Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Gastroenterology > Conceptual constructs of liver disease > Flashcards

Conceptual constructs of liver disease Flashcards

1
Q

Name some LFTs

A

ALT
AST
Albumen
Globulin
Alkaline phosphatase
Bilirubin
GGT

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What scoring system is used for liver cirrhosis?

A

Child-Pugh score
Classified A-C
A = good prognosis
C = poor prognosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Where is bile made (microscopically)?

A

between 2 hepatocytes in the canaliculus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What is a fibroscan?

A

non-invasive way of stratifying extent of scar tissue

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What does ALT stand for?

A

alanine aminotransferase

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What does AST stand for?

A

asparte aminotransferase

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What happens to albumen in cirrhosis?

A

it decreases

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What does it mean if ALT or AST is raised?

A

enzymes that originate in hepatocytes
raised = something is damaging liver cells

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Solubility of unconjugated and conjugated bilirubin

A

unconjugated = insoluble
conjugated = soluble

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What is intrahepatic cholestasis?

A

something is going wrong with making bile between hepatocytes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Define cholestasis

A

alteration in flow of bile

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What LFT is raised in cholestasis?

A

alkaline phosphatase

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What does it mean if both alkaline phosphatase and GGT are raised?

A

HPB origin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What does it mean if alkaline phosphatase is raised by GGT is normal?

A

raised alk phos from somewhere else

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What is GGT?

A

gamma glutamyl transferase

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

How does acute liver injury occur?

A

normal liver has an acute insult

17
Q

LFTs in acute liver injury

A

high ALT
INR >1.5
jaundice (high bilirubin)
high ammonia (encephalopathy)

18
Q

What can interruption to bile flow be caused by?

A

large duct obstruction (extrahepatic cholestasis)

failure of liver cells to make bile at level of canaliculus (intrahepatic cholestasis)

19
Q

Describe the patterns of liver injury (hepatic vs cholestatic)

A

hepatic:
- ALT >5x ULN
- Alk phos <2x ULN

cholestatic:
- ALT <2x ULN
- Alk phos >5x ULN

mixed:
- ALT 2-5x ULN
- Alk phos 2-5x ULN

[ULN = upper limit of normal]

20
Q

What is DILI?

A

drug-induced liver injury

21
Q

Signs of chronic liver disease

A

jaundice
raised JVP
spider naevi
gynaecomastia
clubbing
palmar erythema
ascites
oesophageal varices
splenomegaly
rectal varices
fetor hepaticus
loss of sexual hair
testicular atrophy
liver flap (asterixis)
bleeding tendency
ankle oedema
anaemia

22
Q

What are the likely causes if ALT >1000 IU/L?

A

ischaemia - eg. syncope can cause episodic reduced perfusion to liver

drug-induced (prescribed + non-prescribed)

viral hepatitis

acute biliary obstruction

23
Q

Non-liver causes of raised ALT

A

haemolysis
myositis/myopathy
strenuous exercise
sepsis

24
Q

Causes of raised ALT (but <500IU/L)

A

alcohol excess
NAFLD
viral hepatitis
metabolic (haemochromatosis, Wilson’s, alpha-1-antitrypsin deficiency)
autoimmune hepatitis
drug-induced liver injury
acute Budd Chiari
acute bile duct obstruction

25
Q

What screening tool can be used to assess alcohol excess?

A

AUDIT C

26
Q

Which viral hepatitis can cause chronic infection?

A

B + C

27
Q

Autoimmune hepatitis antibody

A

anti-smooth muscle antibody
anti LKM
anti LCA
p-ANCA
ANA

28
Q

Test results for Wilson’s disease

A

low total copper
low caeruloplasmin

29
Q

What investigations should be done in NAFLD?

A

BMI
fasting glucose
HbA1C
urate
fasting lipids

30
Q

Who is at risk of Hep C?

A

ex and current drug users
blood transfusions before 1991
organ/tissue transplant before 1992
lived in area with high levels of Hep C
mother has Hep C
health workers accidentally exposed
tattoo/piercing in place where equipment not sterilised
sexual partners, family members and close contacts of those with Hep C

31
Q

Who is at risk of Hep B?

A

vaginal, anal or oral sex without a condom
injecting drugs/sharing needles
injured by a needle
tattoo/piercing with unsterilised equipment
blood transfusion in country that does not check for Hep B
can pass to babies during pregnancy/birth from mother

32
Q

Most likely cause of isolated raised bilirubin

A

Gilbert’s syndrome
normal LFTs
no bilirubin in urine
normal stool colour
exclude haemolysis (FBC, LDH, haptoglobin, reticulocyte)

33
Q

What is urine and stool like in hepatic and post-hepatic jaundice?

A

dark urine
pale stools

34
Q

Extrahepatic cholestasis causes

A

stones
cancer
primary sclerosing cholangitis

35
Q

Main symptoms of intrahepatic cholestasis

A

fatigue
pruritis

36
Q

Intrahepatic cholestasis causes

A

primary biliary cholangitis
small duct PSC
amyloid - renal disease
lymphomas
granulomatous disease
immunodeficiencies (panhypogammaglobulinaemia)
cholestasis of sepsis
heart failure

37
Q

What antibody is present in primary biliary cholangitis?

A

antimitochondrial antibody

Gastroenterology (43 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions