Hepatic Disorders

Question 1

What is the most common precursor of cirrhosis?

Answer 1

alcoholic hepatitis

Question 2

Your patient with chronic liver disease and ascites is now complaining of fever and abdominal pain. You find no peritoneal signs on examination. You perform abdominal paracentesis, and ascitic fluid neutrophil count is 500 WBC/mcL. What is it?

Answer 2

spontaneous bacterial peritonitis

Question 3

Malignant ascites is usually caused by what?

Answer 3

primary adenocarcinomas of ovary, uterus, pancreas, stomach, colon, lung, or breast

Question 4

What is the presentation of a patient with malignant ascites?

Answer 4

nonspecific abdominal discomfort

weight loss with increased abdominal girth

Question 5

What are the skin manifestations of cirrhosis?

Answer 5

~spider angiomas on the upper half of the body
~palmar erythema
~glossitis, cheilosis

Question 6

What are the lab findings of cirrhosis?

Answer 6

~macrocytic anemia
~low RBC
~thrombocytopenia
~prolonged PTT
~progressive elevation of bilirubin
~increase in AST and alk phos

Question 7

Cirrhosis may be reversible if cause (e.g. alcohol) is removed.
T/F

Answer 7

True.

Question 8

What is the difference in AST:ALT ratios in alcoholic liver disease and non-alcoholic fatty liver disease?

Answer 8

alcoholic liver disease: > 2:1 AST:ALT

NAFLD: < 1:1 AST:ALT

Question 9

Hepatitis C is more common among (blacks, whites).

Answer 9

blacks