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GI (MKSAP) > Disorders of the Liver > Flashcards

Disorders of the Liver Flashcards

1
Q

Formula for Maddrey Discriminant Function Score

A

4.6 x (Patient PT - Control PT + Total Bilirubin in mg/dL)

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2
Q

Components of the Model for End-Stage Liver Disease (MELD) Score

A

Total bilirubin, creatinine, and INR

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3
Q

Most commonly implicated antibiotic in drug-induced liver disease

A

Amoxicillin-clavulanate

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4
Q

Most specific histologic criteria for autoimmune hepatitis

A

Interface hepatitis with lymphocytes and plasma cells in portal, periportal, or lobular areas

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5
Q

Absolute indications for treatment of autoimmune hepatitis (4)

A

(1) AST >10x, (2) AST >2x with gamma-globulin >2x, (3) bridging or confluent necrosis on biopsy, (4) symptoms: fever, nausea, vomiting, jaundice

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6
Q

Risk factors for progressive hepatic fibrosis in nonalcoholic fatty liver disease (4)

A

(1) Age >50, (2) BMI >28, (3) serum triglyceride levels >150 mg/dL, (4) ALT >2x

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7
Q

Most common screening test for Wilson disease

A

Serum ceruloplasmin

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8
Q

Kayser-Fleischer rings in Wilson syndrome indicate copper deposition in this layer of the cornea

A

Descemet membrane

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9
Q

Pathognomonic finding on liver biopsy in primary biliary cirrhosis characterized by focal duct obliteration with granuloma formation

A

Florid duct lesion

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10
Q

Gold standard for diagnosis of primary sclerosing cholangitis

A

Cholangiography

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11
Q

Pathologic hallmark of primary sclerosing cholangitis

A

Fibro-obliterative cholangiopathy

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12
Q

Portal vein pressure at which clinically significant portal hypertension occurs

A

8-10 mmHg

normal: 3-5 mmHg

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13
Q

Target heart rate when using nonselective beta-blockers for prophylaxis against variceal bleeding

A

Reduction in resting HR of 25% or 55-60/min

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14
Q

Frequency of surveillance endoscopy in patients with negative screening endoscopy for esophageal varices

A

Every 2-3 years

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15
Q

Most effective secondary prophylaxis for variceal hemorrhage

A

Nonselective beta-blockers plus endoscopic variceal band ligation

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16
Q

Most frequent complication of portal hypertension

A

Ascites

17
Q

Definition of rapidly progressive reduction in renal function in type I hepatorenal syndrome

A

Doubling of the initial serum creatinine to greater than 2.5 mg/dL (221 umol/L) or a 50% reduction of the initial 24-h creatinine clearance to <20 mL/min/1.73 m2 in less than 2 weeks

18
Q

Type of hepatorenal syndrome commonly associated with refractory ascites

A

Type II hepatorenal syndrome

19
Q

Most effective treatment for hepatorenal syndrome

A

Liver transplantation

20
Q

Diagnostic finding in hepatopulmonary syndrome on contrast-enhanced echocardiography

A

Microbubble visualization within the left atrium after 3-6 cardiac cycles

21
Q

Confirmatory test for portopulmonary hypertension

A

Right heart catheterization

22
Q

Hemodynamic criteria for portopulmonary hypertension (3)

A

(1) Mean PAP 25 mmHg or greater, (2) pulmonary vascular resistance 240 dynes/s/cm-5 or greater, and (3) PA occlusion pressure <15 mmHg

23
Q

Portopulmonary hypertension has a poor prognosis when mean pulmonary artery pressures exceed this level

A

35 mmHg

not candidates for transplantation due to increased risk for perioperative death

24
Q

Third leading cause of cancer-related death worldwide

A

Hepatocellular cancer

25
Q

Most widely available and least expensive imaging modality for hepatocellular cancer

A

Ultrasound

26
Q

Recommended interval for surveillance for hepatocellular cancer in patients with negative initial imaging

A

6 months

27
Q

Most effective therapy for early-stage hepatocellular cancer

A

Liver transplantation

28
Q

Group of fulminant hepatic failure with the best overall prognosis

A

Hyperacute liver failure (failure within 1 week)

29
Q

Duration of acute liver failure

A

1 to 4 weeks (hyperacute if within 1 week, subacute if between 4-12 weeks)

30
Q

Preferred therapeutic approach to a large symptomatic simple hepatic cyst

A

Laparoscopic fenestration

31
Q

Benign liver lesion with a characteristic “central scar” on CT or MRI

A

Focal nodular hyperplasia

32
Q

Benign liver lesion associated with the use of oral contraceptives

A

Hepatic adenoma

33
Q

Indications for surgical resection of hepatic adenomas (2)

A

(1) Greater than 5 cm, (2) pregnancy is being considered

34
Q

Pregnancy-related liver disease associated with long-chain 3-hydroxyacyl-CoA dehydrogenase deficiency

A

Acute fatty liver of pregnancy

GI (MKSAP) (7 decks)

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