25: Chronic Liver Dz And Cirrhosis Flashcards

1
Q

Major complication associated with Hep B vs Hep C

A

Hep B: polyarteritis nodosa

Hep C: mixed cryoglobulinemia

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2
Q

Major lab + imaging to ID fibrosis due to cirrhosis

A
  1. Serum fibrosure lab

2. US elastography

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3
Q

Risk of an HBV positive mother transmitting to infant at time of delivery

A

90%

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4
Q

Leukopenia in alcoholics

A

Occasionally seen but resolves after cessation of drinking

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5
Q

CBC issues possibly seen in alcoholics

A
  1. high or low WBCs
  2. Anemia
  3. Folic acid deficiency
  4. Thrombocytopenia
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6
Q

Mallory (Mallory-Denk) bodies

A

Alcoholic hyaline seen on liver biopsy in alcoholic liver disease

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7
Q

What happens if you administer glucose without thiamine in alcohol-induced liver disease

A

Can precipitate Wernicke Korsakoff

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8
Q

Three major treatments for severe alcoholic hepatitis

A
  1. Steroids
  2. Pentoxifylline
  3. Liver transplant
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9
Q

Requirement for liver transplant for alcohol-induced liver disease

A

Must abstain from alcohol for 6mo to be considered

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10
Q

Three scores for severity of alcohol-induced liver disease + the score that indicates a poor prognosis

A
  1. Maddrey’s discrimination function (DF): 32
  2. Glasgow Alcoholic hepatitis score: 9
  3. MELD: model for end-stage liver disease: 21
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11
Q

Wernicke Korsakoff sx

A

AMS, ataxia, involuntary eye movements (nystagmus)

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12
Q

Korsakoff sx

A

Severe memory issues, confabulation

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13
Q

Treatment for Wernicke encephalopathy

A

Thiamine

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14
Q

Two things that protect against NAFLD

A
  1. physical activity

2. Coffee consumption

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15
Q

What is seen on liver biopsy in NAFLD

A

Macrovesicular steatosis +/- inflammation and fibrosis, PMN infiltrate, Mallory hyaline - indistinguishable from alcoholic steatohepatitis

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16
Q

Lung disease seen in a1 antitrypsin deficiency

A

Pan-acinar emphysema in lower lobes (smokers get emphysema in upper lobes)

17
Q

Most commonly diagnosed inherited hepatic disorder in infants/children

A

A1 antitrypsin deficiency

18
Q

PiM, PIS, PiZ and PiZZ phenotypes in a1AT deficiency

A
  1. PiM: normal, most common
  2. PIS: mildly reduced levels
  3. PiZ: severe reduction
  4. PiZZ: most severe reduction
19
Q

What is iron stored as + where is it stored in hemochromatosis

A

Hemosiderin -> liver, panc, heart, adrenals, testes, pituitary, kidneys

20
Q

Neurological manifestations in Wilson disease

A

Parkinson’s, tremor, ataxia, dysarthria, dysphagia, spasticity, migraines, insomnia, seizure

21
Q

How to check for SBP?

A

Paracentesis

22
Q

Two major scores to calculate for cirrhosis

A
  1. Child-Turcotte Pugh

2. MELD

23
Q

What to order for MELD vs Child-Turcotte-Pugh

A

MELD: bili, creat, Na, INR
CTP: bili, INR, albumin, assess for encephalopathy and ascites

24
Q

What two things should be monitored every 6 months in cirrhosis to monitor for HCC?

A

Alpha fetoprotein, US

25
Three treatments for NAFLD
1. Weight reduction 2. Exercise 3. Control metabolic syndrome
26
Three pt populations that need paracentesis for ascites
1. New onset ascites 2. Pts admitted to hospital with ascites 3. Known ascites deterioration
27
What level of PMN suggests SBP in ascites?
250 mcL
28
What does SAAG stand for?
Serum albumin- ascites gradient
29
Four things that increase severity of esophageal varices
1. Size larger than 5mm 2. Red wale markings 3. Severity of liver disease 4. Active alcohol abuse
30
Esophageal varices prevention drug
No selective beta-adrenergic blockers
31
Major treatment for esophageal varices
Band ligation
32
Treatment for hepatic encephalopathy + how it works
Lactulose -> colonic acidification and diarrhea