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Conditions > Acute Liver Failure, Fulminant Hepatic Failure, Chronic Liver disease > Flashcards

Acute Liver Failure, Fulminant Hepatic Failure, Chronic Liver disease Flashcards

1
Q

Antibiotics that can cause acute liver failure

A

NSAID, co-amoxiclav, flucloxacillin

Remember penicillin and ‘fat burner’ and ‘protein powders’ can also cause drug induced liver disease

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2
Q

Pathology of chronic liver disease

A

Recurrent inflammation and repair with fibrosis and regeneration

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3
Q

What can chronic liver disease progress to?

A

Cirrhosis

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4
Q

What can methotrexate cause?

A

Cirrhosis/liver disease

Methotrexate is used to treat cancers

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5
Q

What is described as having a two hit paradigm?

A

Non alcoholic fatty liver
First Hit-excess fat acculumation
Second Hit-intrahepatic oxidative stress, lipid peroxidation, TNF-alpha, cytokine cascade

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6
Q

Who is most commonly affected by primary biliary cirrhosis?

A

Middle aged women
PBC is T-cell mediated
(In autoimmune hepatitis, women are also more commonly affected than men)

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7
Q

Symptoms of primary biliary cirrhosis

A

Usually asymptomatic but fatigue, itch without rash, xanthelasma, xanthoma

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8
Q

Urseo doxycholic acid used to treat what?

A

Primary biliary cirrhosis

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9
Q

Raised IgM or IgG in PBC?

A

Raised IgM in PBC. Raised IgG is more characteristic of hepatitis.

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10
Q

Interface hepatitis?

A

Autoimmune hepatitis!!

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11
Q

Oxyphenistatin, methyldopa, nitrofurantoin, diclofenac, minocycline and statins may trigger what kind of hepatitis?

A

Autoimmune hepatitis

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12
Q

“the bronzed diabetic”

A

Haemochromatosis

  • Cirrhosis
  • Cardiomyopathy
  • Pancreatic insufficiency
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13
Q

Signs of Wilson’s Disease

A

Neurological: chorea-atheitoid movements
Hepatic: Cirrhosis or sub-fulminant liver failure
Kaiser Fleisher rings
Treatment: copper chelation drugs

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14
Q

Clinical signs of Alpha 1 anti trypsin deficiency

A

Lung emphysema
Mutant protein deposited in liver
(treatment is supportive)

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15
Q

Protein C or S deficiency leads to a what tendency?

A

Thrombotic tendency

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16
Q 
Congenital Webs
(protein C/S deficiency)
A

Budd Chiari

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17
Q

What is methotrxate used to treat?

A

Rheumatoid arthritis and psoriasis

can cause liver fibrosis

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18
Q

Problems with methotrexate?

A

Can cause liver fibrosis

Treatment: Stop the treatment

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19
Q

Loss of function or a mutation in caeruloplasmin could lead to what?

A

Wilson’s disease

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20
Q

Acetoaminophen toxicity could lead to what?

A

Acute liver failure

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21
Q

What kind of jaundice may be seen in pregnant women?

A

Hepatic jaundice

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22
Q

Macronodular or microdnodular cirrhosis associated with alcoholic?

A

Micronodular

23
Q

Cause of spider naveii and gynaecomastia

A

Hyperestrogenism

24
Q

Cause of purpura and bleeding in liver failure

A

Reduced production of clotting factors

25
Q

Why is infection common in liver failure?

A

Reduced Kupffer cell number and function

26
Q

What is manifested by the production of Mallory’s hyalin?

A

Alcoholic liver disease

27
Q

Hepatitis C virus type 3 could cause what?

A 
Fatty liver
(diabetes could do this also)
28
Q

Mallory bodies seen in what?

A

Alcoholic hepatitis

29
Q

What can be seen in alcoholic fibrosis?

A

Collagen

30
Q

What could you use to stain a liver to see alcoholic cirrhosis?

A

Massons trichrome

31
Q

Ebstein virus could cause what?

A

Viral hepatitis

32
Q

Yellow fever virus could cause what?

A

Viral hepatitis

33
Q

Herpes simplex virus could cause what?

A

Viral hepatitis

34
Q

Cytomegalovirus could cause what?

A

Viral hepatitis

35
Q

Delta agent could cause what?

A

Viral hepatitis

Delta agent is hepatitis D LOL

36
Q

Piecemeal necrosis seen in what?

A

Hepatitis

37
Q

What is a council man body?

A

A hepatocyte undergoing apoptosis

38
Q

Antibodies in primary biliary cirrhosis?

A

Autoantibodies to mitochondria

39
Q

Chronic portal inflammation
Bile ducts inflamed
Granulomas around duct…?

A

Primary biliary cirrhosis

40
Q

Autoimmune hepatitis more common in males or females?

A

Females

PBC also more common in females

41
Q

Antibodies to smooth muscle, nuclear or LKM seen in what?

A

Autoimmune hepatitis

Raised IgG as well and numerous plasma cells

42
Q

What is primary sclerosing cholangitis associated with?

A

Ulcerative colitis

43
Q

Onion-skinning fibrosis?

A

Primary sclerosing cholangitis

44
Q

Method of inheritance of Haemochromatosis?

A

Autosomal recessive

Worse in homozygotes, men

45
Q

What does haemochromatosis predispose to?

A

Maignancy (hepatocellular carcinoma)

Also causes diabetes, cardiac failure and impotence

46
Q

Perls stain confirms what?

A

Iron!

47
Q

Where does copper accumulate in Wilson’s disease?

A

Liver and brain (basal ganglia)

48
Q

What does Wilson disease cause?

A

Chronic hepatitis and neurological deterioration

49
Q

What does alpha-1 anti-trypsin deficiency cause?

A

Emphysema AND cirrhosis

50
Q

“Cytoplasmic globules of unsecreted globules of protein in liver cells”

A

Alpha-1 anti-trypsin deficiency

51
Q

What is a hepatoma?

A

Hepatocellular carcinoma

52
Q

Paracetemol in liver disease, gutathione stores?

A

Reduced

53
Q

P4502E1 in alcoholics?

A

Increased

Conditions (20 decks)

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