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Meded Flashcards 2020 > Biliary and liver > Flashcards

Biliary and liver Flashcards

1
Q

What does this man likely have?

What are his sign?

A

chronic liver failure

Ascites

tattoo

gynecomastia

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2
Q

What are causes of chronic liver failure?

A
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3
Q

Label the table

A
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4
Q

Fill out the table

A
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5
Q

Fill out the table

A
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6
Q

What does this man likely have?

What are his sign?

A

chronic liver failure

palmar erythema

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7
Q

fill out the table

A
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8
Q

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A
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9
Q

SBA 5

A

A

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10
Q

SBA 3

A

D

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11
Q

SBA 4

A

A

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12
Q

SBA 6

A

D

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13
Q

SBA 7

A

C

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14
Q

SBA1

A

A

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15
Q

SBA2

A

D

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16
Q

Fill out the table

A
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17
Q

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A
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18
Q

What are the sign of chronic liver disease?

A
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19
Q

What does this man likely have?

What are his sign?

A

chronic liver disease

Spider naevi

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20
Q

Fill out the table

A
21
Q

FIll out the table

A
22
Q

A person presents with nausea vomitting diarrhoea, fever, jaundice and abdominal pain. His ALP, AST, ALT are all super high. Furthermore he has has done the following

  • is a man that has had sex with another man
  • has recently eaten shellfish

What is the most likely dignosis?

A

HEP A

shellfish

and men having sex with men

ORAL sex

23
Q

If questions ask to differnetiate between HEP A and C?

What do you look for?

A

Symptoms are simmilar: diarrhea, fever, jaundice, vomitting

1. THROUGH the source of infection

Hep A: faecal oral route- shellfish (purify water, if faeces in there you ingest them), oral anal sex (eating faeces), unwashed vegetables (if used contaminated water) COMMON In ASIA AND AFRICA (travel)

Hep C: via blood products (blood transfusion, period sex), Needle sharing (IVDU, tattoo, piercing, needle stick )

2. THROUGH the chronicity

Hep C is more likely to be chronic and have feature like cirrhosis and hepatocellular carcinoma in comparison to Hep A

24
Q

What doe sthe triad of

raised AST/ ALT

fever

Jaundice indicate

A

LIVER problem

NOT biliary

25
Q

What percentage of Hep C is asymtomatic?

A

80%

26
Q

What infections can cause transaminitis in the 1000s?

A
  1. paracetamol overdose
  2. acute viral hepatits (not B)
  3. Ischaemic hit
27
Q

What are signs of acohol excess?

What are signs of severe alcoholic hepatitis?

A

Signs of alcohol excess:

  1. Malnourished
  2. palmar erythema
  3. dupuytren contracture
  4. Facial telangectasia
  5. parotid enlargement
  6. Spider naevi
  7. Gynecomastia
  8. Testicular atrophy
  9. Hepatomegaly
  10. Easy bruising

SIgns of sever alcoholic hepatits

  1. Tachycarida
  2. low grade fever
  3. Ascites
  4. encephalopathy
  5. Hepatomegaly
  6. Splenomegaly
  7. bruising
  8. Jaundice
28
Q

How do treat ascites in acoholoc hepatitis?

A

Diuretics

spironolactone with or without furosemide

29
Q

Fill out the table

A
30
Q

how do treat encephalopathy in severe alcoholic hepatitis?

A

lactulose and phosphate enema

31
Q

What is hepatorenal syndrome?

A

blood vessels in the Splanchnic circulation (intestinal blood flow) dilate due to the portal hypertension -> reduces effective blood volume detected in kidney -> activation of the RAS system -> vasoconstriction of vessels in the kidney-> kidney failure

32
Q

fill out the table

A
33
Q

What is the ascending colangitis pentad called and what are the components?

A

Reynolds

Hypotension, Confusion, fever, RUQ pain, Jaundice

34
Q

What is cholelithiasis and what is the treatment?

What is choledocholithiasis and what is the treatment?

A

What is cholelithiasis and what is the treatment?

presence of solid concretion in the GB

TREATMENT: cholecystectomy

What is choledocholithiasis and what is the treatment?

solid concretion from GB but exits into the bile duct

TREATMENT: ERCP

35
Q

Pancreatic cancer

Peak incidence

Risk factors

key symptoms

Investigations:

A

Peak incidence:65-75 years old

Risk factors: smoking, FH

key symptoms:jaundice, non-specific abdo pain, FLAWS

Investigations: LFT’s, Protocol CT scan

36
Q

What is courvoiser’s law?

A

palpable gallbladder in the presence of painless jaundice is unlikely to be due to stones

i.e. GP+Jaundice= head of pancreas/CBD cancer

37
Q

What is a hepatocellular carcinoma?

Aetiology?

What are risk factors?

signs

What are the investigations?

A

What is a hepatocellular carcinoma?

Aetiology? Chronic liver disease (alcohol, NASH or viral), metabolic disease, alpha 1 antitrypsin deficiency

What are risk factors? malignancy, exposure to carcinogens, aflatoxin

Signs: liver cirrhosis/failure

What are the investigations? urgent USS (assess liver), LFT, alphafetoprotein, tumour markers, hepatitis serology

38
Q

SBA 10

A

B

39
Q

Fill out the table

A
40
Q

SBA11

A

D

41
Q

SBA 9

A

A

42
Q

SBA 8

A

C

43
Q

Fill out the table

A
44
Q

Fill out the table

A
45
Q

Fill out the table

A
46
Q

What is a cholangiocarcinoma?

What is the marker for it?

What are the symptoms?

What is it associated with

A

What is a cholangiocarcinoma? primary adenocarinoma ofthe biliary tree

What is the marker for it?CA 19-9 (same as pancreatic cancer)

What are the symptoms? obstructive jaundice

What is it associated with? UC+ primary sclerosing cholangitis

47
Q

What are the different types of liver cysts?

A
48
Q

What is this?

In what sex is it more common

How is it found?

A

What is this? simple cyst

In what sex is it more common? female

How is it found? incidentally

49
Q

What is this?

What is most common pathogen for this thing?

A

What is this? infectious cyst

What is most common pathogen for this thing? Pyogenic= polymicrobial (80%), Entamoeba histolytica - Amoebic (10%), Fungal = candida (10%)

Meded Flashcards 2020 (36 decks)

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