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Year 2- GIT > Chronic Liver Disease > Flashcards

Chronic Liver Disease Flashcards

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1
Q

How long does a person have liver disease before it is classified as chronic liver disease?

A

6 months

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2
Q

What are some of the causes of cirrhosis?

A

Alcohol
Autoimmune conditions
Haemochromatosis
Chronic viral hepatitis
Non-alcoholic fatty liver disease
Drugs
Cystic fibrosis
Vascular problems

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3
Q

Give some examples of autoimmune conditions which can cause cirrhosis.

A

Autoimmune hepatitis
Primary Biliary Cholangitis
Primary Sclerosing Cholangitis

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4
Q

Which two types of hepatitis are more likely to be chronic viral hepatitis?

A

B and C

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5
Q

Describe the pathological changes to the liver in cirrhosis.

A

Production of collagen and fibrinogen blocks off openings prevents blood flow and nutrients.

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6
Q

What is ascites?

A

Accumulation of fluid in the abdomen

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7
Q

How would ascites be identified?

A

Physical exam- dullness in flanks
Confirmed by Ultrasound

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8
Q

What are some of the symptoms which are suggestive of ascites?

A

Spiders, palma erythema, abdominal veins, fetor hepaticus
Umbilical nodule
JVP elevation
Flank haematoma

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9
Q

How is ascites diagnosed?

A

Fluid must be tested (diagnostic paracentesis)

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10
Q

What must fluid from ascites be tested for?

A

Protein and albumin concentration
Cell count
Serum-ascites albumin gradient

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11
Q

What would a serum-ascites albumin gradient of >1.1g suggest?

A

Portal hypertension related

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12
Q

What would a serum-ascites albumin gradient of <1.1g suggest?

A

Non portal hypertension related

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13
Q

What are some of the treatment options for ascites?

A

Diuretics
Large volume paracentesis (removing large volumes of liquid)
TIPSS
Aquaretics
Liver transplant

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14
Q

What may there be excess of in those with hypertension?

A

Nitric oxide

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15
Q

What happens in hepatorenal syndrome?

A

Portal hypertension causing splanchnic vasodilation which reduces effective blood volume.

->more info in recording, idk what to write on the flashcard sorry!

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16
Q

What are some of the treatment options for hepatorenal syndrome?

A

Volume expansion w albumin
TIPSS
Vasopressors e.g. teripressen or octreotide
Liver transplant

17
Q

What causes variceal haemorrhage?

A

Portal hypertension

18
Q

What is variceal haemorrhage?

A

When blood cannot flow through the liver, it finds alternative paths through the GIT, like the skin, oesophagus, rectum, posterior wall or stomal

19
Q

What happens if a variceal haemorrhage starts to bleed?

A

Bleeds like a tap!

20
Q

What should you do the patient if they have a variceal haemorrhage?

A

Resuscitate them
Ensure good IV access
Blood transfusion if required
Emergency endoscopy

21
Q

What is the management option for a variceal haemorrhage?

A

Endoscopic band ligation to stop bleeding.

22
Q

Which drug would be added for control after a variceal haemorrhage?

A

Terlipressen

23
Q

What may get inserted if there is uncontrolled bleeding?

A

Sengstaken-Blakemore tube

24
Q

What can be given for rebleeding after band ligation for variceal haemorrhage?

A

TIPSS

25
Q

What is Hepatic Encephalopathy?

A

Confusion after liver disease

26
Q

What happens in Hepatic Encephalopathy?

A

Toxins in the gut are converted by bacteria into ammonia.
Liver cannot convert the ammonia into urine so it gets to the brain and causes confusion.

27
Q

Which type of antibiotic should be given for someone with Hepatic Encephalopathy?

A

Broad range, non absorbed antibiotic e.g. neomycin

28
Q

What is the commonest cause of liver cancer?

A

Hepatocellular carcinoma

29
Q

How does hepatocellular carcinoma present?

A

Decompensation of liver disease
Abdominal mass
Abdominal pain
Weight loss
Bleeding from tumour

30
Q

How can a diagnosis for hepatocellular carcinoma be given?

A

Tumour markers
Radiological tests- US, CT, MRI
Sometimes a liver biopsy

31
Q

What are some of the treatment options for hepatocellular carcinoma?

A

Hepatic resection (one lobe of liver removed)
Liver transplantation
Chemotherapy
Locally ablative treatments
Hormonal therapy

32
Q
A

Year 2- GIT (37 decks)

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