Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

clin med > hepatic > Flashcards

hepatic Flashcards

1
Q

GGT (gamma glutamyl transferase), ALP, and TBIL → tell us about

A

bile ductal cells

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

ast and alt detect

A

injury to hepatocytes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Best test for measuring day to day synthetic function of the liver:

A

prothrombin time/INR

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

ercp?

A

allows you to treat and dx probs of the liver, GB, bile ducts, and pancreas

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

ercp procedure

A

Endoscope goes into the duodenum, dye is injected into CBD, and can see by fluoroscopy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

portal htn back up

A

Blood backs up in the stomach, intestines, spleen, pancreas, when portal venous system is backed up

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

portal htn leads to

A

esophageal varices and hemorrhoids

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

cirrhosis?

A

Fibrosis and nodules in liver

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

dx ascites

A

Dx with US or CT… hard to dx on PE

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

ascites trmt

A

Trmt- Na restriction, diuretics

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Kayser fleischer rings

A

corneal copper deposition in wilson’s disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Fetor hepaticus?

A

(bad odor of breath and urine)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

guaiac + stools are a sx in this disease

A

cirrhosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Asterixis ?

A

flappy tremor of arms

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

choreoathetosis ?

A

dancing extremities

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

common causes of cirrhosis

A

Common: Hep B and C, alcoholic liver disease, hemochromatosis, NASH (nonalcoholic steatohepatitis)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Extrahepatic cholestasis?

A

Bile flow from liver is reduced bc of an obstruction outside the liver

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Intrahepatic cholestasis?

A

Bile flow from liver is reduced bc of an obstruction inside the liver

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Primary sclerosing cholangitis (PSC)?

A

Chronic progressive inflammation, fibrosis, and stricturing of medium and large ducts in intra and extra hepatic biliary tree that leads to fatigue

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Primary sclerosing cholangitis (PSC)

cause

A

unknown

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Primary sclerosing cholangitis (PSC) sx

A

Asymptomatic

Fatigue, pruritus (from hyperbilirubinemia), RUQ pain, arthropathy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Primary sclerosing cholangitis (PSC)

pe

A

May be normal
Hypopigmentation, excoriation (from itching), jaundice
Late stage: ascites, clubbing, edema

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Primary sclerosing cholangitis (PSC)

dx

A 
\+ antimitochondrial antibodies (AMA)
Inc LFT esp. Alk phos
Histology shows Asymmetric destruction of bile ducts
Do liver biopsy, MRCP, ERCP
Need all 3 to dx
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Associated with UC

A

Primary sclerosing cholangitis (PSC)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
“Beading of bile ducts”
Primary sclerosing cholangitis (PSC)
26
Primary sclerosing cholangitis (PSC) | 2 trmt goals
Slow and reverse disease progression- many drugs dont succeed Manage disease and complications
27
Primary sclerosing cholangitis (PSC) | trmt
Ursodeoxycholic acid (UDCA)/Ursodiol is best Endoscopic therapy to dilate or stent the stricture No widely acceptable trmt Treat underlying sx: itching, bone disease, hyperlipidemia Ursodeoxycholic acid (UDCA)/Ursodiol- good if trmt starts early bc it thins the bile duct Cholestyrene resin reduces pruritis Liver transplant if they think you'll die within a year
28
Acute Hepatitis A | cause
Hep A virus (HAV)
29
Acute Hepatitis A | sx
Nausea, vomiting, fatigue, diarrhea, fever, jaundice
30
Acute Hepatitis A | prevention?
yes, Vaccine
31
Acute Hepatitis A | transmission
Fecal oral route | No bloodborne transmission
32
Hepatitis B | cause
Hepatitis B virus (HBV)- DNA virus
33
Hepatitis B | transmission
Transmitted by blood, sex Present in saliva, semen, or vaginal secretions HBsAg + mothers can transmit HBV when delivering baby
34
Hepatitis B | sx
Anorexia, NV, malaise | Fever, enlarged liver and tender, jaundice
35
Hepatitis B | dx
High aminotransferases (ALT and AST) Liver biopsy: hepatocellular necrosis Chronic hep B will have high aminotransferase levels for over 6 mo
36
Hepatitis B | prevention?
yes 3 series vaccine
37
Hepatitis B | trmt
No trmt bc it resolves on its own | For chronic hep B give immune modulators (INF) and antiviral agents in nucleoside analogues (lamivudine)
38
Hepatitis B | complications
Cirrhosis in pts with chronic hep B and HBV or HCV | Pts with cirrhosis at risk for hepatocellular carcinoma
39
skin sx cirrhosis
Jaundice, palmar erythema, Spider angioma, Ecchymosis, Dilated abdominal wall veins, Xerotic eczema, Caput medusae, Hemochromatosis- inc pigmentation, Xanthomas- primary biliary cirrhosis, Needle tracts- viral hepatitis
40
MCC portal hypertension
ascites
41
MC blood borne infection
Acute Hepatitis C
42
Leading cause of chronic liver failure
Acute Hepatitis C
43
MC indication for liver transplant
Acute Hepatitis C
44
Acute Hepatitis C | cause
HCV- RNA virus
45
Acute Hepatitis C | transmission
Bloodborne | Transmitted by IV drug use (MC), transfusion, sexual activity, and tattoos previously (think needles)
46
Acute Hepatitis C | sx
Mostly asymptomatic | Jaundice, abd pain, anorexia, malaise… nonspecific
47
Acute Hepatitis C | dx
``` Enzyme immunoassay (EIA) to look for anti-HCV antibody- dont do often Then do Recombinant immunoassay (RIBA) to confirm if this is + HCV RNA PCR- we do this now High AST/ALT and bilirubin ```
48
Acute Hepatitis C | trmt
INF + any -vir drug
49
in hep C: Genotype 1 and 4 have ____ response to trmt Genotype 2 and 3 have ____ response to trmt ____ less likely to respond to trmt
poor better AA/males
50
Important historical breakthrough… over 95% of pts show response in this disease but... Expensive… 50-90K
Acute Hepatitis C
51
Acute Hepatitis C | trmt goals
Get rid of infection Slow disease progression Improve QOL Sustained virological response: aviremia 12-24 wks after antiviral therapy
52
MCC of cirrhosis
Alcoholic cirrhosis
53
Alcoholic cirrhosis | cause
4 beers a day for ten yrs | Malnourished and anemic bc ppl drink more than they eat
54
Alcoholic cirrhosis | dx
AST>ALT | High bilirubin
55
Alcoholic cirrhosis | trmt
Stop drinking | Transplant
56
Nonalcoholic steatohepatitis/fatty liver (NASH) | sx
Most asymptomatic | Fullness in RUQ, fatigue, malaise, hepatomegaly
57
Nonalcoholic steatohepatitis/fatty liver (NASH) | dx
``` High ALT and AST No infectious hepatitis HLD Inc PTT and bilirubin, hypoalbuminemia US/CT/MR shows fatty liver Biopsy makes dx ```
58
dx for Nonalcoholic steatohepatitis/fatty liver (NASH) | is based on
histological findings
59
criteria for NASH
Based on histological findings Low alcohol consumption No serological evidence of other disease Biopsy: macrovesicular steatosis or steatohepatitis
60
NASH can lead to
Can lead to insulin resistance
61
Nonalcoholic steatohepatitis/fatty liver (NASH) | trmt
Lose weight, control HLD and hyperglycemia, liver transplant
62
MC metastatic CA
Hepatocellular neoplasms
63
Hepatocellular neoplasms | come from
lung, colon, breast, prostate
64
Hepatocellular carcinoma aka
hepatoma
65
Hepatocellular carcinoma cause
Hep B and C
66
Hepatocellular carcinoma sx
Weight loss | Signs of cirrhosis
67
Hepatocellular carcinoma dx
US MC | AFP (alpha fetoprotein) tumor marker present
68
Hepatocellular carcinoma trmt
Transplant or resection
69
Hemochromatosis inheritance
autosomal recessive
70
Hemochromatosis?
Inc iron in various organs
71
Hemochromatosis sx
Arthralgias, hepatomegaly, gray skin, DM, ED
72
Hemochromatosis dx
Hallmark: inc % transferrin saturation and high serum transferrin
73
Hemochromatosis trmt
Weekly phlebotomy
74
Wilson's disease?
Disorder of copper transport and copper accumulates in liver, brain, kidneys and cornea
75
Wilson's disease | sx
Looks like acute or chronic liver disease (malaise, high LFT) hallmark: Kayser- fleischer gold ring in iris periphery Low serum ceruloplasmin Diagnostic: urine copper
76
Wilson's disease | trmt
Penicillamine
77
Autoimmune hepatitis?
Chronic inflammation of the liver dt circulating autoantibodies
78
Autoimmune hepatitis | sx
Jaundice, fatigue, anorexia, nausea, abd pain, pruritus, arthralgia
79
Autoimmune hepatitis | dx
``` Antinuclear Ab (ANA), anti smooth mc Ab (ASMA) Liver biopsy shows inflammation ```
80
Autoimmune hepatitis | trmt
``` Transplant No hepatotoxins (in meds) ```
81
Acetaminophen poisoning?
7.5-10g APAP over 24 hrs
82
Acetaminophen poisoning | sx
0-24 hrs nausea vomiting, anorexia 24-72 hrs RUQ pain, inc AST and ALT 72-96 hrs ast and alt peak Over 5 days revolution or death
83
Acetaminophen poisoning | dx
APAP in blood
84
Acetaminophen poisoning | trmt
N-acetylcysteine | Liver transplant
85
MELD- model for end stage liver disease?
Predicts disease severity and mortality in pts with hepatic dysfunction Helps us give priority too liver transplant pts
86
MELD- model for end stage liver disease calculation?
Calculated using bilirubin, creatinine, and INR

clin med (35 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions