Liver, Gallbladder, and Pancreas Diseases

Comprehensive vocabulary flashcards reviewing the anatomical, physiological, pathological, and diagnostic concepts of liver, biliary tree, and pancreatic diseases.

Dual Blood Supply of the Liver

The vascular inflow system supplying the liver (which weighs $1.4\text{--}1.6\,\text{kg}$), consisting of both the hepatic artery and portal vein.

Steatosis

The abnormal accumulation of toxic fatty products within hepatocytes as a cellular response to liver injury.

Cholestasis

The systemic or hepatic accumulation of bilirubin and other bile solutes resulting from impaired bile secretion or obstruction of bile flow.

Serum Aminotransferases (AST and ALT)

Cytosolic hepatocellular enzymes whose serum elevation indicates acute hepatocyte damage resulting from ischemia, toxic exposure, or viral hepatitis.

AST:ALT Ratio in Cirrhosis

A laboratory ratio that may become $>1$ because cytosolic ALT leaks easily upon early damage, whereas mitochondrial AST is released as hepatocytes undergo complete cellular destruction and are replaced by fibrous scar tissue.

Alkaline Phosphatase (ALP) and GGT

Plasma membrane enzymes located in the bile canaliculus whose elevation in the blood specifically signifies biliary canalicular damage and obstruction of bile flow.

Direct Bilirubin Elevation

A high concentration of water-soluble conjugated bilirubin in the serum, which indicates that the liver is functionally conjugating bilirubin but an obstruction to bile excretion is present.

Jaundice (Icterus)

Yellow discoloration of tissue caused by excess serum bilirubin levels exceeding $>2.0\,\text{mg/dL}$; hemolytic anemias represent the number one cause worldwide.

Cirrhosis

A severe end-stage liver condition characterized morphologically by diffuse, nodular regeneration bounded by bridging fibrous septa; it ranks among the top 10 causes of adult death in the US.

Ascites

The accumulation of serous fluid within the peritoneal cavity caused by portal hypertension, decreased albumin synthesis, and altered vascular pressures in cirrhosis.

Esophageal Varices

Dilated collateral veins forming in the submucosa of the esophagus due to portal hypertension that bypass the scarred liver to reach the caval system, presenting a severe risk of fatal rupture.

Spider Angiomas

Vascular skin lesions characterized by central arterioles with radiating capillaries that develop in patients with chronic liver failure and cirrhosis.

Hepatitis A Virus (HAV)

A benign, self-limited RNA virus transmitted via the fecal-oral route through contaminated food and water, having an incubation period of $2\text{--}6\,\text{weeks}$ and no chronic disease or carrier state.

Hepatitis B Virus (HBV)

A parenteral and sexually transmitted DNA virus with an incubation period of $4\text{--}26\,\text{weeks}$; roughly $90\%$ of cases resolve spontaneously while $5\%\text{--}10\%$ progress to chronic hepatitis.

Hepatitis C Virus (HCV)

An RNA virus spread by parenteral or sexual contact that progresses to chronic hepatitis in $85\%$ of cases due to genomic instability, which also precludes vaccine development.

Fulminant Hepatitis

A severe form of acute hepatitis defined by massive hepatocyte necrosis leading rapidly to acute liver failure, often requiring liver transplantation to avoid death.

Chronic Hepatitis

Hepatic inflammation associated with abnormal liver function persisting for $>6\,\text{months}$, histologically characterized by portal tract inflammation and progressive fibrosis.

Alcoholic Liver Disease

A spectrum of alcohol-induced hepatic disorders accounting for $60\%$ of chronic liver disease, manifesting in three main features: hepatic steatosis, alcoholic hepatitis, and cirrhosis.

Mallory Bodies

Eosinophilic cytoplasmic inclusions within degenerating hepatocytes seen characteristically in the setting of alcoholic hepatitis.

Hemochromatosis

An autosomal recessive genetic disorder linked to the HFE gene on chromosome 6 that disrupts hepcidin regulation, leading to excessive iron absorption and toxic deposition of hemosiderin in the liver, pancreas, and heart.

Wilson's Disease

An autosomal recessive disorder characterized by the toxic accumulation of copper within the liver, brain, and eyes.

Hepatocellular Adenoma

A benign liver tumor composed of bland hepatocytes lacking bile ducts, associated with oral contraceptive use, which can present as an acute abdomen secondary to intra-abdominal hemorrhage.

Hepatocellular Carcinoma (HCC)

The most common primary malignant tumor of hepatocytes, displaying a $3:1$ male predominance, strong correlation with cirrhosis ($90\%$), HBV, HCV, and aflatoxin, and a high propensity for vascular invasion.

Cholangiocarcinoma

An aggressive adenocarcinoma arising from bile duct epithelium inside or outside the liver, commonly remaining asymptomatic until late stages.

Cholesterol Gallstones

The most common form of cholelithiasis in Western populations ($80\%$), primarily radiolucent, and associated with Caucasian ethnicity, advanced age, female sex, and elevated estrogen levels.

Pigment Gallstones

Gallstones composed primarily of bilirubin salts ($20\%$ in the West) that are mostly radiopaque and linked to chronic hemolysis, gastrointestinal disorders, and biliary infections.

Acute Cholecystitis

Acute inflammation of the gallbladder presenting with severe right upper quadrant (RUQ) abdominal pain, often triggered by cystic duct obstruction, ischemia, or chemical irritation.

Gallbladder Carcinoma

An adenocarcinoma representing the 5th most common gastrointestinal malignancy, with a peak in the 7th decade, a higher prevalence in females, a $95\%$ association with gallstones, and a 5-year survival rate of only $5\%$.

Acute Pancreatitis

Reversible acute inflammatory injury of the pancreas driven by autodigestion via activated lipases and proteases, vascular destruction with hemorrhage, and localized fat necrosis, with $80\%$ of cases caused by gallstones or alcohol abuse.

Chronic Pancreatitis

Progressive, irreversible destruction of the exocrine pancreatic parenchyma followed by loss of endocrine islets and extensive fibrosis, commonly caused by long-term alcoholism.

Pancreatic Ductal Carcinoma

A malignant exocrine neoplasm (mostly adenocarcinoma) ranking as the 4th leading cause of US cancer deaths; it exhibits silent growth and poor prognosis, with smoking doubling disease risk.