14. Chronic Liver Disease Flashcards
Which blood tests show damage to hepatocytes?
AST and ALT
Does AST or ALT have a longer half life?
ALT
What tissues is AST released from?
Liver Heart Skeletal muscle Kidneys Brain RBCs
Which blood tests show cholestasis?
Alk phos
GGT
Which blood tests show liver function?
Bilirubin Albumin Prothrombin time Platelets Glucose
How can you differentiate between non-alcoholic and alcoholic fatty liver disease?
NAFLD: ‘ballooning’ degeneration hepatocytes
Alcohol: Mallory’s hyaline
What is the treatment for fatty liver disease?
Lose weight
Are hepatitis B and C curable?
C is curable with interferon free combination treatment
B is not curable
What is the treatment for hepatitis B?
Pegylated interferon
Entecevir
Tenofovir
What gene is mutated in Wilson’s disease?
ATP7B gene which codes for copper transporting ATPase 2
What can be seen in the eye on a patient with Wilson’s disease?
Dark rings around iris: Kaiser-Fleischer rings
What is the treatment for Wilson’s disease?
Penicillamine to reduce copper
What is the typical presentation of a patient with PBC?
Middle aged woman, itchy, with cholesterol deposits around eyes and on skin
May have related Sicca syndrome and thyroid disease
What blood tests are positive in PBC?
AMA antibody
High alk phos and GGT
What is the treatment for PBC?
UCDA: choleretic to reduce bile
Bezafibrate
Obeticholic acid
Budesonide