Chronic Liver Disease

Question 1

what is chronic liver disease

Answer 1

liver disease that persists beyond 6 months

Question 2

what is cirrhosis

Answer 2

normal liver tissue replaced by scar tissue

Question 3

4 common causes of cirhossis

Answer 3

hep B, hep C, alcohol abuse and non-alcoholic fatty liver disease

Question 4

what immune cells infiltrate in cirrhosis

Answer 4

lymphocytes

Question 5

complications of cirrhosis

Answer 5

portal hypertension, liver insufficiency and liver failure

Question 6

what is ascites

Answer 6

build up of fluid in abdominal cavity

Question 7

what is the most common manifestation of cirrhosis

Answer 7

ascites

Question 8

what proportion of patients with ascites have cirrhosis

Answer 8

75%

Question 9

examination of ascites

Answer 9

shifting dullness:
percuss from centre of abdomen till sounds dull
ask patient to turn onto side away from hand. percuss again, if resonant then fluid

fluid thrill:
flick side and feel with hand on other side for wobble

Question 10

5 F thing that distend abdomen

Answer 10

fat
faeces
flatulence
fluid
foetus

Question 11

what causes varices

Answer 11

portal hypertension

Question 12

where are the variceal sites

Answer 12

periumbilical
oesophageal
rectal
posterior abdominal wall

Question 13

management for variceal haemorrhage

Answer 13

good IV access to blood transfuse

endoscopic band ligation of vessel

Question 14

what is hepatic encephalopathy

Answer 14

confusion due to liver disease and associated bleed, infetion dehydration or medication

Question 15

what sign is present in hepatic encephalopathy

Answer 15

asterixis

Question 16

treatment of hepatic encephalopathy

Answer 16

treat underlying
laxatives
antibiotics
maybe transplant ultimately