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Pathoma
Exocrine Pancreas, Gallbladder, and Liver Pathology
80
Pathology
Graduate
02/24/2014

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Cards

Term
annular pancreas
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
pancreatic pseudocyst
Definition
formed by fibrous tissue surrounding liquefactive necrosis and pancreatic enzymes; abdominal mass with elevated serum amylase
Term
pancreatic abscess
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
pancreatic insufficiency
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
obstructive jaundice
Definition
pale stools and palpable gallbladder with tumors in head of pancreas
Term
trousseau sign
Definition
migratory thrombophlebitis
Term
tumor marker for pancreatic cancer
Definition
CA-19-9
Term
whipple procedure
Definition
removal of head and neck of pancreas, proximal duodenum and gallbladder
Term
biliary atresia
Definition
biliary obstruction within first 3 months of life; jaundice and progresses to cirrhosis
Term
causes of gallstones
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
biliary colic
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
rokitansky aschoff sinus
Definition
herniation of gallbladder mucosa into muscular wall
Term
porcelain GB
Definition
shrunken, hard GB 2/2 chronic inflammation, fibrosis and dystrophic calcification
Term
porcelain GB
Definition
shrunken, hard GB 2/2 chronic inflammation, fibrosis and dystrophic calcification
Term
ascending cholangitis
Definition
gram- bacteria; sepsis, jaundice and abdominal pain
Term
gallstone ileus
Definition
obstructs the small bowel; with fistula
Term
GB CA
Definition
glandular epithelium that lines the GB; with gallstones, elderly women
Term
inc bilirubin level
Definition
>2.5
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
HAV and HEV
Definition
fecal-oral, acute hepatitis, immunization for HAV
Term
travelers hepatitis
Definition
HAV
Term
contaminated water or undercooked seafood
Definition
HEV
Term
hepatitis in pregnancy
Definition
HEV
Term
parenteral transmission
Definition
HBV, HCV
Term
chronic hepatitis in most cases
Definition
HCV
Term
HDV
Definition
superinfection or confection with HBV
Term
HBsAB+, HBeAG +, HBcAB IgM
Definition
acute hepatitis
Term
IgM HBcAB
Definition
window period
Term
IgG HBcAB, IgG HBsAB
Definition
resolved
Term
HBsAG, HBeAG+, IgG HBcAB
Definition
chronic
Term
HBsAG, HBeAG+, IgG HBcAB
Definition
chronic
Term
HBsAB IgG
Definition
immunization
Term
ALT > AST
Definition
acute viral hepatitis
Term
what mediates fibrosis in cirrhosis?
Definition
TGF-beta from stellate cells which lie beneath the endothelial cells that line the sinusoids
Term
portal HTN leads to
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
alcoholic hepatitis
Definition
acetaldehyde mediates damage; swelling of hepatocytes of mallory bodies, painful hepatomegaly and AST> ALT
Term
mallory bodies
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
gene in hemochromatosis
Definition
HFE gene (C282Y)
Term
symptoms of hemochromatosis
Definition
cirrhosis, secondary DM, and bronze skin
Term
labs in hemochromatosis
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
gene in wilson disease
Definition
ATP7B= ATP mediated hepatocyte copper transport
Term
clinical features of wilsons
Definition
cirrhosis, neurologic manifestations , kayser fleisher rings
Term
labs of wilsons
tx?
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
reye syndrome cause
Definition
liver failure and encephalopathy in children with viral illness given ASA
Term
presentation of reye
Definition
hypoglycemia, elevated liver enzymes, and N/V
Term
hepatic adenoma
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
budd chiari
Definition
liver infartion secondary to ehpatic vein obstruction
Term
serum marker for hepatocellular carcinoma
Definition
alpha-fetoprotein
Term
sources of liver metastases
Definition
colon, pancreas, lung and breast
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