chronic liver disease

Question 1

PBC affects

Answer 1

women more

Question 2

PBC pathophysiology

Answer 2

T-lymphocyte mediated attack on bile duct epithelial cells

Question 3

what antibodies are found in PBC

Answer 3

Antimitochondrial antibodies

Question 4

PBC symptoms

Answer 4

Pruritus, with or without jaundice
hepatosplenomegaly and xanthelasma
=

Question 5

PBC signs

Answer 5

a raised serum alkaline phosphatase or autoantibodies

steatorrhoea and malabsorption of fat-soluble vitamins

Question 6

what is the abnormality in the liver biochemistry in PBC

Answer 6

ALP

Question 7

what do you look for in the blood for PBC

Answer 7

Serum AMA

Question 8

treatment of PBC

Answer 8

lifelong ursodeoxycholic acid

Question 9

what is ursodeoxycholic acid

Answer 9

natural bile acid

Question 10

how can you help with pruritus in PBC

Answer 10

cholestyramine

Question 11

PBC prognosis

Answer 11

jaundice = die in 5 years
asymptomatic = normal life expectancy

Question 12

Hereditary haemochromatosis inheritance

Answer 12

autosomal recessive

Question 13

what is Hereditary haemochromatosis

Answer 13

iron deposition in organs leading to fibrosis

Question 14

in Hereditary haemochromatosis what is the mutation

Answer 14

HFE

Question 15

what is HFEs normal job

Answer 15

protein in the small intestine allowing absorption of iron

Question 16

what is raised in Hereditary haemochromatosis

Answer 16

serum iron

Question 17

management of Hereditary haemochromatosis

Answer 17

removing blood twice a week

Question 18

big complication with Hereditary haemochromatosis

Answer 18

liver cirrhosis

Question 19

wilsons inheritance

Answer 19

recessive

Question 20

what happens in wilsons

Answer 20

decreased secretion of copper into the biliary system

and reduced incorporation of copper = accumulation

Question 21

in wilsons where does copper accumulate

Answer 21

liver
basal ganglia
cornea
renal tubules

Question 22

affects of wilsons

Answer 22

liver = cirrhosis
basal ganglia = Parkinsonism/dementia
cornea
renal tubules

Question 23

signs of wilsons

Answer 23

ring in the cornea

Question 24

diagnosing wilsons

Answer 24

low total serum copper and caeruloplasmin

urinary copper

Question 25

wilsons treatment

Answer 25

penicillamine
trientene
zinc

Question 26

what does α1-Antitrypsin deficiency lead to

Answer 26

cirrhosis

Question 27

what isnt inhibited in α1-Antitrypsin deficiency

Answer 27

neutrophil elastase

Question 28

diagnosis of α1-Antitrypsin deficiency

Answer 28

low serum levels of α1-AT

Question 29

common sign of alcoholic hepatitis

Answer 29

rapid onset jaundice

Question 30

other features of alcoholic hepatitis

Answer 30

nausea, anorexia, right upper quadrant pain, encephalopathy, fever, ascites and tender hepatomegaly

Question 31

alcoholic hepatitis FBC

Answer 31

shows leucocytosis
elevated MCV
thrombocytopenia

Question 32

alcoholic hepatitis electrolytes

Answer 32

hyponatraemia

Question 33

alcoholic hepatitis LFT

Answer 33

AST and ALT with a disproportionate rise in AST
high bilirubin
low albumin
prolonged prothrombin

Question 34

common co morbidity in PSC

Answer 34

UC

Question 35

commonly raised in PSC

Answer 35

ALP

Question 36

PSC symptoms

Answer 36

pruritus, jaundice or cholangitis

Question 37

PSC diagnosis techniques

Answer 37

MRCP

liver biopsy

Question 38

cancer which can develop from PSC

Answer 38

cholangiocarcinoma

Question 39

risk factors for HCC

Answer 39

aflatoxin
teroids
contraceptive pill
chrnic liver disease

Question 40

rapid development of which features in patients with cirrhosis indicated what

Answer 40

Weight loss, anorexia, fever, ascites and abdominal pain

Question 41

what can be raised in HCC

Answer 41

AFP