Nbde Microbiology/pathology Lv Dis

Front 1

What is the most common cause of portal hypertension?

Back 1

Cirrhosis

Front 2

Abnormally high blood pressure in the portal vein, the large vein that brings blood from the intestine to the liver.

Back 2

Portal hypertension

Front 3

How is portal hypertension often classified?

Back 3

By the site of portal venous obstruction

Front 4

Caused by portal and splenic vein obstruction, most often by thrombosis

Back 4

Prehepatic Portal Hypertension

Front 5

Caused by intrahepatic vascular obstruction, most often by cirrhosis or metastatic tumor, and more rarely by _____.

Back 5

Intrahepatic Portal hypertension
Schistosomiasis (parasitic infection)

Front 6

Caused by venous congestion in the distal hepatic venous circulation, most often as a result of constrictive pericarditis tricuspid inefficiency, congestive heart failure, or hepatic vein occlusion (Budd Chiari Syndrome)

Back 6

Posthepatic Portal Hypertentsion

Front 7

What two factors can increase blood pressure in the portal veins?

Back 7

1. Volume of blood going through vessels
2. Increased resistance to blood flow through the liver

Front 8

What is the most common cause of portal hypertension?

Back 8

Increased resistance to blood flow in the liver caused by cirrhosis (alcoholics)

Front 9

What are the classic complications of portal hypertension?

Back 9

Esophageal varices
Splenomegaly
Ascites

Front 10

What is considered by some to be the single most important sign of portal hypertension?

Back 10

Splenomegaly

Front 11

What is often the first sign of portal hypertension?

Back 11

Bleeding from esophageal varices (dilated tortuous veins in the submucosa of the lower esophagus)
Coughing up of blood (Hemoptysis)

Front 12

What is one of the most common causes of death in patients with cirrhosis associated with portal hypertension?

Back 12

Upper GI hemorrhage from bleeding esophageal varices

Front 13

A columnar metaplasia of the esophageal epithelium that occurs with chronic reflux

Back 13

Barrett's Esophagus

Front 14

What can be associated with esophageal webs and is also called plummer-vision syndrome and is rare?

Back 14

Iron deficiency anemia

Front 15

Clinically the first evidence of _____ is an increase in abdominal girth accompanied by weight gain.

Back 15

Ascites

Front 16

A detectable collection of free fluid in the periosteal cavity. Almost pure plasma and contains large amounts of protein.

Back 16

Ascites

Front 17

What are the two important factors relating to the formation of ascites?

Back 17

1. Increase in total body sodium and water
2. Increased sinusoidal portal pressure

Front 18

What disease is the most common cause of ascites

Back 18

Liver disease

Front 19

What are the disorders that can be associated with ascites?

Back 19

Cirrhosis
Hepatitis
Portal V. Thrombosis
Constructive Pericarditis
Congestive heart failure
Liver Cancer
Nephrotic Syndrome
Pancreatitis

Front 20

End stage renal disease in which the normal hepatic architecture is destroyed and replaced by bands of fibrous scar tissue. 75% of cases are caused by alcoholism.

Back 20

Cirrhosis of the liver

Front 21

What are the signs and symptoms of cirrhosis of the liver?

Back 21

Ascites
Splenomegaly
Sudden upper GI bleeding
vomiting blood
Jaundice

Front 22

What kind of angiomas are common in alcoholics?

Back 22

Spider angiomas

Front 23

Jaundice is not an illness, but a medical condition in which too much _____ is circulating in the blood.

Back 23

Bilirubin

Front 24

Where does bilirubin dissolve in jaundice?

Back 24

Subcutaneous fat
Causes yellow skin and eyes

Front 25

All cases of jaundice indicate overload or damage to the liver, or inability to move bilirubin from the liver through the biliary tract to the gut except what?

Back 25

Newborn jaundice
1st week of life
normal

Front 26

What are the common causes of jaundice?

Back 26

1. Increased destruction of RBC's with rapid bilirubin release into blood
2. Obstruction of the bile ducts or damaged liver cells keeping bilirubin from excreting into GI tract

Front 27

What is bilirubin the chief component of?

Back 27

Bile

Front 28

Formed by the conjugation of bilirubin with glucuronic acid.

Back 28

Conjugated bilirubin

Front 29

What is the important characteristic of Free bilirubin?

Back 29

Unbound and toxic

Front 30

High levels of bilirubin causing damage to the brain of newborn infants.
Can result in a characteristic form of crippling called _____ _____ _____.

Back 30

Kernicterus
Athetoid Cerebral Palsy

Front 31

About 80% of people with hepatocellular carcinomas have what?

Back 31

Cirrhosis

Front 32

A cancer that arises from hepatocytes, the major cell of the liver.

Back 32

Hepatocellular carcinoma

Front 33

What increases the risk of developing hepatocellular carcinoma?

Back 33

Hep B and Hep C
Also Aflatoxins

Front 34

Produced by a mold that is a contaminant of nuts (peanuts), grains, and beans

Back 34

Aflatoxins

Front 35

What is a viral hepatitis that was not caused by the type A or type B virus called?

Back 35

non-A, non-B Hepatitis

Front 36

What other viruses can cause non-A and non-B virus infections?

Back 36

Hep C
Hep D
Hep E

Front 37

What is the most common reason for liver transplant in the US?

Back 37

Hep C

Front 38

Serum hepatitis that is caused by a virus antigenically different from Hep A and Hep B. Most cases of post-transfusion hepatitides are of this type. Usu. much milder than A and B but is otherwise clinically indistinguishable from them.

Back 38

Hep C

Front 39

Which form of hepatitis has a higher incidence of chronic disease, cirrhosis, and hepatocellular carcinoma?

Back 39

Hep C

Front 40

Requires coinfection with Hep B. Drug addicts are at relatively high risk.

Back 40

Hep D

Front 41

Transmitted enterically, much like Hep A. A common sporadic cause of viral Hepatitis in _____. Close to 20% mortality in pregnant women.

Back 41

Hep E

Front 42

Which of the hepatitis forms does not develop into chronic hepatitis or cirrhosis?

Back 42

Hep A

Front 43

Highly contagious infectious disease of the liver. Usually transmitted by fecal-oral route. May also be transmitted parenterally as can _____ _____. Usually a result from ingestion to contaminated food, milk, or water. Many outbreaks are from ingestion of seafood and polluted water.

Back 43

Hep A
Hep B and Hep D

Front 44

In what individuals does Hep A most often occur in?
What are the initial symptoms?

Back 44

Young Adults
Fever, malaise, abdominal pain, anorexia, jaundice

Front 45

When do the symptoms of Hep A usually occur?

Back 45

Incubation period of 3-6 weeks
Complete resolution in most cases

Front 46

There is _____ _____ of HAV with either cirrhosis or hepatocellular carcinoma, as there is for _____ and _____.

Back 46

No Association
Hep B
Hep C

Front 47

How is Hep B transmitted?

Back 47

Parenteral and sexual contact

Front 48

What are the risk factors for Hep B?

Back 48

Mult. Sex partners
IV drug abuse
Receipt of blood

Front 49

What are the signs and symptoms of Hep B?
What is the incubation period?

Back 49

Similar to Hep A
Longer incubation period 6-8 weeks
Symptoms slower/ Duration longer

Front 50

Most patients recover fully from Hep B, but what can they develop if they don't?

Back 50

Chronic liver disease

Front 51

What is an indication of hepatocellular damage?

Back 51

Increased serum transamines

Front 52

What does the presence of the surface A or B antigen in a patient's serum indicate ?

Back 52

Patient is potentially infectious for Hep (carrier state)

Front 53

Hepatitis virus is very _____ _____.
More so than _____ _____.

Back 53

Hepatitis Virus
AIDS Virus

Front 54

Cirrhosis is twice as common in _____.

Back 54

Men

Front 55

Characterized anatomically by widespread nodules in the liver combined with fibrosis, the formation of which causes distortion of the normal liver architecture which interferes with blood flow through the liver.

Back 55

Cirrhosis

Front 56

At what ages is cirrhosis the third most common cause of death behind heart disease and cancer?

Back 56

45-65

Front 57

What are the causes of cirrhosis?

Back 57

Alcohol abuse 9Most common)
Chronic viral Hep B,C, and D
Inherited metabolic diseases
Chronic Bile Duct Diseases
Chronic Congestive Heart Failure
Parasitic Infections
Nonalcoholic Steatohepatitis
Long term exposure to toxins and drugs

Front 58

What can men often develop when they have liver cirrhosis?

Back 58

Gynecomastia from increased production of estrogen

Front 59

Flapping Tremor

Back 59

Tremor common from liver disease

Front 60

Small lesions on the skin containing a centrally dilated, enlarged, blood vessel from which several smaller vessels radiate.

Back 60

Spider Angiomas (Spider telanglectasias