Anthony Shared "PathII-Liver" - 17 Picmonics

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PathII-Liver

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
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3 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
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2 mins
Hepatitis A
Characteristics
Picornavirus
4 Week Incubation Period
Fecal-oral
Day Care Centers
Travel to Developing Countries
Signs and Symptoms
Usually Asymptomatic
Acute Disease
Jaundice
Fever
Vomiting
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2 mins
Hepatitis B Virus Characteristics
Hepadnavirus
Enveloped
Circular
Partially Double-stranded DNA
Has Reverse Transcriptase
IV Drug Use
Sex
Maternal fetal routes
3 month incubation period
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2 mins
Hepatitis C
Characteristics
Enveloped
RNA Virus
Flavivirus
Icosahedral
SS positive Linear
Clinical Features
Most Cases are Due to IV Drug Use
Turns to Chronic Hepatitis in Over 70% of Cases
Cirrhosis
Hepatocellular Carcinoma
Most Common Indication for Liver Transplantation
Associated With Type I MPGN
Porphyria Cutanea Tarda
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2 mins
Primary Biliary Cholangitis (Primary Biliary Cirrhosis)
Mechanism
Autoimmune Destruction of Bile Ducts
Intrahepatic
Cholestasis
Occurs in Middle-Aged Females
Signs and Symptoms
Fatigue
Pruritus
Skin Hyperpigmentation
Hepatomegaly
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3 mins
Complications of Cirrhosis
Portal Hypertension
Ascites
Esophageal Varices
Coagulation Defects
Portal-Systemic Encephalopathy
Hepatorenal Syndrome
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Primary Biliary Cholangitis (Primary Biliary Cirrhosis) Diagnosis and Treatment
Diagnosis
Positive Antimitochondrial Antibodies
Increased Alkaline Phosphatase (ALK-P)
Increased Cholesterol
Treatment
Ursodiol
Liver Transplant
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2 mins
Wilson's Disease Symptoms
Cirrhosis
Hepatocellular Carcinoma
Basal Ganglia Degeneration
Dementia
Dyskinesia
Asterixis
Kayser-Fleischer Rings
Slit Lamp Exam
Hemolytic Anemia
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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
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2 mins
Hemochromatosis Signs and Symptoms
Signs and Symptoms
Micronodular Cirrhosis
Hepatocellular Carcinoma
Diabetes
Bronze Skin Coloring
CHF
Arthropathy
Testicular Atrophy
Impotence
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2 mins
Clonorchis Sinensis
Pathophysiology
Trematode (Fluke)
Undercooked Fish
Biliary Tract Inflammation
Pigmented Gallstones
Associated with Cholangiocarcinoma
Treatment
Praziquantel
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Reye's Syndrome
Cause
Aspirin (Salicylates) to Treat Viral Illness (In Children)
Assessment
Cerebral Edema
Lethargy (Decreased LOC)
Vomiting
Liver Failure
Interventions
Monitor for Increased ICP
Mannitol (Osmitrol)
Considerations
No Aspirin for Children
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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
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3 mins
Liver Enzyme Tests: AST and ALT
AST/ALT Ratio
AST: 10-30 U/L
ALT: 10-40 U/L
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1 min
Primary Sclerosing Cholangitis Mechanisms
Mechanism
Unknown Mechanism
"Onion Skin" Fibrosis
"Beading" of Bile Ducts
Symptoms
Pruritus
Hepatosplenomegaly
Jaundice
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2 mins
Primary Sclerosing Cholangitis Labs and Treatment
Labs
Increased Conjugated Bilirubin
Increased ALK-P
Increased IgM
Associated Pathologies
Ulcerative Colitis
Cholangiocarcinoma
Secondary Biliary Cirrhosis
Treatment
Liver Transplant
Stent
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2 mins

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