14. Chronic Liver Disease Flashcards

1
Q

Which blood tests show damage to hepatocytes?

A

AST and ALT

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2
Q

Does AST or ALT have a longer half life?

A

ALT

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3
Q

What tissues is AST released from?

A
Liver
Heart
Skeletal muscle
Kidneys
Brain
RBCs
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4
Q

Which blood tests show cholestasis?

A

Alk phos

GGT

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5
Q

Which blood tests show liver function?

A
Bilirubin
Albumin
Prothrombin time
Platelets
Glucose
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6
Q

How can you differentiate between non-alcoholic and alcoholic fatty liver disease?

A

NAFLD: ‘ballooning’ degeneration hepatocytes
Alcohol: Mallory’s hyaline

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7
Q

What is the treatment for fatty liver disease?

A

Lose weight

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8
Q

Are hepatitis B and C curable?

A

C is curable with interferon free combination treatment

B is not curable

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9
Q

What is the treatment for hepatitis B?

A

Pegylated interferon
Entecevir
Tenofovir

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10
Q

What gene is mutated in Wilson’s disease?

A

ATP7B gene which codes for copper transporting ATPase 2

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11
Q

What can be seen in the eye on a patient with Wilson’s disease?

A

Dark rings around iris: Kaiser-Fleischer rings

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12
Q

What is the treatment for Wilson’s disease?

A

Penicillamine to reduce copper

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13
Q

What is the typical presentation of a patient with PBC?

A

Middle aged woman, itchy, with cholesterol deposits around eyes and on skin
May have related Sicca syndrome and thyroid disease

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14
Q

What blood tests are positive in PBC?

A

AMA antibody

High alk phos and GGT

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15
Q

What is the treatment for PBC?

A

UCDA: choleretic to reduce bile
Bezafibrate
Obeticholic acid
Budesonide

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16
Q

What disease is PSC associated with?

A

Ulcerative colitis

17
Q

How is PSC diagnosed?

A

High alk phos and GGT

MRCP

18
Q

What complication is associated with PSC?

A

Cholangiocarcinoma

19
Q

What is the typical presentation of autoimmune hepatitis?

A

Young woman

Non-drinker and non-viral hepatitis

20
Q

What blood tests are positive in autoimmune hepatitis?

A

High ALT, AST, IgG

SMA antibody

21
Q

What does a liver biopsy show in autoimmune hepatitis?

A

Lymphocyte infiltration

22
Q

What is the treatment for autoimmune hepatitis?

A

Steroids

23
Q

What is the treatment for itching in PBC?

A
Cholestyramine
Naltrexone
Rifampicin
Plasma exchange
Liver transplant
24
Q

What mutations cause hereditary haemochromatosis?

A

C282Y and H63D on chromosome 6