Chiamaka Shared "Clin Med final " - 27 Picmonics
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Clin Med final
Hemochromatosis Pathophysiology
- Pathophysiology
- Hemosiderin Deposition
- Autosomal Recessive
- HLA-A3
- Secondary to Transfusion Therapy
- Increase Iron
- Increase Ferritin
- Increased Transferrin Saturation
2 mins
Hemochromatosis Signs and Symptoms
- Signs and Symptoms
- Micronodular Cirrhosis
- Hepatocellular Carcinoma
- Diabetes
- Bronze Skin Coloring
- CHF
- Arthropathy
- Testicular Atrophy
- Impotence
2 mins
alpha-1-anti-trypsin
- PAS-positive
- Resist Diastase
- Co-dominant
- Cirrhosis
- Emphysema
- Polymerization of AAT
- Misfolding
Wilson's Disease Symptoms
- Cirrhosis
- Hepatocellular Carcinoma
- Basal Ganglia Degeneration
- Dementia
- Dyskinesia
- Asterixis
- Kayser-Fleischer Rings
- Slit Lamp Exam
- Hemolytic Anemia
2 mins
Wilson's Disease Pathophysiology
- Autosomal Recessive
- Mutation in ATP7B gene
- Chromosome 13
- Decrease in Ceruloplasmin
- Inadequate copper excretion
- Liver
- Brain
- Kidney
- Cornea
- Joints
- Treat with Penicillamine
2 mins
Gilbert's Syndrome
- Pathophysiology
- Decreased UDP-Glucuronosyltransferase Activity
- Decreased Bilirubin Conjugation
- Signs and Symptoms
- Often Asymptomatic
- Jaundice (Mild)
- Fasting
- Stress
- Alcohol Intake
- Labs
- Increased Unconjugated Bilirubin
2 mins
Crigler-Najjar Syndrome Type 1
- Pathophysiology
- Autosomal Recessive
- Absent UDP-glucuronosyltransferase
- Symptoms
- Neonatal Jaundice
- Kernicterus
- Diagnosis
- Normal Liver Function Tests
- Elevated Unconjugated Bilirubin
- Treatment
- Phototherapy
- Plasmapheresis
- Calcium Phosphate and Orlistat
- Death often by Age 2
- Considerations
- No Response to Phenobarbital
3 mins
Dubin Johnson Syndrome (with Audio)
- Pathophysiology
- defective hepatocyte secretion in to proper canal
- Autosomal recessive- "hereditary conjugated hyperbilirubinemia"
- Absent MRP2 (multidrug resistant protein)
- Error is inside the hepatocyte.... NOT due to a clogged bile duct
- Signs/symptoms
- Liver changes from Brown to Black
- Jaundiced (otherwise asymptomatic)
- labs
- Conjugated hyperbilirubinemia
- Treatment
- NO excess urinary coproporphyrins
- no treatment necessary (benign disease)
6 mins
Dubin Johnson syndrome and Rotor syndrome
- Autosomal recessive
- Increased Conjugated Bilirubin
- Dubin -johnson syndrome
- defective liver excretion
- deficiency of bilirubin canalicular transport protein
- black liver
- coarse pigmented granules
- develop episodes of jaundice
- in the context of a trigger (illness, prego, OCP)
- Rotor syndrome
- milder in presentation
- without black liver
- impaired hepatic uptake and excretion
- Jaundice
Rotor's Syndrome
- Autosomal Recessive
- Normal Liver
- High Urine Coproporphyrin
- Jaundice
- Increased Conjugated Bilirubin
- Dysfunction of SLCO1B Genes for Blood Bilirubin Uptake Protein
Cirrhosis Assessment
- Mechanism
- Degeneration and Destruction of Liver Cells
- Signs and Symptoms
- Jaundice
- Fatigue
- Palmar Erythema
- Spider Angiomas
- Hepatosplenomegaly
- Edema
- Gynecomastia
- Change in LOC
2 mins
Cirrhosis Interventions
- Interventions
- Maintain Nutrition
- Paracentesis
- Esophageal and Gastric Varices
- Drug Therapy
- Endoscopic Band Ligation or Sclerotherapy
- Balloon Tamponade
- Transjugular Intrahepatic Portosystemic Shunt (TIPS)
- Hepatic Encephalopathy
- Lactulose
- Antibiotics
2 mins
Complications of Cirrhosis
- Portal Hypertension
- Ascites
- Esophageal Varices
- Coagulation Defects
- Portal-Systemic Encephalopathy
- Hepatorenal Syndrome
1 min
Hepatitis A (HAV) Assessment
- Transmission
- Fecal-Oral
- Ingestion of Contaminated Food or Water
- Incubation
- 4 Weeks
- Assessment
- Fever
- General Malaise
- Hepatomegaly
- Considerations
- Self-Limiting
- Proper Hand Washing
2 mins
Hepatitis B (HBV) Assessment
- Transmission
- Bodily Fluids
- Blood Transmission
- People Who Use IV Drugs
- Incubation
- Variable 1-6 Months
- Assessment
- Fever
- Nausea and Vomiting
- Hepatomegaly
- Chronic Disease
- Cirrhosis
- Hepatocellular Carcinoma
- Considerations
- Vaccination
2 mins
Hepatitis B Virus Disease
- Can turn chronic
- < 10% of adults become chronic carriers
- 90% of newborns become chronic carriers
- Cirrhosis
- Hepatocellular carcinoma
- Membranous Glomerulonephritis
- Polyarteritis nodosa
- Serum sickness like syndrome
2 mins
Hepatitis C (HCV) Assessment
- Transmission
- Blood Transmission
- High Risk Sex (rare)
- IV Drug Users
- Incubation
- 7 Weeks
- Chronic Disease
- Cirrhosis
- Considerations
- Barrier Protection
2 mins
Budd-Chiari Syndrome
- Causes
- Pregnancy and Postpartum
- Hematologic Disorders
- Tumors
- Chronic Infections
- Mechanism
- Thrombosis of Major Hepatic Veins
- Centrilobular Congestion and Necrosis
- Symptoms
- Abdominal Pain
- Ascites
- Hepatomegaly
- Nutmeg Liver
3 mins
Hepatocellular carcinoma/hepatoma
- Most common 1° malignant tumor of liver in adults
- Associated with HBV (+/− cirrhosis) and all other causes of cirrhosis (including HCV, alcoholic and nonalcoholic fatty liver disease, autoimmune disease, hemochromatosis, α1-antitrypsin deficiency (A1AT deficiency), and Wilson Disease).
- Related to specific carcinogens (eg, aflatoxin from Aspergillus). These toxins induce p53 mutations.
- May lead to Budd-Chiari syndrome and Anemia of Chronic Disease.
- Findings:
- Jaundice, tender hepatomegaly, ascites, polycythemia, anorexia.
- Spreads hematogenously.
- Diagnosis
- Increased α-fetoprotein (AFP); ultrasound or contrast CT/MRI, biopsy.
Primary Sclerosing Cholangitis Mechanisms
- Mechanism
- Unknown Mechanism
- "Onion Skin" Fibrosis
- "Beading" of Bile Ducts
- Symptoms
- Pruritus
- Hepatosplenomegaly
- Jaundice
2 mins
