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A_First Aid Random Memorizing > Pancreas, Gallbladder, Liver > Flashcards

Pancreas, Gallbladder, Liver Flashcards

(52 cards)

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1
Q

first enzyme activated in acute pancreas

A

trypsin

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2
Q

what types of necrosis seen in acute pancreas

A

liquefactive necrosis of pancreas itself

fat necrosis of peripancreatic fat

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3
Q

how does alcohol effect sphincter of Oddi

A

causes contraction -> blocks pancreas drainiage = pancreatitis!

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4
Q

what can trigger pancreatitis

A

hypercalcemia, hyperlipidemia (drugs, scorpin stings, mumps), rupture of posterior ulcer

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5
Q

lab values in acute panc

A

elevated lipase amylase

HYPOCALCEMIA (from fat necrosis and soponification)

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6
Q

persistently elevaed amylase with fever infection

A

pancreatic abscess (usu. e coli)

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7
Q

two devastating complications of pancreatitis

A

DIC and ARDS

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8
Q

MCC chronic panc in adults and hcildren

A

adult - alcohol

children - cystic fibrosis

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9
Q

how does pancreatic insufficiecy present

A

fat malabsorption (steatorrhea), vitamin deficiency (ADEK), dystrophic calcifcation
secondary DM!!! alte complication
increase risk of pancreatic arcinoma

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10
Q

major risk factors pancreatic carcinoma

A

smoking

chronic pancreatitis

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11
Q

how does pancreas head tumors present

A

obstructive jaundice with nontender gallbladder (Courvoisier)

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12
Q

tumor marker pancreatic cancer

A

CA 19 9

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13
Q

migratory thrombophelibitis

A

red flag for pancreas cancer!

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14
Q

thin elderly person suddenly develops DM….

A

suspicious for pancreatic cancer…(this is not the demographic of people who get DM!!!)

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15
Q

decreasd phospholipids and bile acids

A

increase risk of cholesterol stone (increased risk of preciptating)

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16
Q

what lipid lowering agent can increase risk for cholesterol stones

A

bile acid resins (cholestyramine, colestipol, colestivam)

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17
Q

where does reuptake of bile acids and bile salts occur

A

terminal ileum (crohns disease here increase risk of stone)

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18
Q

risk factor for BILIRUBIN/pigented stone

A

extravascular hemoylsis

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19
Q

where does acute cholecystitis pain occur

A

RUQ radiating to RIGHT SCAPULA

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20
Q

porcelain gallbladder

A

chronic cholecystitis causes this….take out gallbaldder for increased risk of cancer

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21
Q

very old woman with cholecytitis (past age dmographic)

Study These Flashcards
A

gallbladder carcinoma

22
Q

pitch black liver…discolored

Study These Flashcards
A

dubinjohnson (problem with transport of conjugated bili)

23
Q

Gilbert and Crigler Najar

Study These Flashcards
A 
AR deficiency in UGT (uglucouronlytransferase)
gilbert is mild
crigler najar (EVIL NAME) is almost absent UGT...usually fatal
24
Q

biliary tract obstruction what will beelevated in blood

Study These Flashcards
A

conjbili, plasma bile acids, alk phos, dark urine claycolored stool

25
how are hepatocytes destroyed in hepatitis
cd8 t cell killing
26
HEV in pregnantwoman?
may progress to fulminant hep (very bad)
27
what's worse superinfection of hpD on previous hepb or concurrentinfection of HBV HDV
superimpoed superinfection
28
what cell mediates fibrosis in liver
TGF beta form stellate cells which lie beneath endothelial cells that line sinusoids
29
signs and symptoms of excess estrogen
gynecomastia spider angioma palmar erythema
30
histologic hallmark of alcoholic hepatitis
Mallory bodies (intracytoplasmic eosinophilic inclusions of DAMAGED INTERMEDIATE FILAMENTS, KERATIN FILAMENTS)
31
non alcoholic fatty liver disease associated with...
obesity...ALT>AST
32
how is hemochromotasis causing damge?
generation of free radicals from iron from fentin reaction | deposits in tissues as hemosiderosis
33
primary hemochromatosis gene mechanism
HFE gene (c282y) recessive leads to abnormal iron sensing in enterocytes leading to increasd absorption (increased ferriton, increased iron, decreased TIBC, INCREASED TRANSFERRIN, high percent sat)
34
how can secondary hemochromatosis happen
from transfusions multiple
35
how to differentiate between iron an lipofuscin in liver
Prussian blue stain!
36
autosomal recessive defeect in ATP7B gene (ATP mediated hepatocyte copper transport)
wilson dx | lack of copper transport into bile and ceruloplasmin leading to tissue deposition
37
how does copper cause damage
free fradicals by production of hydroxyl free radicals
38
rx wilsons
copper chelation with d penicillamine or zinc or trientine
39
labs on wilsons
increased urinary iron LOW CERULOPLASMIN increaed copper in liver
40
antibody for PBC
antimitochondrial
41
obstructive jaundice, with late cirrhosis associated with other autoimmune disease, woman
PBC damage to intrahepatic ducts
42
histology of PSC
concentric "onion skin" bile duct fibrosis with alternating stricture and dilation with "string and bead" apeparnts of both INTRA AND EXTRA hepatic ducts
43
PSC associated with what disease and what marker
UC | p-anca
44
child has viral illness and takes asprin...
reye syndrome | fulminant liver failure and encephalopathy... via MITOCHONDRIA DAMAGEL
45
mitochondria abnormalities, fatty liver, HYPOGLYCEMIA, vomiting, hepatomegaly, coma in child
REY syndrome | decerased b oxidation off reversible inhibition of mitochondrial enzymes
46
only time u give child aspirin
KAWASAKIS
47
hepatic adenomas (benign) are assocaited with what medication
oral contracept
48
what fungus can increase risk of HCC
aflatoxins form aspergillus by inducing p53 mutations
49
liver infarction secoondary hepatic vein obstruction
budd chairi | presents wiht painful hepatoegaly and ascites
50
serum tumor marker for HCC
AFP
51
sources of liver mets
colon pancreas lung, breast RESULTS IN MULTIPEL NODULES IN LIVER...can feel noduels on physical
52
MOA duodenal atresia vs jejunal/ileal atresia
duodenal - failure of recanalization at 8-10 weeks gestation, aw Downs jejunal/ileal - vascular occlusion = ischemia and narrowing/obliteration, apple peel deformity

A_First Aid Random Memorizing (17 decks)

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