Term
|
Definition
| pancreas forms a ring around duodenum; duodenal obstruction |
|
|
Term
| necrosis in acute pancreatitis |
|
Definition
| liquefactive hemorrhagic necrosis of pancreas and fat necrosis of per pancreatic fat |
|
|
Term
| causes of acute pancreatitis |
|
Definition
| trauma, hypercalcemia, hyperlipidemia, drugs, scorpion stings, mumps and rupture of a posterior duodenal ulcer |
|
|
Term
| clinical features of acute pancreatitis |
|
Definition
| epigastric abdominal pain that radiates to back, N/V, per umbilical and flank hemorrhage, elevated lipase and amylase, hypocalcemia |
|
|
Term
| complications of acute pancreatitis |
|
Definition
| shock, pancreatic pseudocyst, pancreatic abscess, DIC and ARDS |
|
|
Term
|
Definition
| formed by fibrous tissue surrounding liquefactive necrosis and pancreatic enzymes; abdominal mass with elevated serum amylase |
|
|
Term
|
Definition
| due to E coli; abdominal pain, high fever and elevated amylase |
|
|
Term
| causes of chronic pancreatitis |
|
Definition
| alcohol and cystic fibrosis (children) |
|
|
Term
| clinical features of chronic pancreatitis |
|
Definition
| epigastric abdominal pain that radiates to back; ancreatic insufficiency, dystrophic calcification, secondary DM |
|
|
Term
|
Definition
| malabsorption with steatorrhea and fat soluble vitamin deficiencies |
|
|
Term
| dystrophic calcifications |
|
Definition
| in pancreatic parenchyma; chain of lakes patter due to dilation of pancreatic ducts |
|
|
Term
| risk factors for pancreatic carcinoma |
|
Definition
| smoking and chronic pancretitis |
|
|
Term
| clinical features of pancreatic carcinoma |
|
Definition
| epigastric pain and weight loss; obstructive jaundice, secondary DM, pancreatitis, Trousseau |
|
|
Term
|
Definition
| pale stools and palpable gallbladder with tumors in head of pancreas |
|
|
Term
|
Definition
| migratory thrombophlebitis |
|
|
Term
| tumor marker for pancreatic cancer |
|
Definition
|
|
Term
|
Definition
| removal of head and neck of pancreas, proximal duodenum and gallbladder |
|
|
Term
|
Definition
| biliary obstruction within first 3 months of life; jaundice and progresses to cirrhosis |
|
|
Term
|
Definition
| supersaturation of cholesterol/bilirubin; decreased phospholipids/bile acids or stasis |
|
|
Term
| radiolucent vs radioopaque stones |
|
Definition
radiolucent= cholestersol
radiopaque= calcium, bilirubin |
|
|
Term
| risk factors for cholesterol gallstones |
|
Definition
| 40s, female, obesity, pregnancies, OCP, clofibrate, Native american, crown and cirrhosis |
|
|
Term
| biliary infection leading to gallstones |
|
Definition
ascaris lumbricoides= roundworm
clonorchis sinensi= chila, korea, and vietman = cholangitis and cholangiocarcinoma also |
|
|
Term
| complications of gallstones |
|
Definition
| bliary colic, acute and chronic cholecystitis, ascending cholangitis, gallstone ileum and GB cancer |
|
|
Term
|
Definition
| waxing and waning RUQ pain; GB contracting against stone |
|
|
Term
| acute cholecystitis causes |
|
Definition
| impacted stone, E coli and inflammation |
|
|
Term
| presentation of cholecystitis |
|
Definition
| RUQ pain radiating to R scapula, fever, inc alk phos |
|
|
Term
|
Definition
| herniation of gallbladder mucosa into muscular wall |
|
|
Term
|
Definition
| shrunken, hard GB 2/2 chronic inflammation, fibrosis and dystrophic calcification |
|
|
Term
|
Definition
| shrunken, hard GB 2/2 chronic inflammation, fibrosis and dystrophic calcification |
|
|
Term
|
Definition
| gram- bacteria; sepsis, jaundice and abdominal pain |
|
|
Term
|
Definition
| obstructs the small bowel; with fistula |
|
|
Term
|
Definition
| glandular epithelium that lines the GB; with gallstones, elderly women |
|
|
Term
|
Definition
|
|
Term
| normal bilirubin metabolism |
|
Definition
| heme -> UCB -> UCB-albumin -> liver -> CB -> gut bacteria -> urobilinogen -> 80% excreted, 20% reabsorbed |
|
|
Term
| extravascular hemolysis - bilirubin - why dark urine? |
|
Definition
| - UCB - from inc urine urobilinogen (UCB not water soluble) |
|
|
Term
physiologic jaundice of newborn
- cause
- lab
- clinical features
- tx |
|
Definition
- low UGT activity
- UCB
- deposit in basal ganglia (kernicterus)
- photothearpy |
|
|
Term
Gilbert
- etiology
- lab
- clinical features |
|
Definition
- mildly low UGT
- UCB
- during stress |
|
|
Term
CN II
- etioloty
- lab
- clinical features |
|
Definition
- absent UGT
- UCB
- kernicterus, usually fatal |
|
|
Term
dubin johnson
- etiology
- lab
- clinical features |
|
Definition
- deficiency of bilirubin canalicular transport
- inc CB
- liver is dark |
|
|
Term
obstructive jaundice
- etiology
- lab
- clnical features |
|
Definition
- gallstone, pancreatic CA, cholangiocarcionma, parasites, and liver fluke
- CB, dec urobilinogen, inc alk phos
- dark ruing, pale stool, pruritus (inc bile acids), hypercholesterolemia with xanthomas, stator rhea |
|
|
Term
viral hepatitis
- etioloty
- lab
- clinical features |
|
Definition
- infalmmation disrupts hepatocyes and small bile ductules
- CB and UCB
- dark urine 2/2 inc bilirubine |
|
|
Term
|
Definition
| fecal-oral, acute hepatitis, immunization for HAV |
|
|
Term
|
Definition
|
|
Term
| contaminated water or undercooked seafood |
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
| chronic hepatitis in most cases |
|
Definition
|
|
Term
|
Definition
| superinfection or confection with HBV |
|
|
Term
| HBsAB+, HBeAG +, HBcAB IgM |
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
| what mediates fibrosis in cirrhosis? |
|
Definition
| TGF-beta from stellate cells which lie beneath the endothelial cells that line the sinusoids |
|
|
Term
|
Definition
| ascites, congestive splenomegaly/hypersplenism, portosystemic shunts, hepatorenal syndrome |
|
|
Term
| decreased detoxification leads to |
|
Definition
| mental status change, asterisix and coma, gynecomstia, spider angiomata, jaundice |
|
|
Term
| decreased protein synthesis leads to |
|
Definition
| hypoalbuminemia with edema, coagulopathy due to decreased synthesis of clotting factors |
|
|
Term
| most common cause of liver disease in the west |
|
Definition
| alcoholic related liver disease |
|
|
Term
|
Definition
| acetaldehyde mediates damage; swelling of hepatocytes of mallory bodies, painful hepatomegaly and AST> ALT |
|
|
Term
|
Definition
| damaged cytokeratin filaments, necrosis and acute inflammation |
|
|
Term
| nonalcoholic fatty liver diases |
|
Definition
| without exposure to alcohol, with obesity |
|
|
Term
| causes of hemochromatosis |
|
Definition
| AR defect in iron absorption or chronic transfusions |
|
|
Term
|
Definition
|
|
Term
| symptoms of hemochromatosis |
|
Definition
| cirrhosis, secondary DM, and bronze skin |
|
|
Term
|
Definition
| inc ferritin, dec TIBC, inc iron and inc % sat |
|
|
Term
| liver biopsy in ehmochromatosis |
|
Definition
| brown pigment in hepatocytes, prussian blue distinguishes from lipofuscin |
|
|
Term
|
Definition
| ATP7B= ATP mediated hepatocyte copper transport |
|
|
Term
| clinical features of wilsons |
|
Definition
| cirrhosis, neurologic manifestations , kayser fleisher rings |
|
|
Term
|
Definition
- inc urinary copper, dec serum ceruloplasmin, inc copper on liver biopsy
- penicillamine |
|
|
Term
| parimary biliary cirrhosis |
|
Definition
| women, antimitochondrial antibody, obstructive jaundice |
|
|
Term
| primary sclerosing cholangitis |
|
Definition
| onion skin, beaded, UC, p-ANCA, obstructive jaundice |
|
|
Term
|
Definition
| liver failure and encephalopathy in children with viral illness given ASA |
|
|
Term
|
Definition
| hypoglycemia, elevated liver enzymes, and N/V |
|
|
Term
|
Definition
| OCP use, rupture and intraperitoneal bleeding esp in pregnancy |
|
|
Term
| risk factors for hepatocellular carcinoma |
|
Definition
| chronic hepatitis (HBV, HCV), cirrhosis, aflatoxins (induce p53 mutations) |
|
|
Term
|
Definition
| liver infartion secondary to ehpatic vein obstruction |
|
|
Term
| serum marker for hepatocellular carcinoma |
|
Definition
|
|
Term
| sources of liver metastases |
|
Definition
| colon, pancreas, lung and breast |
|
|
