Hepatocellular Carcinoma Flashcards

1
Q

what is hepatocellular carcinoma also called

A

hepatoma

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2
Q

def

A

cancer arising from hepatocytes

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3
Q

what is commonly associated (with regards to the liver) with HC

A

cirrhosis

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4
Q

when is HC not associated with cirrhosis

A

patients with chronic hep B

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5
Q

epi

A

elderly

men>women

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6
Q

what viruses are associated with HC

A

hep B and C

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7
Q

what are the major risk factors for HC

A

5Hs

HBV
HCV
heavy alcohol consumption
hyperglycaemia (DM)
hepatitis + cirrhosis
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8
Q

how does DM and obesity cause HC

A

insulin resistance leads to NASH which is a RF for HC

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9
Q

what conditions are associated with HC

A

HH
PBC and PSC
A1AT deficiency

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10
Q

what is aflotoxin

A

toxins produced by aspergillus flavus

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11
Q

what are the first and second most common causes of aspergillosis

A

aspergillosis fumigates

aspergillosis flavus

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12
Q

how does HBV cause HC

A

causes chronic inflammation and cirrhosis

it is a direct carinogen which causes methylation of p16 gene which is known to cause HC

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13
Q

how does aflatoxin cause HC

A

a mycotoxin produced by aspergillus what can cause mutations in p53

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14
Q

what cancer gene does both HBV and HCV affect

A

p53

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15
Q

risk factors

A

hepatitis and cirrhosis
HBV and HCV
heavy alcohol use
hyperglycaemia (DM) + obesity

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16
Q

features of HC

A

elderly
RUQ pain and hepatomegaly
signs of CLD (abdominal distension, jaundice, asterixis, palmar erythema, spider naevi)
weight loss

17
Q

what tumour marker is used for HC

A

AFP raised

18
Q

how is HC diagnosed

A

clinical assessment assessing features and risk factors

imaging with USS

19
Q

what is the first line imaging investigation

A

USS

20
Q

investigations

A

1 bloods
-FBC (microcytic anaemia +/ thrombocytopenia)
-LFTs (raised aminotransferases, ALP, bilirubin, low albumin, PT/INR)
-raised AFP
2 USS
-poorly defined margins and course irregular echoes

21
Q

what causes HCC

A

WHAT causes HCC

Wilsons
HH
A1AT deficiency
Tyrosinosis

Hepatitis (HBV+HCV)
Cirrhosis (PBC +PSC)
Carcinogenes (aflotoxin)