Gastro Podcast Flashcards

1
Q

Bilirubin is a product of

Indirect is, direct is

Process= unconj binds to ____

transported to ___, converted to ___ and eventually

taken to ____ bacteria convert to

10% reabsorbed in ____ and circulates in blood

urine normally has ____

lack of urobilinogen indicates

A

hemoglobin breakdown

unconj, conj

albumin

hepatocyte, glucuronic acid, conj bilirubin

SI, urobilinogen

ileum

small amt

blockage of biliary system

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2
Q

Hematalogic jaundice is bilirubin ___, predominatly

Max total bilirubin of

indirect bilirubin is bound to __ and poorly filtered by ___, not as likely to produce

Ex H____ due to, i____ due to

these pts are

A

overproduced, unconj

3-5

albumin, kidney, dark urine

hemolysis (SCA), ineffective erythropoeisis (B12 def, thalassemia)

anemic

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3
Q

Hepato-biliary jaundice inability to ____ bilirubin

Parenchymal liver dz bilirubin is, ex

Cholestatic dz bilirubin is, ex

Splenomeg seen in both

not in _____ bc pts autoinfarct ___ in early life

A

take up/conj/excrete

mixed, hepatitis/cirrhosis

conj, choledocholithiasis (CBD obs w gallstone) and primary biliary cirrhosis

hepatobiliary/hemato dz

SS sickle cell dz. spleen

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4
Q

Gilbert dz presenttion, exacerbated by

labs show inc

A

mild scleral icterus, fastng/surg/fever/infect/alcohol

unconj bilirubin

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5
Q

Hepatitis vs cirrhosis

Transaminase is
Signs of inflam
Liver is
Portal htn/fxnal impairment

Cirrhosis n be tender w
Hepatitis usually has no

Liver fxn tests in cirrhosis elevated include

A

H- elevated, yes, tender, no (when present think chronic hep)

C- not elevated, no, nontender, yes

RHF
splenomeg

PT, bilirubin, albumin

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6
Q

Alcoholic hepatitis liver is

complicated by

systemic infalam findings

tx

Alcoholic cirrhosis aka

liver is, usually have ___ findings

labs reveal

Labs for both
AST vs ALT ratio for alcohol
AST <
Elevated

A

enlarged, tender

poor nutritional status

fever, inc leuks

systemic CS

Laennecs cirrhosis

small/nodulr, cirrhosis

inc PT/INR, bilirubin, albumin

high
500
MCV

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7
Q

Cirrhosis exam finding caused by blockage of fibrotic liver

severe comp

Cirrhosis may lead to ___ due to high progesterone

A

portal HTN

GI bleeding w esophageal varices

met alk

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8
Q

DDx of splenomegaly

GI
Reticuloendo
Hematopoetic

OWR can lead to

pt w GI bleeding, look for ___ findings

A

Portal HTN
Infect, granulomatous dz, lymphoma
Leukemia, extramedullary hemato, hemolysis, sc sickle cell

slow bleeding in organs

cirrhosis

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9
Q

Mixed cryoglobinemia caused by

Extrahepatic cholestasis is a blockage of

Key clinical findings

1st step, differentiate from

2nd is ____, to differentiate from

Intrahepatic ddx, aka

Extrahepatic ddx

A

polyclonal immune complexes in tissues

CHD, CBD, SoO

jaundice, dark urine, light colored stools

hepatitis

imaging, intra/extrahepatic cholestasis

cholestatic liver dz- drugs, infiltrative dz, PSC, PBC, cholestasis of preg

stone, panc ca, cholangiocarcinoma

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10
Q

Lab findings of cholestasis

minimal __ elev

High ____, absent

Chronic cholestasis leads to
H
F

W panc duct blockage, and loss of panc lipase look for

Generalized pruritis in cholestatic liver dz due to inc

A

transam (diff from hepatitis)

ALP, GGT, direct bilirubin, urine urobilinogen

Hyperlipidemia(xanthelasma, xanthomas)

Fat soluble vitamin def

steatorrhea

inc serum bile salts, endo opioids, lysophosphatidic acid

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11
Q

Choledocolithiasis is a

Mizzi’s syndrome has

Ascending cholangitis due to

Cholestatic picture labs inc, normal

Liver dz in

look for ___, all pt w ___ are predisposed

liver infact w infect leads to

Hemolysis alone can lead to

A

CBD stone

extrinsic biliary compression from impacted cystic stone

obstructed duct, infected

inc ALP/GGT/bilirubin, normal transam

SC anemia

pigmentary (cholesterol), chronic hemolysis

abscess

indirect hyperbilirubinemia

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12
Q

Nutmeg liver consequence of chronically high

pO2 is higher

central vein pressure produces

cells that die are near

seen in pt w dz like

Portal triad includes

A

central venous pressure

away from the vessel

patho, hypoxia

portal vein

constrictive pericarditis

Portal vein, hep artery, CBD

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