Hepatobilliary Flashcards
In uc and primary sclerosing cholangitis, risk of which cancer, is increased?
Cholangiocarcinoma, ca19-9
Ascending cholangitis definitive mx
Biliary drainage either via ERCP with stent in place, or percutaneous transhepatic drainage
Mx for ascites in chronic liver disease
Spironolactone
Important complication of chronic liver disease
Spontaneous bacterial peritonitis
How is SBP diagnosed?
Neutrophil count >200
Most common underlying pathogen in SBP
E Coli
Mx of SBP
- Prompt drainage via ascitic tap
- Abx: cefalexin or tazocin
(Cipro prophylactically)
Anti-smooth muscle AB
Autoimmune hepatitis
P-ANCA
PSC
Features of PBC
- High BR
- Obstructive LFTs
- Often background autoimmune disease
Anti Mitochondrial AB
PBC
Mx for gallstones - symptomatic cholelithiasis or cholecystitis
Laparoscopic cholecystectomy
Mx for choledocolithiasis or cholangitis
ERCP
Which Ix best demonstrates liver synthetic function?
PT (INR)
Cholecystitis v cholangitis
Cholecystitis - inflamm of GB
Cholangitis - inflamm + infx of bile duct
- Location: cholecystitis more RUQ and can radiate to shoulder // cholangitis pain more diffuse often epigastric
- Nature: cholecystitis constant // cholangitis colicky
- Jaundice: more of a cholangitis thang
Diagnostic ix for PSC
MRCP
Which ca is a complx of cirrhosis?
HCC
How will a cirrhotic liver appear on USS?
shrunken
Which test to assess liver damage in paracetamol overdose?
PT
Murphy’s sign
1. What do/how?
2. +ve means?
- Asking pt inhale and hold whilst palpating the right subcostal area. If pain occurs when the inflamed gallbladder comes into contact with the examiner’s hand, Murphy’s sign is positive.
- Cholecystitis
What is choledocholithiasis?
Stone in CBD
Which tumour marker for HCC?
AFP
Common complx of pancreatitis
pancreatic pseudocyst
What can be used to improve 1-month mortality for severe alcohol-associated lvier disease?
steroids
Most common causes liver cirrhosis in UK
- Alcohol
- NAFLD
- Hep B/C
Viral heps route of transmission
- Hep A+E: faecal-oral
- Hep B + C: blood borne
- Hep D: contact w infected bodily fluid
Which type of hepatitis is NOT an RNA virus?
Hep C
Which hep can you only get along with another hep?
Hep D - only with Hep B
Chronic hep B mx
Interferon alpha
Which hep is most likely to progress to CLD?
Hep C
Mx for hep B + HIV co infx
Tenofovir
What is courvoissier’s law?
Painless + palpable GB + jaundice –> Pancreatic ca
SBO after cholecystitis
gallstone ileus
ERCP shows beads on a string
PSC
