Gastroenterology Revision Flashcards
How do you calculate the R factor (ALT to ALP ratio)?
ALT/ULN / ALP/ULN
What does the result of the R factor mean?
< 2 cholestatic
> 5 hepatocellular
2 < R < 5 mixed picture
Which main drugs cause hepatocellular pattern of LFT derangement?
paracetamol
statins
isoniazid
Which main drugs cause cholestatic pattern of LFT derangement?
augmentin
cephalosporins
flucloxacillin
Which main drugs cause a mixed picture pattern of LFT derangement?
anti epileptics
What are the common causes of markedly elevated ALT and AST (>25x ULN)?
ischaemic hepatitis
viral hepatitis (Hep A, Hep B, HSV)
drug induced (paracetamol)
hepatic vein thrombosis
How high is the ALT in alcohol and NAFLD?
generally < 200
In what condition can you see normal ALP but other LFTs deranged?
Wilson’s disease
In what condition do you see reversal of the AST to ALT ratio?
alcoholic hepatitis
What is the common skin manifestation of coeliac disease?
dermatitis herpetiformis
What are the features of secretory diarrhoea?
large volume watery stools that persists despite fasting
What are the features of carcinoid syndrome?
diarrhoea and cramping, flushing, telangectasia, valvular heart lesions, bronchoconstriction
What is the test for carcinoid syndrome?
urinary secretion of 5-HIAA
What are the features of osmotic diarrhoea?
less volume and improves with fasting
What causes osmotic diarrhoea?
IBS, constipation with overflow
