Aetiologies/pathophysiology of liver disease Flashcards

1
Q

what is NAFLD?

A

non alcoholic fatty liver disease
fatty liver or steato-hepatitis in absence of other cause
20-30% also have NASH
of these 20% get cirrhosis

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2
Q

what is the 2 hit paradigm for NAFLD?

A

first hit = excess fat accumulation

second hit = intrahepatic oxidative stress, lipid peroxidation, TNF alpha, cytokine cascade

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3
Q

what can be attributed to the second hit?

A

MCD diets
ischaemia reperfusion injury
lipopolysaccharide
Pro-inflammatory cytokine release

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4
Q

what single hits can cause NAFLD?

A

triglyceride benign
Skinny NASH
hepatocytes can generate TNF alpha
Oxidative stress at the centre of disease

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5
Q

what diseases is NAFLD associated with?

A
obesity
type 2 disbetes
hypertension
low HDL cholesterol
High triglycerides
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6
Q

how is simple steatosis managed?

A

diagnosed via US

weight loss and exercise

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7
Q

how is NASH managed?

A

diagnosis via liver biopsy
weight loss and exercise
experimental treatments

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8
Q

name some auto-immune liver diseases

A
primary biliary cholangitis (cirrhosis)
auto-immune hepatitis
primary sclerosing cholangitis
alcohol related liver disease?
drug reactions?
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9
Q

what causes PBC?

A

autoimmune component
T cell mediated
- CD4 cells reactive to M2 target, why loss of tolerance

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10
Q

how does PBC present?

A
middle aged women mostly
usually asymptomatic/incidental
fatigue
itch without rash
xanthelasma and xanthomas
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11
Q

how is PBC diagnosed?

A

2 of:

  • positive AMA
  • cholestatic LFTs
  • liver biopsy
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12
Q

how is PBC treated?

A

Urseo deoxycholic acid

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13
Q

what are the possible outcomes of PBC?

A

most don’t develop symptoms or liver failure

itch can be a problem

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