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MS2 > GI EXAM II > Flashcards

GI EXAM II Flashcards

1
Q

DILI- Cholestasis

A

Anabolic steroids, phenothiazine derivatives, total parenteral nutrition

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2
Q

DILI- Fatty change

A

Steroids

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3
Q

DILI- Acute Hepatitis

A

INH, Augmentin, Phenytoin

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4
Q

DILI- Fulminant Hep. Failure

A

Acetaminophen, Halothane

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5
Q

DILI- Chronic Hepatitis

A

α-methylDOPA, Isoniazid (INH)

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6
Q

DILI- Fibrosis/Cirrhosis

A

Methotrexate

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7
Q

DILI- Granulomatous Hepatitis

A

Allopurinol, Sulfa drugs

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8
Q

DILI- Hepatic Cell Adenomas

A

Oral contraceptive pills e.g. 1st generation

remove pill tumor regresses

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9
Q

DILI- Hepatocellular Carcinoma

A

Anabolic steroids

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10
Q

Epidemiological Associations

Hepatic adenoma

A

oral contraceptives

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11
Q

Epidemiological Associations (3)

Cholangiocarcinoma

A

Primary sclerosing cholangitis (PSC),

Clonorchis,Opisthorchis (Found mainly in Asia

–> irritation of bile ducts–> bile duct cancer)

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12
Q

Epidemiological Associations

Angiosarcoma

A

Arsenic, (poly)vinylchloride(PVC)

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13
Q

Epidemiological Associations (7)

Hepatocellular Carcinoma

A

Hepatitis B virus
•Hepatitis C virus
•Aflatoxin
•Cirrhosis (e.g. Hemochromatosis, Alcoholic liver dis.)
•Non-alcoholic fatty liver disease (NAFLD)
•Anabolic steroids
•Tyrosinemia/A1AT deficiency

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14
Q

Hepatitis B and Hepatocellular Carcinoma

A

Southeast Asia and Southern Africa

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15
Q

Stromal Tumors of the Liver

Malignant

A 
Malignant
•Angiosarcoma
•Embryonal sarcoma
•Leiomyosarcoma
•Lymphoma
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16
Q

Stromal Tumors of the Liver

Benign

A 
Benign
•Hemangioma
•Mesenchymal hamartoma
•Angiomyolipoma
•Leiomyoma
•Inflammatory pseudotumor
•Peliosis hepatis
17
Q

Epithelial Tumors of Liver

Benign

A 
Benign
•Focal nodular hyperplasia
•Hepatic cell adenoma
•Bile duct hamartoma
•Bile duct adenoma
18
Q

Epithelial Tumors of Liver

Malignant

A

Malignant
•Hepatocellular carcinoma (HCC)
•Cholangiocarcinoma (CC)

19
Q

Treatment Guidelines: Recommendations for First-
Line Therapy in Patients Without Cirrhosis

Preferred (3)

A

Preferred - Tenofovir DF, Entecavir, Peg-IFN alfa-2a

20
Q

Treatment Guidelines: Recommendations for First-
Line Therapy in Patients Without Cirrhosis

Alternative

A

Alternative- Adefovir, Telbivudine*

21
Q

Treatment Guidelines: Recommendations for First-
Line Therapy in Patients Without Cirrhosis

Not Preferred

A

Not Preferred- Lamivudine

22
Q

autoimmune hepatitis

Type 1

Tx: Treatment
• Corticosteroids
• Immunosuppression
– azathioprine

A

Type 1: ANA, ASMA, IgG hypergammaglobulinemia

Most common type

23
Q

autoimmune hepatitis

Type 2

Tx: Treatment
• Corticosteroids
• Immunosuppression
– azathioprine

A

Type 2: Anti‐LKM.

Predominantly in children.
Rare in adults . Patients have more extra hepatic immunologic diseases, lower gamma globulins and higher tendency to develop cirrhosis despite steroid therapy

24
Q

autoimmune hepatitis

Type 3

Tx: Treatment
• Corticosteroids
• Immunosuppression
– azathioprine

A

Type 3: Anti‐SLA. Rare It may rapidly progress to cirrhosis

25
Q

What to order

Chronic liver disease/Cirrhosis- ascites

A 
• Routine
– Cell count
– Albumin
– Culture
• Optional
– Total protein
– Glucose
– Lactic dehydrogenase
– Gram stain
• Special
– Cytology
– TB smear and culture
– Triglycerides
– Bilirubin
– Amylase
26
Q

Hepatorenal syndrome progression may
be slow (type II) or rapid (type I).
• Type I disease frequently is accompanied
by rapidly progressive liver failure.

Diagnosis

A

Diagnosis

• creatinine clearance less than 40 mL/min
• a serum creatinine greater than 1.5 mg/dL,
• urine volume less than 500 mL/d, and a
• urine sodium less than 10 mEq/L is
present.
• Urine osmolality is greater than plasma
osmolality.

Clinically, the diagnosis may be reached if
central venous pressure is determined to
be normal or if no improvement of renal
function occurs following the infusion of at
least 1.5 L of a plasma expander

27
Q

HEPATIC ENCEPHALOPATHY

What gets through BBB
and Grades

A

facilitate the passage of neurotoxins into the
brain [short-chain fatty acids, mercaptans,
false neurotransmitters (eg, tyramine,
octopamine, and beta-phenylethanolamines),
ammonia, and gamma-aminobutyric acid
(GABA) ]

• Grade 0 - Subclinical; normal mental status, but minimal
changes in memory, concentration, intellectual function,
coordination
• Grade 1 - Mild confusion, euphoria or depression,
decreased attention, slowing of ability to perform mental
tasks, irritability, disorder of sleep pattern (ie, inverted
sleep cycle)
• Grade 2 - Drowsiness, lethargy, gross deficits in ability to
perform mental tasks, obvious personality changes,
inappropriate behavior, intermittent disorientation
(usually for time)
• Grade 3 - Somnolent but arousable, unable to perform
mental tasks, disorientation to time and place, marked
confusion, amnesia, occasional fits of rage, speech is
present but incomprehensible
• Grade 4 - Coma, with or without response to painful
stimuli

MS2 (6 decks)

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