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Flashcards in Miscellaneous Deck (54)
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1
Q

In a liver lobule, bile drains toward ______

A

the portal triad/canal

2
Q

annular pancreas

A
  • failure of ventral bud of pancreas to meet with dorsal bud
  • history of pancreatitis
  • circles around duodenum –> vomiting
3
Q

esophageal atresia

A
  • absence of passage/abnormal narrowing of esophagus
  • most common: blind esopheal pouch and tracheoesophageal fistula
  • can bring bowel up to connect two parts
  • present with throwing up and cyanosis/trouble breathing
4
Q

Hep b: Total Anti-Hbc

A
  • IgG antibody to core antigen
  • indicates previous infection or chronic infection
  • stays elevated for life
5
Q

what causes micronodular cirrhosis?

A

alcohol and metabolic disease

6
Q

Autoimmune Hepatitis type 1 antibody

A
  • anti-smooth muscle antibody
  • against F actin
  • also ANA
7
Q

Hepatitis A

A
  • non-enveloped RNA picorna virus
  • oral-fecal transmission
  • common in countries with poor water/food sanitation
  • antibody is protective
  • symptomatic 3-6 weeks after infection (when ALT is highest)
  • viral load lowest by 9 weeks (when IgG is at highest)
  • if IgM positive and IgG negative, then acute infection
  • if IgG positive but IgM negative, then vaccinated or previous infection
  • fever, elevated transaminases (AST and ALT), Jaundice, abdominal pain and diarrhea
8
Q

Zone __ of the liver is oxygen and nutrient rich, whereas zone ___ is oxygen and nutrient poor

A

1,3

9
Q

What are two important tests for liver function?

A
  • albumin and prothrombin time
10
Q

Hep b: HbsAg

A
  • surface antigen

- active infection

11
Q

Hep b: HbcAg

A
  • core antigen

- not used much for testing

12
Q

which vessel solely supplies the hepatic bile ducts (and hepatocellular cancer)

A

hepatic artery

13
Q

Hepatitis D

A
  • RNA delta virus
  • bloodborne
  • DEFECTIVE: NEED Hep B surface antigen in order to survive
  • co-infection with hep B (at the same time)
  • superinfection (get infected with it with preexisting hep b)
14
Q

duodenal atresia

A
  • non biliary vomiting
  • double bubble sign
  • common in down syndrome babies
15
Q

choledocholithiasis

A

gallstones in the bile duct

16
Q

Which zone of the liver is responsible for lipid synthesis and glycolysis?

A

3

17
Q

malrotation

A
  • bowel doesn’t do physiological rotation during gestation
  • cecum in upper quadrant instead of RLQ due to ladd’s bands
  • ladd bands wrap around duodenum (or volvulus, intestine spins around itself)
18
Q

Histologically, ground glass hepatocytes indicate what?

A

hepatitis B (or hep b carrier)

19
Q

Hep b: HbeAg

A
  • antigen (biproduct protein of viral replication)

- indicates active viral replication

20
Q

pyloric stenosis

A
  • baby boys>baby girls
  • non bilious projectile vomiting
  • olive sign
21
Q

biliary atresia

A
  • jaundice

- abnormal LFTs

22
Q

what is the most common malignant liver tumor

A

metastatic tumor from a different organ

23
Q

primary biliary cholangitis antibody

A
  • anti mitochondrial antibody

- against E2 of pyruvate dehydrogenase complex

24
Q

primary sclerosing cholangitis antibody

A
  • p ANCA

same for ulcerative colitis, which they are at high risk for

25
Q

Hep b: IgM Anti-Hbc

A
  • IgM antibody to core antigen

- indicates acute/recent infection

26
Q

In a liver lobule, blood moves from ___ to ____.

A

from the portal triad to the central vein

27
Q

omphalocele

A
  • inability of bowel to come back down after physiological hernia (will be stuck in umbilical lining as opposed to gastroschisis)
28
Q

hirschprung disease

A
  • baby doesn’t excrete meconium by 48 hours
  • narrowed rectum, dilated sigmoid colon
  • due to neural crest cells not migrating properly, making aganlionosis
29
Q

Meckel’s diverticulum

A
  • blood in stool (plus anemia)
  • remnant of umbilical duct
  • usually gastric remnant
  • rule of 2’s: 2% of population, 2 yrs old, 2 inches long, 2 feet from cecum
30
Q

what causes macronodular cirrhosis?

A

viral hepatitis

31
Q

autoimmune hepatitis type 2 antibody

A
  • anti liver kidney microsomal antibody
  • against CP450
  • also ANA
32
Q

Hepatitis B

A
  • hepaDNAvirus
  • bloodborne
  • 90 day incubation
  • 95% adults clear infection, children more likely to have chronic
  • suppress, but never fully clear chronic infection
  • jaundice, elevated AST and ALT, fever, rash and arthralgias
  • Asia and Africa
33
Q

Hep b: Anti- Hbs

A
  • antibody to surface antigen

- if you have this and nothing else, = immunity (vaccination)

34
Q

What is the most common benign liver tumor

A

cavernous hemiangioma

35
Q

Which zone of the liver is responsible for gluconeogenesis?

A

1 (high energy process, gets the most nutrients)

36
Q

choledochocysts

A
  • congenital dilation of ducts
  • jaundice, pain, lipase elevation
  • can go undetected as an adult
37
Q

cholecystolithiasis

A

gallstones in the gall bladder

38
Q

Hepatitis C

A
  • RNA flavivirus
  • bloodborne
  • can be asymptomatic for decades
  • 80% develop chronic, 20% clear (cure) on their own
  • can form cirrhosis/hepatocellular cancer
  • antibody is NOT protective (there is no immunity to hep c, can get infected many times)
39
Q

Which vessel supplies 2/3 of blood to the liver?

A

hepatic portal vein

40
Q

gastroschisis

A
  • congenital formation of abdominal wall

- bowel and contents spill out as opposed to omphalocele

41
Q

During a liver disease process, what happens to the sinusoids?

A
  • stellate cells in the space of disse lay down collagen
  • capillaries of endothelium loose fenestration (“capillarization”)
  • -> portal hypertension and ascites
42
Q

intussusception

A
  • currant jelly stools, palpable mass
  • bowel looping into itself
  • look for leadpoint lesion (can be caused by viral infection increase lymph/peyer’s patch size)
43
Q

Hep b: Anti- Hbe

A
  • cleared infection or chronic infection with low transmission rate
44
Q

reciprocal innervation of gut smooth muscle

A
  • when circular muscle of a region is excited/contracted, the longitudinal muscle relaxes/inhibited and vice versa
  • if both were excited, would not result in propulsion
45
Q

law of intestine

A
  • if an area of the gut were to be stimulated, there would be a stereotypic response with orad contraction and caudad relaxation
46
Q

type of contraction: segmentation

A
  • localized contractions and relaxations that aren’t designed to move food long distance
  • help MIX food with enzymes
  • frequency follows slow wave frequency of region (if slow, then slow mixing, if fast, then fast mixing)
  • duodenum is fastest and it decreases oral to anal
47
Q

type of contraction: tonic contraction

A
  • basally contracted

ex: sphincters

48
Q

type of contraction: peristalsis

A
  • orad contraction, caudad relaxation
  • used to move food along gi tract
  • in esophagus, vasovagal long arc reflex
  • in stomach, short waves
  • in intestine: short arc reflex completely within ENS
49
Q

three types of contraction in the colon

A
  • segmentation/mixing
  • haustral
  • high amplitude/mass movements (BIG CONTRACTION FOR POOPING)
50
Q

haustral contractions

A
  • anti- peristalsis in the colon (anal to oral)
  • used to store poop in the colon (keep in the colon instead of moving towards rectum)
  • allows for microbiota to act on undigested material
51
Q

migrating motor/myeoelectric complex

A
  • digestive housekeeper
  • occurs between meals, stops when you start eating (peristalsis/segmentation takes over)
  • clears tract of residue/particles
  • phase 1 (10 min)- quiescent, no waves above threshold
  • phase 2 (30-45 min)- inconsistent random waves above threshold
  • phase 3 (5- 10 min)- all waves above threshold, contractions af
52
Q

juvenile polyps mutation

A

SMAD4

53
Q

what is the most common infection in hospital cirrhotics

A

spontaneous bacterial peritonitis

54
Q

which disease presents similarly to budd chiari syndrome, but involves central veins and non hepatic veins and is almost always associated with chemo therapy

A

hepatic veno-occlusive disease