Asymptomatic carrier state

23
Q
  1. T/F : Drugs, toxin and alcohol increases the risk of liver diseases for more females than males.
Study These Flashcards
A

True.

* Generally, more adults are affected than pediatric patients

24
Q
  1. Predictable hepatic injury to the liver is possible with what 3 agents?
Study These Flashcards
A

i. Acetaminophen
ii. Ethyl Alcohol
iii. Carbon Tetrachloride
* It is always important to include exposure to a drug or toxicant in the differential diagnosis of liver disease

25
25. List the characteristics associated with Hepatitis A, B
Hepatitis A: a. Common, self-limited infection b. RNA virus with transient viremia c. Oral or fecal transmission d. 15-45 day incubation e. No carrier state or chronic disease Hepatitis B : a. 90% are self-limited infection b. DNA virus (only DNA hepatitis virus) c. Sex or IV transmission d. 30-180 day incubation e. Carrier state includes Chronic hepatitis, Cirrhosis (no symptoms) ``` * HepB induced liver disease is an important precursor to Hepatocellular Carcinoma (HCC) ```
26
List the characteristics associated with Hepatitis C,D
Hepatitis C: a. Persistent infection with Chronic hepatitis b. RNA virus c. Sex or IV transmission d. Carrier state includes Chronic hepatitis, Cirrhosis e. Cirrhosis occurs 80-85% of the time after 5-20 years * HepC is a definite risk factor for Hepatocellular Carcinoma Hepatitis D: a. RNA virus b. HepB virus must also be present
27
List the characteristics associated with Hepatitis E,G
Hepatitis E a. RNA virus, usually self-limited infection b. Waterborne spread w/ high mortality rate in pregnant women c. Rare in the U.S. d. Not associated with Chronic Liver Diseases Hepatitis G: a. Not Hepatotrophic b. No increase in serum aminotransferases c. Replicates in bone marrow and spleen
28
26. What are 3 overlapping forms of Alcoholic Liver Diseases?
i. Fatty Liver (Steatohepatitis)(Hepatic Steatosis) ii. Alcohol hepatitis iii. Cirrhosis (this occurs in minority of patients) * Fatty Alcohol Cirrhosis  
29
27. What are the differences in early versus final stages of fatty liver?
Early Stages : a. Little fibrosis at onset b. Fibrosis increases with further consumption c. “Mallory” bodies-clumps of cytokeratis-eosinophilic Final Stages : Patients may develop chronic disorder such as: a. Steatosis b. Hepatitis c. Progressive Fibrosis d. Cirrhosis (only develop in small percentage) e. Marked Perturbation of Vascular Perfusion
30
28. What are 4 examples of metabolic liver diseases?
i. Non-Alcohol Fatty Liver Disease ii. Wilson’s Disease iii. Hemochromatosis iv. Alpha 1 Anti-Trypsin Deficiency
31
29. What is Hemochromatosis?
Hereditary condition, which leads to excessive accumulation of body iron * Most iron is deposited in the liver and pancreas * Associated with abnormal regulation of intestinal Fe absorption
32
30. Hemochromatosis affects more males than females (7:1) with symptoms that are not exhibited until 5th and 6th decade. These patients present Classic Triad symptoms. What are they?
i. Cirrhosis with Hepatomegally (swelling of the liver beyond normal size) ii. Diabetes Mellitus iii. Skin Pigmentation
33
31. What is Hemosiderosis? What is the cause of the disease?
Excess accumulation of hemosiderin * hemosiderin is iron-storage complex that is always found within cells Caused by ineffective erythropoiesis and myelodysplastic syndromes. Also, frequent transfusion can result in high iron load.
34
32. What characterizes Wilson’s disease?
Accumulation of toxic copper in liver, brain and eyes | * These patients have acute or chronic liver disease
35
33. What are examples of benign liver neoplasms? What are 3 reasons why we concerned about this when they are benign?
i. Cavernous hemangioma ii. Hepatic adenoma (Common in women taking contraceptives) We are concerned because : a. It mimics Hepatocellular Carcinoma b. Results subscapular hemorrhage c. Transform to Hepatocellular Carcinoma
36
34. What are 3 examples of malignant liver tumors?
i. Hepatoblastoma (most common in young pediatric patients) ii. Hepatocellular Carcinoma (3rd most common liver cancer) iii. Cholangiocarcinoma (generally fatal in 6 months)
37
35. What are possible causes of Hepatocellular Carcinoma?
i. Chronic viral infection (Hep B, Hep C) ii. Aflatoxin (Food contaminants or toxin) iii. Non-Alcohol Steatohepatitis iv. Alcoholism (Chronic) * C A N A
38
36. Among 20-40 year old males and females, they may have Fibrolamellar variant of Hepatocellular Carcinoma. Why does this relevant to prognosis?
Patients without this variant have better prognosis because they do not have underlying liver diseases.
39
37. What is Cholelithasis?
Gall Stones
40
38. Frequency of Gall Stones are affected by what factors?
i. White women ii. Age (increases with age) iii. Estrogen (pregnancy and oral contraceptives) iv. Gall bladder stasis * 70-80% of patients are asymptomatic
41
39. What is Cholecystitis?
Inflammation of gall bladder | * It can be acute or chronic and almost always occurs with gall stones
42
40. What are risk factors of gall bladder cancers
Gall stones or infectious agents within the gallbladder (chronic inflammatory states)
43
41. What are 5 significant pathology of exocrine pancreas?
i. Congenital anomalities ii. Cystic fibrosis ii. Acute and Chronic pancreatitis iii. Neoplasms v. Pseudocysts * C (i) C A N P (See I CAN Pee)
44
42. What is Pancreatitis? What are the causes?
Reversible parenchymal injury associated with inflammation. Causes include : a. Obstructions b. Infections (mumps, trauma, metabolic diseases, medications)
45
43. What is cardinal symptom of Pancreatitis?
Abdominal pain (“upper back intense pain”) * Full blown acute pancreatitis is a medical emergency because it has the potential to release toxic enzymes
46
44. What is Chronic Pancreatitis?
Irreversible destruction of exocrine pancreas with ensuing fibrosis and eventual destruction of the endocrine parenchyma * This is where pancreatitis includes both exocrine and endocrine portion
47
45. What is the dominant Cystic Pancreatic Neoplasms?
95% of mucinous cystic neoplasms arise in women | * Can be associated with invasive cancer
48
46. What are Trousseu signs associated with Pancreatic Cancer?
Migratory thrombophlebitis * this is formation of platelet aggregation factors and procoagulants from tumor or its necrotic products * clinical course is very brief and very aggressive, by the time one has pain, by then it’s already too late

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