Extras: Liver Flashcards
Hallmark of chronic hepatitis
Increased portal inflammation with lymphocytic inflammation + fibrosis
Extrahepatic sx of Hepatitis A
Rash, arthralgias, vasculitis, glomerulonephritis, cryoglobulinemia
Two pts who Hep E affects the most
- Immunocompromised -> chronic
2. Pregnant -> fulminant hepatitis
Abs in type I and II AIH
Type I: SMA Abs
Type II: LKM Abs
Histo of AIH
Plasma cells in liver
Treatment for AIH
Prednisone +/- azathioprine
Single best measure of hepatic synthesis function
Coagulation factors
Is albumin better for chronic or acute liver disease
Chronic - long half life
Two things present in Hep B window phase
- HBV DNA
2. HBc IgM
Classic tetrad of hemochromatosis
- Hepatomegaly
- Cirrhosis
- Bronze skin
- DM
- Heart failure
Treatment for Wilson Disease + how it works
Oral Penicillamine: chelates Cu for excretion
Mutation in Dubin Johnson + what that causes
MRP2 gene -> decreased excretion of conjugated bilirubin
What type of liver blood compromise does schistosomiasis cause?
Blocks small intrahepatic veins -> blocks portal vein
What condition is associated with bush tea, post-hematopoeitic SC transplants, and chemotherapy
Sinusoidal Obstruction Syndrome (Veno-occlusive disease)
Conditions associated with Budd Chiari
- Hypercoag state
- Oral contraceptives
- Polycythemia vera
- APA syndrome
- PNH
- Abdominal cancers like HCC
What symptoms separate Budd Chiari from other liver presentations?
Splenomegaly, ascites
Child-Turcotte Pugh calculator is for what?
Chronic liver failure
Four stages of acetaminophen OD
- N/V, abd pain, pallor, sweating
- RUQ pain, LFTs increase
- Rapid liver failure, coma, +/- death
- Recovery if survive stage 3
Lab values that increase in alcohol induced liver disease
AST:ALT 2:1, bili and ALP are increased too
Which of these liver conditions will have increase BNP?
Liver in heart failure
Treatment for hepatic encephalopathy
Lactulose
Fibropolycystic disease
Group of dz with congenital biliary tree malformation due to ductal plate malformation
What liver lesion is well-demarcated with a central scar and no capsule
Focal Nodular Hyperplasia
What liver lesion has a map-like pattern on GS stains?
Focal Nodular Hyperplasia
Three lesions/benign neoplasms of the liver VS five malignant tumors
Lesions/Benign neoplasms 1. FNH 2. Cavernous hemangioma of the liver 3. Hepatocellular adenoma Malignant tumors 1. Hepatoblastoma 2. HCC 3. Intrahepatic cholangiocarcinoma 4. Angiosarcoma 5. Lymphoma
Lab value to look for in HCC
Alpha-fetoprotein
Subtype of HCC and describe it
Fibrolamellar carcinoma: younger adults, large scirrhous tumor, better outcome
Two main lymphomas that affect the liver
- Diffuse large B cell
2. MALT lymphoma
Signs of pre-eclampsia
HTN, proteinuria, peripheral edema, coagulation abnormalities
HELLP syndrome
In pregnancy; hemolysis, elevated liver enzymes, low platelets
Intrahepatic cholestasis of pregnancy sx
Pruritis, dark urine, light stools, jaundice
