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Gastro > Chronic Liver Disease > Flashcards

Chronic Liver Disease Flashcards

1
Q

Definition of chronic liver disease

A

Diseases of the liver lasting >6 months

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2
Q

Risk factors for chronic liver disease (6)

A
  1. IV drug use
  2. Drugs
  3. Alcoholism
  4. Adverse lipid profile
  5. Obesity
  6. Occupational chemical exposure
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3
Q

Causes of chronic liver disease (9)

A
  1. Viral hepatitis (B, C, CMV, EBV)
  2. Alcoholic liver disease
  3. Drugs (amiodarone, methotrexate, nitrofurantoin)
  4. Non-alcoholic fatty liver disease
  5. Haemochromatosis
  6. Wilson’s Disease
  7. Autoimmune (autoimmune, primary biliary cirrhosis, primary sclerosing cholangitis)
  8. RHF
  9. Hepatocellular carcinoma
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4
Q

Signs of chronic liver disease in the hands (5)

A
  1. Clubbing
  2. Leuconychia
  3. Palmar erythema
  4. Pallor of palmar creases (anaemia)
  5. Dupuytren’s contracture (alcohol)
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5
Q

Signs of chronic liver disease in the face (4)

A
  1. Keyser-Fleischer rings (Wilson’s disease)
  2. Pallor of the conjunctiva
  3. Xanthelasma (NAFLD)
  4. Parotidomegally (alcohol)
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6
Q

Signs of chronic liver disease in the chest (4)

A
  1. Spider naevi
  2. Hair loss
  3. Gynaecomastia
  4. Signs of RHF
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7
Q

Signs of chronic liver disease in the abdomen (4)

A
  1. Small irregular liver (cirrhosis)
  2. Hepatomegaly (NAFLD, haemochromatosis, RHF)
  3. Caput medusae
  4. Testicular atrophy
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8
Q

Components of the Child-Pugh score

A 
Albumin
Bilirubin
Clotting (INR)
Distention (ascites)
Encephalopathy
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9
Q

Drug used to treat encephalopathy

A

Rifamixin

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10
Q

Consequences of portal hypertension (3)

A
  1. Ascites
  2. Hypersplenism
  3. Varices (lower oesophaeal/rectal)
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11
Q

Causes of decompensation

A

DIG ROCK

  1. Dehydration
  2. Infection (SBP)
  3. GI bleeding
  4. Renal failure
  5. Opioids, benzodiazepines
  6. Constipation
  7. K (hypokalaemia, hyponatraemia, hypoxia)
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12
Q

Signs of decompensation

A
  1. Hypoalbuminaemia - peripheral oedema, ascites, leukonychia
  2. Bilirubin - jaundice
  3. Clotting - bruising
  4. Distention - ascites
  5. Encephalopathy - drowsiness, hyperventilation, asterixis
  6. Acid-base imbalance (most commonly respiratory alkalosis)
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13
Q

Grading of encephalopathy

A 
0 - subclinical
1 - mild
2 - obvious
3 - severe 
4 - coma
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14
Q

Management of autoimmune hepatitis

A

Prednisone and azathioprine

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15
Q

Management of haemochromatosis

A

Phlebotomy

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16
Q

Management of Wilson disease

A

Trientine and zinc

17
Q

Management of hepatitis C

A

Ritonavir, ombitsavir, dasabuvir, ribavirin

Gastro (24 decks)

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