Clinical stuff Flashcards
how to tell a spider angioma
it is blanchable, often seen on face and trunk…seen when estrogen is elevate (e.g. cirrhosis and pregnancy)
what are stigmata of liver disease?
spider angioma xanthalasma palmar erythema pruritus jaundice Terry Nails Leukonychia Dupuytren's
ascites/varices/caput medusa/hemmrhoids/splenomegaly –> portal hypertension
gynecomastia hepatic encephalopathy (confusion, asterixis) fetor hepaticus (mousy, sweet-ish breath)
What is an acute phase reactant?
a blood protein whose levels increase during inflammation (e.g. CRP, ceruloplasmin, fibrinogen, ferritin, A1AT) ***note that albumin goes down.
how is bilirubin toxic
cerebral toxicity
why do you have to be careful giving warfarin, sulfonamides, anti-inflammatories to newborns with jaundice?
because they bind albumin at the same site. they’ll displace bilirubin and can precipitate bilirubin toxicity
what is alpha-fetoprotein a marker for?
HCC, gonadal cancers…also elevated in pregnancy
what is clonorchis, where is it and what does it predispose to
a liver fluke found in the far east, cholangiocarcinoma
why can platelets be low in splenomegaly?
they are sequestered in the spleen
when would you maybe hear a bruit over the liver?
in alcoholic hepatitis
what is the AST:ALT ratio in alcoholic hepatitis vs. viral hepatitis?
2: 1 AST:ALT in alcoholic
1: 2 in viral
nephrotic range protein
3 mg/mg creatinine
what is metabolic syndrome?
some combination of : abdominal obesity high triglycerides high HDL Cho high blood pressure high fasting glucose (pre-diabetic)
increased echogenicity in the liver means…
fatty liver
What is the clinical picture of decompensated cirrhosis?
Some combiniation of:
ascites, bleeding esophageal/gastric varices, hepatic encephalopathy, spontaneous bacterial peritonitis, hepatorenal syndrome
Labs: hypoalbunemia, coagulopathy, hyperbilirubinemia
if someone has ascites w/o peripheral edema, how much fluid can you mobilize per day before you start depleting the intravascular volume?
0.5 L…furosemide or spironlactone
