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Flashcards in Day 2 Deck (41)
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1

jaundice begins gradually, pruritus is common
• Large, smooth, nontender liver, pale stools, steatorrhea. Dark urine- positive for bilirubin. Elongated prothrombin time
Marked elevated of alkaline phosphate
Mild LFT
normal albumin

Intrahepatic cholestasis

2

o Stone, stricture or tumor blocks flow of bile w/I extrahepatic biliary tree
o Patient may have hx of gallstone, biliary tract surgery, malignancy
o Liver is usually enlarged
o Dark stool, pale urine
o Sudden onset of pain from stones
hihg alkaline phosphatase
moderate high LFTs

Extrahepatic obstruction

3

o Hepatitis + anorexia, nausea, abdominal pain, malaise before jaundice
o Hepatic tenderness and some hepatomegaly
o Ecchymoses may be presents
o Transaminases may become very elevated
o Hep C and alcoholism transaminases only 5x normal
o Dark urine, pale stools

Hepatocellulcar injury

4

No bilirubin in urine, but jaundice

Unconjugated hyperbilirubinemia

5

is cirrhosis symptomatic?

usually not

6

common cause of cirrhosis

Alcohol consumption
Hep C
Nonalcoholic fatty liver

7

most common autosomal condition for cirrhosis. Excessive iron overload.

Hemochromatosis

8

Other causes of cirrhosis

Wilson's
Gaucher's (lyposomal storage disorder)
Primary biliary cirrhosis
Fanconi's (kidney problem)

9

if a person presents with varices, ascities, hypersplenism, encephalopathy, peripheral edema. Have GI bleeding, abdominal discomfort, confusion, early satiety.

Chronic viral or alcoholic hepatitis

10

Women presents with hepatomegaly, jaundice, hyperlipdemia, excoriation what do you suspect? Elevated alk phos, SED. Anti-Mito Antibody

Primary biliary cirrhosis

11

Gold standard of diagnosis for liver cirrhosis.

Liver biopsy

12

Patient presents with dyspnea, arthritis, skin discoloration, fatigue. Have damage to liver, heart, pancreas and gonads. Will look grey or bronze like. Elevation transferrin saturation and ferritin

Hemochromatosis

13

What does TIPS stand for?

transjugular intrahepatic portosystemic shunt
takes pressure off the portal system

14

Tx for primary biliary cirrhosis

transplant
diet- Vit A, D, K, zinc
meds- (a variety)

15

caused by HBV (most common) HCV, cirrhosis, hemochromatosis.
Elevated alpha-fetorprotein
will ahve hemorrhage, necrosis

Hepatocellucular carcinoma

16

Tx for hepatocellular carcinoma

curative resection
transplant

17

Uncommon in cirrhotic liver
hematogenous, lymphatic or direct spread
will have hemorrhage and replacement of hepatocytes by malignant cells

metastatic carcinoma

18

cancer due estrogens or anabolic steroids. will ahve hemorrhage, necrosis.

Hepatocellcular adenoma

19

tx of hepatocellular adenoma

discontinue estrogens/ androgens
resect if possible
do periodic imaging

20

Presents with URQ pain, ascities. occlusion of hepatic veins or inferior vena cava caused by hematogenous disease. Dx via doppler US

budd chiari syndrome

21

Due to congenital problems, estrogens. Is a blood filled cysts lined single layer of flat epithelium.

Cavernous hemangioma

22

Thin walled cyst with clear fluid. Has simple cuboidal endothelium. no co-existing liver dz, congenital. Tx with percutaneous aspiration or surgical

Simple liver cyst

23

Present with fever, RUQ colicky pain that radiates. N/V

acute cholecystitis

24

will have fatty food intolerance, jaundice, pale feces, pruritus, weight loss

chronic cholecystitis

25

What are pigmented stones

increased production of bilirubin conjugated
increased biliary calcium and bicarb

26

where can biliary colic refer to?

tip of scapula
right shoulder

27

tx for biliary colic (recurrent)

laproscopic cholecystectomy

28

distention, edema, ischemia, inflammation along with fever. Acute onset of upper abdominal pain that lasts for several hours and doesn't subside spontaneously. In epigastrium and radiates to right lumbar and shoulder

Acute cholecystitis

29

distention, edema, ischemia, inflammation along with fever. Acute onset of upper abdominal pain that lasts for several hours and doesn't subside spontaneously. In epigastrium and radiates to right lumbar and shoulder

Acute cholecystitis

30

Profound jaundice as a result of compression of common hepatic duct by a cystic duct in the neck of the gallbladder. Dx via US

Mirizzi Syndrome