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Flashcards in Small group GB + Panc Deck (26):
1

Lipase

made by pancreas
- high sensitivity and specificity for acute pancreatitis
- rises within 4-8 hours
- elevated for 8-14 days

2

Amylase

also made in pancreas (lipase), but also in small bowel and salivary glands
- lower sensitivity
- rises 6-24 hours/elevated for 3-7 days

3

Why would you have reduced vitamin K in chronic pancreatitis?

Fat soluble vitamins like vit K are poorly absorbed bc they have greater affinity for non-absorbed fat in intestinal lumen than for their muscosal receptors leading to steatorrhea

4

Salt and pepper chromatin patter and moderate amt of cytoplasm surrounded by fibrovascular core

Neuroendocrine neoplasm

5

painless jaundice

very concerning for pancreatic neoplasm

6

Advantages of EUS guided FNA

less invasive
- pot dx, lower incidence of bleeding
- lower risk of seeding cancer cells than w/ percutaneous biopsy
- more effective staging of cancer

7

Ca19-9

can be associated with pancreatic carcinoma tumor marker (if combined with other findings)

8

acute bacterial cholangitis
- presentation

charcots triad
- pain
- jaundic
- fever

PLus
- hypotension
- altered mental status

9

Which type of gallstones are visible by x ray?

Pigment stones (50-75%)

Cholesterol (20%)

10

AST can indicate what in:
Skeletal muscle -
Cardiac muscle -
RBCs -

Skeletal muscle - rhabdomyolysis
Cardiac muscle - MI
RBCs - Hemolysis

11

Alk phos can indicate what in
Bone -
PLacenta -
Intestine -

Bone - metastatic dis, fracture
PLacenta - pregnancy
Intestine - bowel perforation

12

abnormalities assoc with prolonged PTT or INR

Malabsorption: no correction with subcut. vit K

Synthetic dysfxn:
correction with subcu vit K

13

Cholestatic patttern of injury shows elevation of what levels?

Alk phos

(hepatocellular injury or necrosis is predom AST & ALT elevation)

14

Which Hep is assoc. with shellfish?

Hep A

15

ground glass

suggestive of HBV surface antigen storage.

16

AST>ALT (ratio 2)
Elevated GGT

likely alcohol use causing liver injury

17

Mallory bodies

aggregates of keratin

strongly associated with Alcoholic liver disease
- steatohepatitis

18

fatigue
pruritus
scleral icterus
RA

Primary biliary cirrhosis

- AMA strongly suggestive of PBC

19

tx and test for PBC

Ursodiol, liver transplant

AMA +

20

onion skin fibrosis

PSC
- scant inflammatory cells
- no granulomas/duct lesions

21

PSC or PBC assoc with IBD?

Primary sclerosing cholangitis:
PSC - associated with IBD - UC

22

do more pts with UC get PSC or more pts with PSC have UC?

70-80% of PSC pts have or develop UC

23

Benign neoplasm +
Malignant neoplasm assoc w/
- Hepatocyte

Benign: Focal nodular hyperplasia adenoma

Malignant: Hepatocellular Carcinoma

(adenoma benign, carcinoma not)

24

Benign neoplasm +
Malignant neoplasm assoc w/
- Biliary Duct epithelial cell

Benign:
- Bile duct adenoma

Malignant
- Cholangiocarcinoma

(Adenoma benign, carcinoma not)

25

Benign neoplasm +
Malignant neoplasm assoc w/

Benign:
Hemangioma

Malignant:
Angiosarcoma,
Kaposi sarcoma

26

SAAG

serum albumin - ascites albumin