chronic liver disease Flashcards
PBC affects
women more
PBC pathophysiology
T-lymphocyte mediated attack on bile duct epithelial cells
what antibodies are found in PBC
Antimitochondrial antibodies
PBC symptoms
Pruritus, with or without jaundice
hepatosplenomegaly and xanthelasma
=
PBC signs
a raised serum alkaline phosphatase or autoantibodies
steatorrhoea and malabsorption of fat-soluble vitamins
what is the abnormality in the liver biochemistry in PBC
ALP
what do you look for in the blood for PBC
Serum AMA
treatment of PBC
lifelong ursodeoxycholic acid
what is ursodeoxycholic acid
natural bile acid
how can you help with pruritus in PBC
cholestyramine
PBC prognosis
jaundice = die in 5 years asymptomatic = normal life expectancy
Hereditary haemochromatosis inheritance
autosomal recessive
what is Hereditary haemochromatosis
iron deposition in organs leading to fibrosis
in Hereditary haemochromatosis what is the mutation
HFE
what is HFEs normal job
protein in the small intestine allowing absorption of iron
what is raised in Hereditary haemochromatosis
serum iron
management of Hereditary haemochromatosis
removing blood twice a week
big complication with Hereditary haemochromatosis
liver cirrhosis
wilsons inheritance
recessive
what happens in wilsons
decreased secretion of copper into the biliary system
and reduced incorporation of copper = accumulation
in wilsons where does copper accumulate
liver
basal ganglia
cornea
renal tubules
affects of wilsons
liver = cirrhosis
basal ganglia = Parkinsonism/dementia
cornea
renal tubules
signs of wilsons
ring in the cornea
diagnosing wilsons
low total serum copper and caeruloplasmin
urinary copper
wilsons treatment
penicillamine
trientene
zinc
what does α1-Antitrypsin deficiency lead to
cirrhosis
what isnt inhibited in α1-Antitrypsin deficiency
neutrophil elastase
diagnosis of α1-Antitrypsin deficiency
low serum levels of α1-AT
common sign of alcoholic hepatitis
rapid onset jaundice
other features of alcoholic hepatitis
nausea, anorexia, right upper quadrant pain, encephalopathy, fever, ascites and tender hepatomegaly
alcoholic hepatitis FBC
shows leucocytosis
elevated MCV
thrombocytopenia
alcoholic hepatitis electrolytes
hyponatraemia
alcoholic hepatitis LFT
AST and ALT with a disproportionate rise in AST
high bilirubin
low albumin
prolonged prothrombin
common co morbidity in PSC
UC
commonly raised in PSC
ALP
PSC symptoms
pruritus, jaundice or cholangitis
PSC diagnosis techniques
MRCP
liver biopsy
cancer which can develop from PSC
cholangiocarcinoma
risk factors for HCC
aflatoxin
teroids
contraceptive pill
chrnic liver disease
rapid development of which features in patients with cirrhosis indicated what
Weight loss, anorexia, fever, ascites and abdominal pain
what can be raised in HCC
AFP
