chronic liver disease

Question 1

what is cirrhosis? 2

Answer 1

• the final common pathway of many liver diseases

- inflammation-> fibrosis-> cirrhosis

Question 2

describe the processes in a normal liver? 10

Answer 2

• Regulation of metabolism:
• Protein synthesis
• Carbohydrate metabolism
• Lipid metabolism
• .
• Portal venous drainage:
• Hormone and drug inactivation
• Protein degradation
• .
• Formation of bile
• .
• Immune function:
• Reticuloendothelial system

Question 3

describe processes in a cirrhotic liver? 11

Answer 3

• Reduced metabolic capacity:
• Coagulopathy
• Reduced albumin
• Hypoglycaemia
• .
• Portal hypertension:
• Ascites
• Hypersplenism
• Varices
• Hepatic encephalopathy
• .
• Jaundice
• .
• Impaired immune response

Question 4

what can cause cirrhosis? 6

Answer 4

• Non-alcoholic fatty liver disease
• Alcohol
• Viral hepatitis
• Autoimmune liver disease: autoimmune hepatitis, primary biliary cholangitis, primary sclerosing cholangitis
• Haemochromatosis
• Wilson disease

Question 5

describe compensated cirrhosis? 5

Answer 5

• Well patient
• +/- some symptoms and signs
• Abnormal/ normal LFTs
• Abnormal imaging
• Abnormal biopsy

Question 6

describe decompensated cirrhosis? 7

Answer 6

• Unwell patient
• Jaundice
• Ascites
• Coagulopathy
• Low albumin
• Encephalopathy
• Abnormal LFT’s abnormal imaging

Question 7

describe liver cell failure? 3

Answer 7

• Jaundice
• Coagulopathy
• Encephalopathy

Question 8

describe portal hypertension? 4

Answer 8

• Splenomegaly
• Ascites
• Varices
• Encephalopathy