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DIT Hepatic Path
| Question | Answer |
|---|---|
| A young man with ataxia and tremors with brown pigmentation around his cornea. Tx? | penicillamine |
| Yellow skin but no scleral icterus | carotenemia |
| 20 yo gets influenza then idiopathic hyperbilirubinemia. What's the cause | Gilbert's |
| cholelithiasis | gallstones |
| cholecystits | inflammation of the gallbladder |
| cholangitis | inflammation of the biliary tree |
| choledocholithiasis | gallstones in the bile ducts |
| increases bilirubin prouction causing unconjugated hyperbilirubinemia | hemolytic anemia, SCA, hematoma breakdown |
| impaired bilirubin uptake and storage causing unconjugated hyperbilirubinemia | post viral hepatitis, drug rxn |
| decreases UDP-GT activity cause unconjugated hyperbilirubinemia | Gilbert's, crigler-najjar, neonatalness |
| impaired transport causing conjugated hyperbilirubinemia | dubin johnson, rotor |
| biliary epithelial damage causing conjugated hyper-br-emia | Hep, cirrhosis, liver failure |
| intrahepatic biliary obstruction causing conjugated hyper -br-emia | primary biliary cirrosis, sclerosing cholangitis, drugs |
| extrahepatic biliary obstruction cause conjugated hyper-br-emia | pancreatic neoplasm, pancreatitis, choledocholithiasis, cholangiocarcinoma |
| What happens to bilirubin after it is conjugated and secreted into the GI tract? | gut bacteria-->urobilinogen--->excretion in stool, urine, or reentry via liver |
| most common cause of acute RLQ pain | appendicitis |
| 50 yo female with pruritis without jaundice, lab reveals (+) AMA | primary biliary cirrhosis |
| most common cause of acut LLq pain | diverticulitis |
| gluten sensitivity | celiac |
| pt with GI bleeding has buccal pigmentation | peutz-jeughers |
| 60 y o female with rheumatoid arthritis and no alcohol history presents with fatigue and R abd pain, labs show high ANA and ASMA, eleveated IGG and no viral serological markers | a/i hep |
| colonoscopy shows friable mucosa from rectum to distal transverse colon | ulcerative colitis |
| sm intestinal mucosa with distended macrophages in LP that are filled with PAS+ granules and rod shaped bacilli seen by electron microscopy | whipple |
| most common cause of RUQ pain | cholecystitis |
| evelated LKM-1 abs, no alcohol history, no viral serology. infiltration of the portal and periportal area with lymphocytes | a/i hepatitis |
| diarrhea, fever, and abdominal cramps post antibiotics | pseudomembranous colitis |
| fatal disease of unconjugated bilirubin resulting from a complete lack of UDPGT activity | Crigler-Najjar type I |
| radiography reveals "string-sign" in the terminal ileum | Crohns |
| total or subtotal atrophy of the small bowel villi, plasma cells and lymphocyte infiltration into the LP and epithelium, and hyperplasia/elongation of crypts | Celiac |
| nonfatal disease of unconjugated bilirubin resulting from low levels of UDPGT activity | Gilberst or C/N type II |
| elevated levels of serum ferritin and increased transferrin saturation | hemochromatosis |
| alpha-fetoprotein levels>1000 pg/mL | hepatocellular carcinoma |
| elevated serum copper, decreased serum ceruloplasmin, and elevated 24 hr urinary copper | wilson's |
| liver disease + lung emphysema | alpha1antitrypsin deficiency |
| ERCP reveals alternating strictures and dilation | primary sclerosing cholangitis |
Created by:
kayjames
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