Chronic Liver Disease Flashcards
(50 cards)
What lab tests are characteristic to jaundice?
high ALP and high conjugated bilirubin levels
Alcoholic liver disease AST to ALT ratio?
2:1
ALT is greater than AST by 1000x in what condition?
acute viral hepatitis
alpha-1 antitrypsin deposition of excessive abnormal A1AT occurs in what condition?
Cirrhosis
List the names of drugs that require LFT Monitoring.
Amiodarone
Statins
Acetaminophen toxicity
Methotrexate
Ketoconazole
Itraconazole
Terbinafine
What should be monitored after 2-4 weeks of starting MTX?
ALT
What are baseline tests of methotrexate?
CBC
platelet count
hepatic enzymes
renal function
chest x-ray
For patients on MTX, how often should monitoring occur for hematology and hepatic enzymes?
hematology = atleast monthly
hepatic enzyme and renal function = every 1-2 months
For a patient that is prescribed Terbinafine, what is the baseline tests monitored?
ALT (baseline + periodically)
What are ascites ?
fluid retention in the peritoneal cavity of liver
Drug of choice to treat Ascites
Spironolactone 100-200 mg/day, then add Furosemide 40 mg-160 mg/day
If refractory –> add Metolazone
Symptoms of hepatic encephalopathy
agitation, excitement, disorientation, confusion, slurred speech, loss of consciousness
Treatment for hepatic encephalopathy?
lactulose (to induce 2-3 bowel movements per day).
if no improvement, add rifaximin and reassess in 1-2 days
Treatment for spontaneous bacterial peritonitis
Prophylaxis: cotrimoxazole (cost effective) or norfloxacin
Treatment: 3rd gen ceph - cefotaxime or ceftriaxone x 5 days - add albumin on day 3 of treatment.
Patient has renal impairment. When treating for spontaneous bacterial peritonitis, ceftriaxone is prescribed for 5 days. what is the dose adjustment?
not required in renal impairment.
symptoms of chronic cholestasis (jaundice)?
yellow skin and eyes, itchy skin, abdominal pain, dark urin.
Lab results: high ALP, GGT, bilirubin
Treatment for jaundic
ursodiol or ursodeoxycholic acid - improves serum liver biochemical tests in pts with primary biliary cholangitis and primary sclerosing cholangitis
If a patient has ascites and cannot tolerate spironolactone, what should be an alternative drug used?
amiloride
A patient has spontaneous bacterial peritonitis + ascites. They recovered from SBP, removed the ileum**. What vitamin is required?
Vit b12 injection
*recall: b12 is absorbed in ileum
What is viral hepatitis?
presence of virus in the blood 6 months after the infection
What lab results confirms chronic hepatitis B infection?
Hep B surface antigen (HBsAg) + Hep B antigen test
What lab results confirms the diagnosis of chronic hepatitis C infection?
Hep C antibody and HCV RNA
how do hep B and hep C get transmitted?
parenteral, blood, sexual, needle (hep B)
what is the severity for each type of hepatitis?
Hep A - acute (mild)
Hep B & C - chronic
Hep D & E - mild
