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Pathoma: Fundamentals of Pathology (2018) | Medicine (MD/DO) School Study Aid
Jaundice
- General
- Due To Elevated Conjugated Or Unconjugated Bilirubin
- Unconjugated
- Hemolysis
- Crigler-Najjar Or Gilbert's Syndrome
- Physiologic Jaundice Of Newborn
- Conjugated
- Biliary Obstruction From Stone Or Mass
- Cholangitis
- Dubin-Johnson And Rotor Syndrome
- Mixed
- Cirrhosis
- Hepatitis
5 mins
Bilirubin Lab Value
- 0.2-1.2 mg/dL
- Increased Bilirubin Causes Jaundice
54 secs
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
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
2 mins
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 Virus Characteristics
- Hepadnavirus
- Enveloped
- Circular
- Partially Double-stranded DNA
- Has Reverse Transcriptase
- IV Drug Use
- Sex
- Maternal Fetal Routes
- 3 Month Incubation Period
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 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 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
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
Liver Enzyme Tests: AST and ALT
- AST/ALT Ratio
- AST: 8-20 U/L
- ALT: 8-20 U/L
1 min
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
Complications of Cirrhosis
- Portal Hypertension
- Ascites
- Esophageal Varices
- Coagulation Defects
- Portal-Systemic Encephalopathy
- Hepatorenal Syndrome
1 min
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
Nonalcoholic Fatty Liver Disease
- Characteristics
- Fat Infiltration of Hepatocytes in Absence of Alcohol Consumption
- Obesity
- Hyperlipidemia
- Type II Diabetes
- Diagnosis
- Often Found Incidentally
- Elevated Liver Enzymes
- Ultrasound
- Treatment
- Weight Loss
- Abstinence From Alcohol
3 mins
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
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
Wilson's Disease Symptoms
- Cirrhosis
- Hepatocellular Carcinoma
- Basal Ganglia Degeneration
- Dementia
- Dyskinesia
- Asterixis
- Kayser-Fleischer Rings
- Slit Lamp Exam
- Hemolytic Anemia
2 mins
Primary Biliary Cholangitis (Primary Biliary Cirrhosis)
- Mechanism
- Autoimmune Destruction of Bile Ducts
- Intrahepatic bile ducts
- Cholestasis
- Occurs in Middle-Aged Females
- Signs and Symptoms
- Fatigue
- Pruritus
- Skin Hyperpigmentation
- Hepatomegaly
3 mins
Primary Biliary Cholangitis (Primary Biliary Cirrhosis) Diagnosis and Treatment
- Diagnosis
- Positive Antimitochondrial Antibodies
- Increased Alkaline Phosphatase (ALK-P)
- Increased Cholesterol
- Treatment
- Ursodiol
- Liver Transplant
2 mins
Primary Sclerosing Cholangitis Mechanisms
- Mechanism
- Unknown Mechanism
- "Onion Skin" Fibrosis
- "Beading" of Bile Ducts
- Symptoms
- Pruritus
- Hepatosplenomegaly
- Jaundice
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
2 mins
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
2 mins
Hepatocellular Carcinoma Characteristics and Presentation
- Characteristics
- Malignant Liver Cancer
- Risk Factors
- Cirrhosis
- Chronic Hepatitis B or C
- Aflatoxin
- Alcoholic and Nonalcoholic Liver Disease
- Presentation
- Clinical Findings of Cirrhosis
- Often Asymptomatic
- Jaundice
- Ascites
2 mins
Hepatocellular Carcinoma Diagnosis and Management
- DIAGNOSIS
- Increased AFP
- Ultrasound
- Abdominal CT or MRI
- MANAGEMENT
- Surgical Resection
- Transplantation
- Image-guided Procedures
- Surveillance
- CONSIDERATIONS
- Poor Prognosis
3 mins
Portosystemic Anastomoses
- Characteristics
- Portal Hypertension
- Anastomoses
- Left Gastric Vein - Esophageal Veins
- Esophageal Varices
- Paraumbilical Veins - Epigastric Veins
- Caput Medusae
- Superior Rectal Vein - Middle & Inferior Rectal Veins
- Anorectal Varices
2 mins
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