Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

GI > Hepatic Failure (NAFLD) > Flashcards

Hepatic Failure (NAFLD) Flashcards

1
Q

T/F: LFTs are indicators of liver function.

A
  • false

* indicators of hepatocellular injury

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

Which of the transaminases is liver specific?

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

Total bilirubin can be measured in what 2 ways?

A
  • (direct + indirect)

- (conjugated + unconjugated + delta)

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

What lab value is a good marker for chronic liver disease?

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

Which of the coagulation pathway is a better predictor of liver disease?

A
  • aPTT

INR can be elevated d/t malnutrition

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

All clotting factors except for ____ are made in the liver.

A

Factor VIII

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

NALFD has a strong association with these 2 factors.

A
  • obesity

- insulin resistance

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

The pathophysiology of NALFD is based around what dysfunction?

A
  • triglyceride disregulation

* precursors of TG are hepatotoxic

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

The fatty liver index (FLI) is composed of these 3 variables.

A
  • triglycerides
  • BMI
  • waist circumference
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What are the FLI cut offs and what risks correspond to each?

A
  • <30 = low
  • 30-60 = indeterminate
  • > 60 = high*

*fatty liver ruled in

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

What are some signs of liver dysfunction/failure in later NAFLD? (3 listed)

A
  • angiomas
  • portal HTN
  • jaundice
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What is the first imaging modality you would get for NALFD?

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

What is the gold standard diagnostic study for NALFD?

A
  • liver biopsy

* see fibrosis developed

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

This new type of diagnostic study for NALFD uses ultrasound and low frequency waves.

A

transient elastography

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

What is NASH and what causes it?

A
  • nonalcoholic hepatosteatosis

- result of progression of NALFD when tissue death and necrosis occurs (25% of patients)

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

To get a NAFLD Fibrosis score it requires these 4 variables.

A
  • AST
  • ALT
  • platelet count
  • albumin
17
Q

What NALFD scores do we need to remember? What fibrosis stages do they correlate with?

A
  • < -1.455 = F0-F2

- > 0.675 = F3-F4

18
Q

What do the 4 fibrosis stages correspond with?

A
  • F0 = no fibrosis
  • F1 = mild
  • F2 = moderate
  • F3 = severe
  • F4 = cirrhosis
19
Q

What are the Fibrosis-4 (FIB-4) score criteria and what fibrosis stage do they correlate with?

A
  • <1.54 = 0-1
  • 1.54-3.25 = 2-3
  • > 3.25 = 4

*fibrosis stage

20
Q

Weight loss of ____ % can improve steatosis.

A

3-5%

*10% if steatohepatitis

21
Q

What lifestyle modifications may help in the treatment of NAFLD? (5 listed)

A
  • low carb diet
  • weight loss
  • exercise
  • coffee
  • vitamin E/C
22
Q

Why is metformin not recommended for NAFLD?

A
  • no histological improvement
23
Q

What is one main side effect of pioglitazone?

A
  • weight gain
24
Q

What are the 3 drug therapies that have been used for treatment of NAFLD?

A
  • metformin
  • pioglitazone
  • statins

*none first line

25
Q

Large studies have shown this adverse side effect with bariatric surgery for NAFLD.

A
  • increased fibrosis
26
Q

When NAFLD has progressed to ELSD what is the only treatment option?

A
  • liver transplant
27
Q

What are the 2 markers of hepatic failure?

A
  • Hepatic encephalopathy

- Elevated INR > 1.5

28
Q

What is the typical toxin that causes hepatic encephalopathy?

A
  • ammonia
29
Q

T/F: Diagnosis of hepatic encephalopathy is clinical.

A
  • True
30
Q

How do you treat intercranial hypertension?

A
  • mannitol/hypertonic saline
31
Q

What is the most common cause of hepatic failure?

A
  • acetaminophen (tylenol)
32
Q

Tylenol overdose is reversible if treatment is started how soon?

A
  • first 24 hours

* no damage if started <8 hours

33
Q

At what part of tylenol metabolism does liver damage occur?

A
  • damage occurs when glucuronide pathway is overwhelmed

* NAPBQI will accumulate = toxic*

34
Q

What is the reversal agent for acetaminophen overdose and how does it work?

A
  • N-acetylcysteine (NAC)

- works my replacing glutathione to break down NAPBQI

35
Q

Activated charcoal can also be given with NAC for tylenol overdose if it is within how many hours of ingestion?

A
  • < 2 hr from ingestion
36
Q

What is the first sign of liver damage from tylenol overdose?

A
  • elevated AST
37
Q

What are the 4 potential causes of ischemic hepatitis?

A
  • septic shock
  • cardiogenic shock
  • hepatic vein thrombosis
  • cocaine
38
Q

What does the MELD scoring provide?

What 2 values do we have to remember?

A
  • prediction of 30 day mortality for ESLD

<8 - 5.7%
>20 - 50%

39
Q

The MELD scoring system uses these 4 variables.

A
  • bilirubin
  • creatinine
  • INR
  • Na+

GI (7 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions