Disprders Of Luger And Billsry Tract

Question 1

What does the liver store?

Answer 1

vitamin A and glycogen

Maintains glucose levels in the body

Question 2

Types of liver disease?

Answer 2

Acute - happens quickly e.g. drugs OD

Chronic - more slowly e.g. viruses

Question 3

Hepatitis, fibrosis and Cirrosis?

Answer 3

Chronic liver disease

Hepatitis is inflammation

Fibrosis

Cirrhosis- liver cells replaced by scar tissue, end stage liver disease

Question 4

Features of liver disease?

Answer 4

• None
  – Silent laboratory abnormalities
• Jaundice (excretory dysfunction)
  – Hepatitic or cholestatic
• Synthetic dysfunction
  – Oedema, coagulopathy
• Metabolic dysfunction
  – Hypoglycaemia, encephalopathy
• Features of portal hypertension
  – Gastrointestinal bleeding (varices), ascites
• Systemic features and other “stigmata” on examination

Question 5

Stigmata?

Answer 5

bodily marks, scars, or pains corresponding to those of the crucified Jesus Christ

Question 6

What is Portal hypertension and what is the cause?

Answer 6

a dangerous condition that occurs when the pressure in the portal vein, which carries blood from the intestines to the liver, is abnormally high.

The most common cause of portal hypertension is cirrhosis, or scarring of the liver

Question 7

Risk factors of liver disease?

Answer 7

• Alcohol
• Risk factors for blood-borne viruses
  – IVDU, blood transfusions/products, tattoos, needle stick injuries, foreign travel, high risk sexual practices
• Obesity/diabetes/hyperlipidaemia
• Autoimmune disease
• Medication
• Family history
• Ulcerative colitis
• Chronic biliary tract disease/hepatobiliary surgery

Question 8

Symptoms of portal hypertension?

Answer 8

Enlarged liver and spleen.
Enlarged veins (varices) of the esophagus and stomach. These can cause abnormal bleeding, such as vomiting blood.
Internal hemorrhoids.
Weight loss from malnutrition.
Fluid buildup in the belly (ascites)
Kidney malfunction.
Low platelets.
Fluid on the lungs.

Question 9

What happens to the liver in alcoholic liver disease?

Answer 9

• Steatosis
• Acute alcoholic hepatitis
• Fibrosis
• Cirrhosis

Question 10

Hep B transmission?

Answer 10

Parental
Sexual
Vertical (mother to child)

Question 11

Hep D co-infection what what viral infection?

Answer 11

B

Question 12

Transmission of hep C?

Answer 12

Parenteral (IVDU, blood products inc blood
pre 1992, needlestick), vertical, sexual

Question 13

Risk factors for Non-Alcoholic Fatty Liver Disease?

Answer 13

– Obesity
– Insulin resistance/diabetes
– Hyperlipidaemia
– Malnutrition
– TPN
– Drugs inc alcohol
– Genetics?

Question 14

Non-alcoholic fatty liver disease?

Answer 14

Build up of fat in the liver

Liver…
Fibrosis
Cirrhosis

Question 15

NAFLD aka?

Answer 15

Steatohepatitis

Fatty liver

Question 16

What can drug and toxin related liver disease cause.

Answer 16

• Zonal necrosis
• Hepatitis
• Cholestasis
• Steatosis
• Fibrosis

Question 17

What diseases can be inherited and cause liver disease?

Answer 17

• Hereditary haemochromatosis
• Wilson’s disease
• Alpha-1 antitrypsin deficiency
• Gilbert’s disease

Question 18

Gilberts disease?

Answer 18

Not necessarily the liver but is classed as the most common liver disease

bilirubin cannot be metabolised and there is a build up

Question 19

Tumours of the liver?

Answer 19

metastatic disease

Hepatocellular carcinoma

Question 20

Causes of Biliary diseases?

Answer 20

Gall stones

Autoimmune

Cancer

Question 21

How to monitor liver function? You should tests these

Answer 21

most important - prothrombin time

• Liver “function” tests
  – Bilirubin
  – Albumin
  – Enzymes: hepocyte/duct cell damage
• Clotting profile
  – Prothrombin time
• (FBC)

Question 22

Liver disease can manifest in the tongue?

Answer 22

Liver myeloidosis

Question 23

Other causes of liver disease?

Answer 23

• Cryptogenic
• Infections
  – Bacterial
  – Parasitic
• Vascular insults
• Systemic diseases

Question 24

Causes of biliary disease?

Answer 24

– Cholangiocarcinoma
– Cancer of the gall bladder