Path Exam 3 Winter Flash Cards

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Title: Path Exam 3 Winter
Description: Liver and all that goes with it
Number of Cards: 36
Save Count: 0
Author: moberst7
Created: 2012-01-26
Tags: pathology
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    • Question
    • Answer
    • Side 3
    • What are the functions of hepatocytes?
    • Manufactures proteins: albumin, procoagulants, complement, etc
      conjugates bilirubin
      forms BUN from NH3
    • What are the functions of bile ducts?
    • excretion of bilirubin, bile salts, cholesterol
      Produces enzymes: alk phos, GGT
    • What is LDH?
    • nonspecific marker for necrosis of multiple cell types
      May be elevated in hepatocellular necrosis
    • What do the LFT's look like in a space occupying lesion of the liver?
    • LDH increased
      Alk Phos increased
      Minimal/no other abnormalities
    • What kind of bilirubin increases in obstructive phenomena?
    • DIRECT (conjugated) bilirubin
    • What kind of bilirubin is found in the urine?
    • only direct (conjugated) bilirubin in excreted in the urine
    • What causes elevated urinary bilirubin?
    • periportal swelling: hepatitis
      obstructed biliary tract
      hereditary direct hyperbilirubinemia (Rare) (Dubin Johnson, Rotor Syndrome)
    • What is Alkaline phoshatase?
    • plasma membrane enzyme from damaged bile caniculi
    • What is Crigler-Najjar Syndrome Type I?
    • Absent UGT1A1 activity leading to unconjugated hyperbilirubinemia. Fatal in neonatal period due to kernicterus within 18 mos of birth
    • What is Crigler-Najjar Syndrome Type II?
    • Decreased UGT1A1 activity. Causing unconjugated hyperbilirubinemia. Generally mild, occasional kernicterus. Very yellow skin
    • What is Gilbert Syndrome?
    • Decreased UGT1A1 activity. Mild fluctuating unconjugated hyperbilirubinemia. Innocuous. Unnoticed for years but detected during periods of stress.
    • What is Dubin-Johnson Syndrome?
    • Conjugated hyperbilirubinemia. Impaired biliary excretion of bilirubin glucuronides due to mutation in canalicular multidrug resistance protein 2 (MRP2). Pigmented cytoplasmic globules, epinephrine metabolites. Innocuous.
    • What is Rotor Syndrome?
    • Conjugated hyperbilirubineima. Decreased hepatic uptake, storage and biliary excretion. Innocuous. Jaundice but otherwise normal.
    • What are the causes of Decreased BUN?
    • severe liver disease
      low protein diets (vegans)
    • What are the causes of increased BUN?
    • renal disease
      catabolism (ex: DM)
      GI hemorrhage
    • What is BUN?
    • blood urea nitrogen
      formed in the liver
    • What kind of liver failure does acetominophen cause?
    • Submassive Zone 3 liver cell necrosis
    • How do you treat acetominophen overdose/
    • N-acetylcysteine within 12 hours of overdose. - restores GSH
    • What is the classic triad present in late hemochromatosis?
    • pigment cirrhosis of the liver with hepatomegaly
      Diabetes Mellitus
      Skin pigmentation
    • What is the key test for asymptomatic hereditary hemochromatosis?
    • % saturation of iron in blood
    • What is Banti Syndrome?
    • subclinical neonatal portal vein occlusion with late splenomegaly, varices, and ascites
      Causes:
      - umbilical vein cathaterization as neonate, omphalitis
    • What is Peliosis hepatitis?
    • primary dilation of the sinusoids
      caused by anabolic steroids (rarely, OCP's danazol)
    • What is Budd-Chiari syndrome?
    • Hepatic vein thrombosis: obstruction of two or more major hepatic veins
    • What is the association of veno-occlusive disease?
    • Bone marrow transplant
    • What is the signature morphology of Schistosomiasis?
    • pipe-stem fibrosis
    • What is pancreas divisum?
    • incomplete pancreatic duct fusion, most secretions drain through small stenotic pancreatic ducts via minor papillae. Predisposes to chronic, recurrent pancreatitis
    • What is annular pancreas?
    • the second part of the duodenum is surrounded by a ring of pancreatic tissue continuous with the head of the pancreas. This portion of the pancreas can constrict the duodenum and block or impair the flow of food to the rest of the intestines: Gastric distention and vomiting
    • What 2 diseases are associated with true cysts of the pancreas?
    • polycystic kidney disease
      von Hippel Lindau disease
    • What are the 5 features of preeclampsia?
    • Maternal HTN
      Proteinuria
      Peripheral edema
      Coagulation abnormal
      DIC
    • What additional features make eclampsia?
    • Preeclampsia + hyperreflexia & convulsions
    • What does HELLP stand for?
    • Hemolysis
      Elevated liver enzymes
      Low Platelets
    • What type of injury results from revascularization and perfusion of donor liver?
    • preservation injury
    • What are the 4 major etiologic associations for HCC?
    • Non-alcoholic steatosis
      viral infection (HCV, HBV)
      Chronic alcoholism
      Food contaminants (aflatoxins)
    • What is the variant of HCC with a better prognosis? In whom does it occur?
    • Fibrolamellar variant
      Young males/females (20-40) no association with HBV, cirrhosis
    • What does a strawberry gallbladder refer to?
    • cholesterolosis - mucosal surface studded with minute, yellow flecks.
    • What are Rokitansky-Aschoff Sinuses?
    • outpouchings of mucosal epithelium through the wall in the gallbladder