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50 Cards in this Set
- Front
- Back
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Liver Bl supply
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Portal Vein: from GI --> Sinusoidal
Hepatic Arteriole central zone last to get Blood out --> inferior vena cava |
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Chronic liver injury
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limiting plate problems
Piecemal Necrosis: random death fibrosis |
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Cholestasis
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liver plugged up - bile don't move
stone, tumor, Rx, Viral Infection accumulation of bile |
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Kupfer Cell
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liver macrophage
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Cirrhosis Sx
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Ascites
Caput medusae Gynecomastia Spenomegaly Esophageal Varices |
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Chronic Inflammation
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Round Cell infiltrate
Fibrosis Ongoing Injury |
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Ascites
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abdomen full of fluid
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Caput medusae
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umbilicas, veins on enlarged abdomen
blood finding way around liver |
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Esophageal Varices
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dilated veins
b/c back pressure from liver distal 1/3 esophagus |
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Causes of Cirrhosis
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Alpha 1 anti trypsin deficiency
too much Iron Protein deficient viral/ EtOH |
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Cirrhosis histo
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inflammatory state
stellate cell --> fibroblast 1. injury 2. damage cellular matrix 3. Fibrosis 4. Failed regeneration 5. Vascular shunting |
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Cirrhosis Symptoms
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Esophageal Varices
Splenomegaly Hepatic Encephalopathy Hemorrhoids low albumen, bleeding problems |
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Liver Parasitic
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Schistosomiasis
Clonorchis Sinensis |
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Bacteria Liver
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Cholangitis
Abscesses |
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Viral Liver
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EBV - mono --> Kupffer Cells
CMV Hep A, B, C |
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Acute Viral Hepatitis
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Hep A
Sx: - Councilman Bodies = Random necrosis, bright pink - Portal Swelling - Bile Stasis |
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Chronic Hepatitis
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Piecmeal Necrosis- Lumps die
Bridging Necrosis & Fibrosis - breakdown limiting plate - scaring btw triads |
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Hepatitis A
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infectious, Stool --> Food
Self Limiting |
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Hepatitis B
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STD
Common in Asia may become Chronic, silent |
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Fulminant Hepatitis
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acute liver failure
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Hepatitis C
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Blood borne
70% Chronic, Cirrhosis have it for life |
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Delta Agent
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Needs Hep B
fulminant loss of liver |
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Autoimmune Hepatitis
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women > men
chronic no viral marker |
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Reye's Syndrome
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Child w/Fever + Asprin
transient mitochondria problem Fulminant liver failure |
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Lance: What is Fulminant Liver Failure
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what is Fulminant Liver Failure
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Alcoholic Liver
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OH --> Acetic Acid, drops pH
Glutathione can't keep up |
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Acute alcoholic liver
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PMNs
Mallory bodies, ballon degeneration liver enzymes in blood acute fatty liver |
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Kwashiorke
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protein deficiency
acute fatty liver |
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hobnails
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micronodular pattern
Alcoholic Cirrhosis |
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Pigmentary Cirrhosis
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congenital
absorb too much Iron bronze diabetes |
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Wilson’s Disease
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missing Copper transporter
Cirrhosis, brain degeneration, corneal ring |
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Alpha-1 Anti-trypsin Deficiency
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can't get Alpha-1 Anti-trypsin out of liver
Cirrhosis & Emphysema |
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Intrahepatic Biliary Disease
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Drug related: stasis, inflammation, scarring
autoimmune |
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Primary Biliary Cirrhosis
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problem with biliary tree
Women always Granulomatous destruction med duct Xanthomas Mitochondrial Ab Sicca syndrome |
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Sicca syndrome
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Dry eyes & mouth
Scleroderma Rheumatoid arthritis All autoimmune in nature |
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Primary Sclerosing Cholangitis
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sm duct onion skinning
w/Ulcerative Colitis no Ab |
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• HELLP syndrome
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Prego, liver & kidney vascular problem
-“Hypertension, elevated liver enzymes and low platelets” thrombosis of sinusoids clotting in space of Disse |
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• Eclampsia
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Prego, liver problem
Excessive vomiting and fluid retension -High BP -Fatty liver -May be life threatening |
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Tumors of Liver
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usually from else where: bowel, lung, kidney, breast
Hepatocellular Carcinoma Cholangiocarcinoma |
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Hepatocellular Carcinoma
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• Malignant hepatocytes
Hep B multiple foci |
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Cholangiocarcinoma
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bile duct epithelium
Adenocarcinoma desmoplasia- Scarring |
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Gall Stones
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Risk: female, fat, (over) forty, fertile
• Pigmentary stones: biliruben |
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Cancer of Gallbladder
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Chronic cholecystitis
multiple gallstones |
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Acute Pancreatitis
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Mumps, Alcohol
Auto Digestion |
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Pancreatic Pseudocyst
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Chronic Pancreatitis
rotting mass NO hormone/enzyme no epithelial lining |
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Chronic Pancreatitis
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scaring
• Calcifications in ducts |
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Cystic fibrosis
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Can't move Cl-
• Thick mucus clogs ducts |
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Pancreatic Cancer
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• Adenocarcinoma - ductal epithelium
duct is compressed - bile stasis |
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Pancreatic Islet Cell Tumors
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endocrine, release too much hormones
• Zollinger-Ellison: gastrin • Glucagonomas: glucagon • VIPomas: increased peristalsis |
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Muscle cells Glucose receptor
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Glut 4
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