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Chem Path > Chem Path: Liver diseases CPC > Flashcards

Chem Path: Liver diseases CPC Flashcards

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1
Q

What are the causes of high bilirubin

A

Pre hepatic - Haemolysis - You will have unconjungated bilirubin
hepatic
Post hepatic - Obstruction

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2
Q

What is Van den Bergh reaction?

A

Test for unconjugated vs conjugated bilirubin

Direct - Conjugated
Indirect - Unconjugated

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3
Q

What is Gilberts

A

Benign raised bilirubin due to UDP glucoronyl transferase activity downregulation

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4
Q

How is Gilbert inherited

A

Autosomal recessive

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5
Q

What makes Gilbert’s worse and how is Gilberts treated

A

Worse on fasting and treated by phenobarbital

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6
Q

What does it mean if there is no urobilinogen in urine?

A

Bilirubin is broken down by gut bacteria into sterco and uro bilinogen. Some of this is reabsorbed and peed out. If it is not present in urine, that means the biliary tree is blocked

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7
Q

When would ALT leak out?

A

Liver damage

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8
Q

How would the LFTs be in paracetamol overdose

A

Very high ALT and AST

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9
Q

What is the antidote for paracetamol overdose

A

N acetyl cysteine

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10
Q

How is Prothrombin time a good indicator of how serious paracetamol overdose is

A

If PT > no of hours since overdose, liver transplant is needed

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11
Q

Which LFT rises a lot in obstruction

A

ALP

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12
Q

How do you contract Hep A?

A

Contaminated water and faecal matter

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13
Q

What is the serology of Hep A like?

A

Jaundice

Rise in IgM, which will eventually taper off

Later rise in IgG which will stay forever

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14
Q

What is the serology of Hep B like for someone who has been infected?

A

HbS and HbE antigens will present first. When they fall there will be a rise in Antobodies against HbS and HbE and HbC

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15
Q

What will the serology of a Hep B vaccinated person look iike?

A

Only antibody against HbS will be there

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16
Q

What would you see in fatty changes in liver

A

Swollen/Ballooing cell - Mallory-Hyaline

17
Q

What would you see in histology of alcoholic hepatitis

A

Neutrophil polymorphs and megamitochondria

18
Q

What does it mean if you see blue staining on liver histology?

A

Collagen - End stage liver disease

19
Q

What does thiamine/B1 deficiency cause?

A

Beri beri

20
Q

What does vit C deficiency cause

A

Scurvy

21
Q

What does B12 deficiency cause

A

Pernicious anaemia

22
Q

What does b3 deficiency cuase

A

Pellagra - caused by mothers who do not take folic acid

23
Q

How does stable chronic liver disease present

A

Spider naevi
Duputryens contracture
Gynacomastia
Palmar erythema

24
Q

What would you see in portal hypertension

A

Caput Medusa and splenomegaly and ascites (You will NOT have hepatomegaly)

25
Q

What is the portal vein made up of

A

Splenic vein and superior mesenteric vein

26
Q

What does shifting dullness indicate?

A

Ascites

27
Q

What kind of nodules will you have in alcoholic cirrhosis

A

Micronodular

28
Q

What happens in porto systemic anastomoses

A

If portal pressure increases, it can lead to varices and blood can back down the azygos vein. It it bursts, you can die

29
Q

List some sites where varices can form

A

Oesophageal
Rectal
Spleno-rectal
Umblicial vein recanalising

30
Q

What happens in liver failure

A

Decrease in clotting factors
Reduced clearance of bilirubin
Reduced clearance of ammonia leading to hepatic encephalopathy

31
Q

What do scratch marks in the background of jaundice mean?

A

Obstructive jaundice is the only reason you will have scratch marks due to bile salts

32
Q

What is courvasiers law

A

A palpable gall bladder with jaundice mostly mean its pancreatic cancer

33
Q

What type of cancer is pancreatic tumour

A

Adenocarcinoma

34
Q

How does pancreatic cancer spread

A

Lymph

35
Q

How does pancreatic cancer spread to the liver

A

Via the portal vein that goes back to the liver

Chem Path (22 decks)

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