Gi: For Test Ii Part B

Front 1

if the biliary system is obstructed, production of urobiligen and stercobilinogen is prevented causing...?

Back 1

stool is light and urine is dark showing bilirubin

Front 2

increased serum unconjugated bilirubin, impaired hepatic uptake + jaundice in stress, benign is indicitive of?

Back 2

gilbert's & certain drugs; rifampin

Front 3

increase in serum unconjugated serum bilirubin, genetic + impaired conjugation

Back 3

gilbert's or crigler-Najjar syndrome, drug inhibitions: anabolic steroids

Front 4

increased alk phos x 3 or x 4 normal values is indicitive of ??

Back 4

cholestatic jaundice

Front 5

hx of pale stools + pruritis + nausea is indicitive of...

Back 5

gallstones= biliary obstruction

Front 6

5-10 fold increase of transaminases (ast/alt) and > 2-3x normal alk phos is indicitive labs of???

Back 6

biliary obstruction

Front 7

> 10-15 fold increase in transaminases (ALT/AST) and < 2-3x normal alk phos is indicitive of???

Back 7

hepatocellular disease

Front 8

what is the diagnostic procedure of choice to determine extra hepatic obstruction?

Back 8

CT or US: stone or dilitation

Front 9

what is the diagnostic procedure of choice to manage and treat bile duct dilitation?

Back 9

ERCP: endoscopic retrograde cholangiography

Front 10

what are the 3 main complications with hepatitis?

Back 10

1.massive hepatic necrosis
2.chronic hepatitis
3.cholestatic hepatitis syndr.

Front 11

what is the MC cause of hepatitis?

Back 11

virus

Front 12

22 y/o female presents with fever, malaise, N/V, (exudative)sore throat and lymphadenopathy, HA what is the most likely dx?

Back 12

mono. after R/O preg

Front 13

what medication is never given to a mono patient?

Back 13

AMPICILLIN: causes maculopular rash

Front 14

what are the 4 hallmark signs of MONO?

Back 14

fever
exudative pharyngitis
lymphadenopathy
splenomegaly

Front 15

what are some additional complications with MONO?

Back 15

bacterial pharyngitis
upper airway obstruction
Bells Palsy
ruptured spleen

Front 16

what virus presents similarly to MONO with out pharyngitis or respiratory symptoms, more common in transplant or AIDS patients?

Back 16

cytomegalic virus CMV

Front 17

if mono test is neg in a patient you suspect to be pos, what will you do next?

Back 17

CMV titer

Front 18

patient presents with malaise, fever and abdominal pain. you notice jaundice and palpate hepatosplenomegaly. patient just returned from a foreign country where she was eating clams every day...what is high on your diff dx?

Back 18

Hep A

Front 19

what is the first virologic marker detectable in serum in acute HBV infection?

Back 19

HBsAg

Front 20

which serological marker is not detectable in serum?

Back 20

HBcAg

Front 21

what serious manifestation are patients dx with Hep B more likely to develop?

Back 21

hepatocellular carcinoma

Front 22

which viral hepatitis is associated with blood transfusions 85% of the time?

Back 22

hep c

Front 23

a finding of a liver biopsy, common in alcoholics that is an accumulation of iron in the lungs?

Back 23

hemosiderosis

Front 24

Mainly a disease of young women
Most have hypergamaglobulinemia & ANA positive

Back 24

chronic autoimmune hepatitis

Front 25

Consider any young female with elevated liver function studies without course with hepatitis for greater than 6 months
Positive ANA
Elevated GG =means chronic
Liver biopsy showing chronic inflammation to have what disease????

Back 25

chronic/autoimmune hepatitis

Front 26

what is the most reliable indicator of active viral replication?

Back 26

HBV DNA

Front 27

this serological test results signifies that the virus is actively replicating, it is the most acute phase, most likely to be transmitted?

Back 27

the envelope= HBeAg

Front 28

after replication, when the virus is in the system indefinetely, it will show on serological testing as what?

Back 28

Anti HBe

Front 29

the triad of necrosis, regenerating nodules and fibrosis is indicitive of?

Back 29

cirrhosis

Front 30

a metabolic disorder that affects the basal ganglia, eyes and kidney. there is an abnormal accumulation of copper in the hepatocytes. serum ceruloplasm is low and therefore cu cannot be carried?

Back 30

wilson's disease

Front 31

a hereditary disease characterized by improper processing by the body of dietary iron which causes iron to accumulate in a number of body tissues, eventually causing organ dysfunction. It is the main iron overload disorder.

Back 31

haemochromatosis

Front 32

this syndrome is seen in the pediatric age group associated with the flu, and asa...increasing drowsiness, belly pains.

Back 32

reye's syndrome

Front 33

in teenages and adults, this is a progressive liver disease with pulmonary manifestations, due to the deficiency of a potent protease inhibitor found in the serum, body fluids and tissues

Back 33

alpha 1- antitrypsin deficiency

Front 34

acute severe impairment of liver function with encephalopathy and coma in patients who have had liver disease for less than 8 weeks and causes liver failure

Back 34

fulminant liver failure

Front 35

what physical manifestations are seen on a patient with liver failure (chronic) esp on the arms?

Back 35

CLAPS:
Clubbing
Leukonychia
Asterixis
Palmar Erythema
Stretch marks

Front 36

what are some precipitating factors for hepatic encephalopathy?

Back 36

HEPATICS:
Hemorrhage in GIT/Hyperkalemia
Excess protein in diet
Paracentesis
Acidosis/Anemia
Trauma
Infection
Colon Sx
Sedatives

Front 37

a metabolic disorder of the CNS and neuromuscular system with slight changes in the brain (edema) with clinical manifestations such as confusion, asterixis, drowsiness and coma --> death CAUSED by elevated levels of NH3?

Back 37

hepatic encephalopathy

Front 38

Kayser-Fleischer ring

Back 38

Wilson's Disease

Front 39

an obese 48 Y/O patient who has had multiple incidences of vaginitis, presents with a global darkening of her skin color. the patient was previously on Atkins diet, but denies any abnormal eating habits now. what do you recc?

Back 39

patient has Bronze diabetes or primary hemochromatosis.
this requires early phlebotomy to improve survival...primary tx is INSULIN

Front 40

classic triad indicating liver disease?

Back 40

1. skin pigmentation
2. cirrhosis
3, DM

Front 41

an uncommon condition induced by thrombotic or nonthrombotic obstruction to hepatic venous outflow?

Back 41

budd-chiari syndrome

Front 42

what are some causes of hepatic cirrhosis?

Back 42

HEPATIC
Hemochromocytosis
Enzyme Deficiency (alpha 1 anti-trypsin)
Post hepatic (infection+drug)
Alcoholic
Tyrosinosis
Indian childhood (galactosemia)
Cardiac/Cholestatic(biliary)/ Cancer/Copper (wilson's)

Front 43

common causes of cirrhosis?

Back 43

ABC
alcohol
B (hep)
C (hep)

Front 44

very rare causes of cirrhosis?

Back 44

ABC!!
autoimmune
biliary cirrhosis
copper (wilson's)