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Flashcards in Week 3 review Deck (47)
1

Acetampinophen overdose

centrilobular coagulative necrosis WITHOUT significant inflammatory cell infiltrate

2

Hep E in pregnancy

Causes increased mortality!!!

3

Findings in Autoimmune Hep

Elevated IgG
Anti-smooth muscle Ab
Plasma cell rich interface and centrilobular hepatitis
Female predominance

4

Findings in alpha-1- antitrypsin deficiency

PAS-positive, diastase resistant globules in hepatocytes (misfolded)

Emphysema

5

Findings in PBC

Elevated IgM
Anti-mitochondria Ab (AMA)
Mostly middle-aged women
Female predominance
Granulomatous lymphocytic cholangitis/ florid duct lesion
Can lead to osteopenia and osteoporosis

Usually itching is first sign

6

Findings in PSC

Ulcerative Colitis
Choleangiography with large bile duct strictures
Male predominance

7

Cholangiocarcinoma word associations

Tumor of bile ducts
Malignant
Gland-forming tumor with marked desmoplasia
Associated with PSC

8

Hepatocellular carcinoma associations

Tumor of hepatocytes
Malignant
Thickened hepatic plates/trabeculae with unpaired arteries
Almost exclusively pts with cirrhosis
Hep B
Most common primary malignant tumor

9

Hepatocellular adenoma associations

Tumor of hepatocytes
Benign
Female predominance
Birth control- reproductive age
Normal hepatic plate thickness with unpaired arteries

10

Hemangioma associations

Tumor of blood vessels
Benign
Most common hepatic tumor

11

Focal Nodular Hyperplasia associations

Tumor of hepatocytes
Benign
Proliferation/hyperplasia/non-neoplastic
Central scar and malformed blood vessels
Vascular malformation/anomaly etiology

12

What's the big risk factor for esophageal adenocarcinoma?

Barrett esophagus

13

Definition of esophageal varices

tortuous and dilated submucosal blood vesels

14

Features of steatohepatitis

Can be due to alcohol, metabolic syndrome, and drug related liver injury
If due to alcohol, AST is usually twice ALT
Steatosis
Ballooning degeneration
Include Mallory bodies

15

Plasma cells in liver think what?

Autoimmune hepatitis

16

Grade vs stage

Grade= Amount of inflammation and injury
Stage= fibrosis

17

TIPS and mesocaval shunt

TIPS- portal vein to hepatic vein shunt

mesocaval shunt- works to shunt blood from the portal vein to the IVC to circumvent the liver

Decrease pressure in the portal vein system but increase the effects of toxic compounds on the system (would worsen encophalopathy, may shock heart with increased flow to right side of heart, also causes hepatic ischemia due to loss of blood flow)

18

Lab values of a cholestatic pattern

Normal ALT AST, elevated bili and Alk Phos

19

What is ERCP used for?

stones in the duct

20

Bactram

(trimethoprim-sulfamethoxazole) is hepatotoxic and usually has cholestatic pattern

21

What slows the progression of fibrosis in PBC?

Ursodeoxycholic acid

22

Causes of encephalopathy

bleeding, drugs/alcohol, SBP (infection), Renal failure (creatinine level)

23

Which of the viral heps (a-e) have vaccines?

A and B

24

Which hep (a-e) is replication incompetent and requires co-infection with another hep virus?

D requires co-infection with B

25

What sequesters iron to suppress bacterial overgrowth?

lactoferrin
released during cephalic phase of digestion

26

lysozyme

pore forming antimicrobial enyzme
released during cephalic phase of digestion

27

Stimulation of pancreatic release of digestive enzymes via the ENS is mediated primarily by what?

ACh

28

What causes increased acinar cell secretion and vasodilation of blood vessels surrounding the acini (results in protein rich & fluid/ion rich solution)?

Parasympathetic NS

29

What causes increased acinar cell secretion (results in high protein/low fluid solution)

Sympathetic NS

30

DEGLUTITION

swallowing

31

Protease enzymes

Secreted from acinar cells to break down proteins into amino acids

32

Amylase

breaks down the α1-4 bond of amylose and amylopectin yielding maltose, maltotriose and glucose

33

What produces bicarbonate solution to liquify and neutralize the chyme in the duodenum that has a low pH?

ductal cells

34

secretin

Decreased intestinal pH stimulates release of the enzyme secretin which in turn drives bicarbonate release from the pancreas

35

CCK release

Fats and amino acids in the intestine compete for the enzyme trypsin allowing for signaling by CCK-RF and monitor peptide to increase the release of CCK from duodenal I cells

36

CCK actions

acts back on the pancreas to increase release of digestive enzymes into the duodenal lumen via relaxation of the sphincter of Oddi

This also causes contraction of the gallbladder to facilitate the release of bile acid which aids digestion and absorption of fat

It also has a negative effect on gastric motility and gastric emptying

37

What are primary bile acids are produced in the liver from?

cholesterol

38

What are secondary bile acids are formed by?

bacteria in the intestine and colon

39

How are bile salts made?

Bile acids are complexed with glycine or taurine

40

What breaks down dietary fats?

lingual and gastric lipase

41

What hydrolyses trigylcerides into FFAs?

pancreatic lipase

42

Na+ absorption

Mostly absorbed in the jejunum

often linked with the transport of other dietary components

43

What two ions compete for absorption into enterocytes?

Ca2+ and Mg2+

44

TAENIA COLI

Muscles that run along the colon but are shorter than it.

45

Semilunar folds

allow expansion while supporting the weight of the digesta

46

Haustra

small pouch that give the colon its segmented appearance

47

What causes relaxation of the internal anal sphincter

intrinsic neuron derived VIP and NO