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Gastrointestinal Week 6 2016/17 > 8: Aetiologies and pathophysiology of chronic liver disease > Flashcards

8: Aetiologies and pathophysiology of chronic liver disease Flashcards

1
Q

What is chronic liver disease?

A

Liver disease lasting longer than 6 months which leads to cirrhosis

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2
Q

What is the end-stage of chronic liver disease if untreated?

A

Cirrhosis

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3
Q

What hepatic cells become activated to start fibrosis?

A

Hepatic stellate cells

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4
Q

Lots of liver diseases are chronic.

What is the official definition of chronic liver disease?

A

A disease lasting > 6 months WHICH LEADS TO CIRRHOSIS

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5
Q

What is NAFLD?

A

Non-alcoholic fatty liver disease

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6
Q

Which diseases cause NAFLD?

A

Hypertension

Hyperlipidaemia

T2 diabetes

Obesity

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7
Q

NAFLD / NASH is a fatty liver in the (presence / absence) of other causes.

A

absence

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8
Q

What is NASH?

A

Non-alcoholic steatohepatitis

Fat in the liver AND inflammation

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9
Q

Triglycerides are stored in pockets away from the mitochondria of hepatocytes (NAFLD). What happens when these triglycerides are exposed to oxidative stress?

A

NASH

non-alcoholic steatohepatitis, i.e inflammation

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10
Q

How is NAFLD diagnosed?

A

Ultrasound / Liver biopsy if required

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11
Q

How is NAFLD treated?

A

Weight loss

Exercise

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12
Q

How is NASH diagnosed?

A

Liver biopsy

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13
Q

The end stage of NASH is ___.

A

cirrhosis

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14
Q

How is NASH treated?

A

Exercise and weight loss

Experimental drugs

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15
Q

What type of liver disease is primary biliary cholangitis?

A

Autoimmune

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16
Q

What tissue is affected by autoantibodies in PBC?

A

Biliary tree tissue

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17
Q

Who tends to get PBC?

A

Middle aged women

18
Q

What are some symptoms of PBC?

A

Fatigue

Itch without rash

Xanthelasma / Xanthomas

19
Q

How is PBC treated?

A

Ursodeoxycholic acid

20
Q

PBC involves the immune system attacking the ___ ducts.

A

bile

21
Q

What is radical treatment for PBC?

A

Liver transplant

22
Q

Who tends to be affected by autoimmune hepatitis?

A

Young women

23
Q

How would autoimmune hepatitis be described by a pathologist?

A

Chronic hepatitis with piecemeal necrosis and lobular involvement

24
Q

What can trigger autoimmune hepatitis?

A

Viruses

Toxins

Drugs

25
Q

How is autoimmune hepatitis treated?

A

Corticosteroids (prednisolone)

Immunosuppressors (azathioprine, steroid-sparer)

26
Q

Eventually, those with autoimmune hepatitis will go on to develop ___.

A

cirrhosis

but 13-20% of patients have spontaneous resolution

27
Q

What is primary sclerosing cholangitis?

A

Autoimmune disease of LARGE bile ducts

primary biliary cholangitis affects the small bile ducts

28
Q

What IBD is associated with primary sclerosing cholangitis?

A

UC

29
Q

What investigations are used to diagnose primary sclerosing cholangitis?

A

MRCP

ERCP

30
Q

What is haemochromatosis?

A

Autosomal recessive disease of iron overload

31
Q

Patients with haemochromatosis lay down iron in their skin. What sign is associated with this?

A

Bronzed skin

32
Q

What are some complications of haemochromatosis?

A

Cirrhosis

Cardiomyopathy

Pancreatic failure

Bronze diabetics

33
Q

Is Wilson’s disease autosomal dominant or recessive?

A

Autosomal recessive

34
Q

Which copper-carrier loses its function in Wilson’s disease?

A

Ceruloplasmin

35
Q

Which metal is deposited in the tissue in Wilson’s disease?

A

Copper

36
Q

What are Kaiser Fleisher rings?

A

Rings of copper in the eyes

37
Q

What is the liver outcome of untreated Wilson’s disease?

A

Cirrhosis

38
Q

alpha 1 anti-trypsin deficiency is another example of a chronic liver disease

lung emphysema, cirrhosis

slide doesn’t make any sense

A
39
Q

What is Budd-Chiari syndrome?

A

Thrombosis of hepatic veins

blood can’t drain from the liver, causing cirrhosis

40
Q

What are the symptoms of Budd-Chiari syndrome?

A

Jaundice

Tender hepatomegaly

Ascites

41
Q

Which immunosuppressant is toxic to the liver and causes cirrhosis?

A

Methotrexate

42
Q

What is cardiac cirrhosis?

A

Incompetent tricuspid valve causes backflow of blood to the liver

Liver can’t drain blood - cirrhosis

Gastrointestinal Week 6 2016/17 (14 decks)

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