Hepato-Biliary Disorders Flashcards

Flashcards covering the pathophysiology, clinical manifestations, types of hepatitis, cirrhosis complications, and biliary disorders based on the lecture transcript.

Unconjugated (indirect) bilirubin

Formed from the breakdown of hemoglobin, this type of bilirubin is not water soluble and is transported in the blood with albumin.

Conjugated (direct) bilirubin

Bilirubin that has been processed in the liver by glucuronic acid to become water soluble, allowing it to be secreted in bile.

Hemolytic Jaundice

A condition resulting from hemolysis, sickle cell crisis, or transfusion reaction, characterized by elevated unconjugated bilirubin.

Hepatocellular Jaundice

Jaundice caused by damaged liver cells leaking conjugated bilirubin, often seen in hepatitis, cirrhosis, or liver cancer.

Cholestatic (Obstructive) Jaundice

Jaundice caused by the obstruction of bile flow, resulting in an elevation of conjugated bilirubin only and a lack of urobilinogen in the urine.

Alanine Aminotransferase (ALT)

A liver enzyme released from dead hepatocytes; it is used to monitor for liver injury such as drug toxicity or hepatitis.

Aspartate Aminotransferase (AST)

A liver enzyme that, when elevated, indicates liver injury or damage to hepatocytes.

Hepatitis A

A non-chronic viral liver infection transmitted via the fecal-oral route, often through contaminated food or water, and preventable by a two-shot vaccine series.

Hepatitis B

A blood-borne viral infection transmitted via body fluids, needle sharing, or perinatally; it is vaccine-preventable but becomes chronic in $5 ext{-}10$% of cases.

Hepatitis C

A blood-borne viral infection that is the leading cause of liver transplants, is not vaccine-preventable, and becomes chronic in $75 ext{-}85$% of cases.

Anti-HAV IgM

A serological marker that indicates an active or recent Hepatitis A infection.

HBsAg

Hepatitis B surface antigen, which signifies an active Hepatitis B infection.

Anti-HBs

An antibody indicating immunity to Hepatitis B, acquired either naturally or through vaccination.

HCV RNA

A test that measures the Hepatitis C viral load to confirm an active infection.

Cirrhosis

A chronic, progressive condition involving the destruction of liver cells and subsequent fibrosis, leading to obstructed bile and vascular flow.

Portal Hypertension

Elevated pressure in the portal circulation caused by distorted sinusoidal architecture, contributing to esophageal varices and ascites.

Esophageal Varices

Enlarged veins at the base of the esophagus that are at high risk of bleeding, which has a high mortality rate.

TIPS Procedure

Transjugular Intrahepatic Portosystemic Shunt; an interventional radiology procedure that redirects blood flow from the portal vein to the hepatic vein to treat portal hypertension.

Ascites

The abnormal accumulation of fluid in the peritoneal cavity, caused by factors such as portal hypertension and hypoalbuminemia.

Spironolactone (Aldactone®)

A diuretic medication used in the management of ascites to help fluid balance.

Coagulopathy

A condition in liver dysfunction characterized by decreased clotting factor synthesis (increased PT/INR) and thrombocytopenia due to splenomegaly.

Hepatic Encephalopathy

A neuropsychiatric condition where toxins like ammonia cross the blood-brain barrier because they are not detoxified by the liver.

Asterixis

Often called 'liver flap,' this is a clinical manifestation of hepatic encephalopathy involving a flapping tremor of the hands.

Lactulose

A treatment for hepatic encephalopathy that traps ammonia in the gut and increases its excretion.

Cholelithiasis

The clinical term for gallstones, which are typically composed of cholesterol.

Biliary Colic

Sharp, localized RUQ pain that may radiate to the right shoulder, occurring after eating fatty foods due to transient cystic duct obstruction.

Cholecystitis

Infection and inflammation of the gallbladder, often indicated by a positive Murphy's sign and persistent RUQ pain.

Murphy’s sign

A physical exam finding where the patient experiences pain and stops breathing during inspiration while the gallbladder is being palpated, indicating cholecystitis.

Kupffer cells

Specialized cells in the liver that perform phagocytosis to remove debris and pathogens.