Clinical & Testing
Deep Spiral
Spiral
Liver Problems
Iron
400
This test is done to help rule out a osteological cause of elevated alkaline phosphatase.
What is gamma glutamyl transpeptidase (GGT).
400
A possible explanation for the low platelet count seen in Mr. Webb is decreased levels of this, produced mainly by the liver parenchyma.
What is thrombopoietin
400
The image below depicts this problem with the liver.
What is cirrhosis
400
This finding, portrayed above, is a common finding of hemochromatosis.
What is blue-gray skin
800
Like ascites, edema is a result of a combination of these two issues.
What are portal hypertension and hypoalbuminemia
800
The negative predictive value of the fluid wave test is not particularly great; many people who test this for this are this.
What is many people who are positive for ascites test negative.
800
Although not mentioned, liver problems may result in this condition characterized by impaired purine degradation.
What is gout
800
The image presents a finding classic for this liver complication.
What is alcoholic hepatitis
800
This is the main reason only two of the above biopsies above would be seen in a child with the C282Y mutation.
What is iron takes time to build up in the body
1200
The higher a patient's MELD-Na score, the more priority they are given for this treatment.
What is a liver transplant
1200
Despite giving Mr. Clancy exogenous Factor VII, his Prothrombin Time (PT) is still elevated. A possible reason could be deficiency in this other liver-synthesized coagulation zymogen that results in elevated Thrombin Time (TT).
What is prothrombin
1200
As bodies enter a starved state, this amino acid becomes important in transporting muscle breakdown products to the liver for breakdown and removal.
What is alanine
1200
We would expect the region in the above slide to sustain damage last in both Mr. Clancy and Mr. Webb because it is here.
What is the periportal zone (Zone 1)
1200
A C282Y mutation in the HFE gene results in increased levels of serum Fe through unopposed action of this protein.
What is ferroportin
1600
A very low SAAG score would be a cause for concern because it indicates that this is happening.
What is albumin leaking into the peritoneum
1600
A year ago, if Mr. Webb was also overweight, we might prescribe these in addition to his oral hypoglycemics to improve his BMI.
What are incretins (sitagliptin, liraglutide) or SGLT2 inhibitors (canagliflozin)
1600
The difference between compensated and decompensated cirrhosis is presence of these 4 symptoms (no partial credit)
What are jaundice, ascites, variceal hemorrhage, and encephalopathy
1600
This property of intestinal cells make them the only significant method to prevent iron overload in the body; it is why an HFE C282Y mutation is so problematic.
What is short lifespan/high turnover
2000
High levels of blood urea nitrogen and creatinine indicate the development of this two-organ named condition.
What is hepatorenal syndrome
(HOM)
2000
As part of the inflammatory response in hepatitis, stellate cells can be activated by this signaling pathway that involves proteins like Smoothened and Gli2
What is Hedgehog
2000
The image above represents keratinized squamous epithelial tissue and most likely represents this complication of portal hypertension.
What is hemorrhoids
2000
Mr. Webb's diagnosis from a year ago can be explained by iron buildup in a specific area leading to this inflammatory condition.
What is isletitis