GI

Question 1

AST: ALT >2

Answer 1

Alcoholic Hepatitis

Question 2

-Irreversible liver fibrosis w/ nodular regeneration
-MC d/t ETOH in US. Also, Hep. fatty liver
-Sx: Fatigue, weakness, decreased weight, anorexia, spider angiomas, caput medusa, HSM, bleeds, Palmor erythmea, hepatic encephalapothy, astorixis, as cities, gynecomastia
-Dx: Labs, US
Tx: Encephalopathy: Lactulose & neomycin
Ascities: Na restriction, diruetics. Paracentisis. Definitive=transplant

Answer 2

Cirrhosis

Question 3

MC d/t chronic hepatitis

Screen w/ US. Definitive=Bx

Answer 3

Hepatocellular carcinoma

Question 4

-Excessive Fe deposits in organs/tissues
-D/t genetic disorder of increased Fe storage & absorption
-Men>women
-Sx: >40, Fatigue. Others organ specific. Liver: cirrhosis, HM, Pain
Testicles: Hypogonadism
Heart: Arrhythmia, cardiomyopathy
Skin: Bronze, metallic skin
Dx: Serum Fe; ferratin; increased LFTs; hepatic Bx gold standard
Tx: Phlebotomy; chelating agents

Answer 4

Hemochromatosis

Question 5

-D/t obesity, DM, hyperlipids, Drugs (steroids, HAART)
-Very common in US
Sx: Asx, HM
Dx: Increased ALT, AST (though normal 80%), US/CT/MRI, Bx gold standard
Tx: Lifestyle changes can reverse

Answer 5

Fatty Liver