Brainscape's Knowledge GenomeTM

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


See full index

Meds 2 > Hepatology > Flashcards

Hepatology Flashcards

1
Q

Liver makes what clotting factors

A

5,7,9,10
Prothrombin
Fibrinogen

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

Portal htn causes what?

A

thrombocytopenia

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

Tests for hepatocellular injury

A

AST & ALT

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

Tests for cholestatic injury

A

alk phos & total bilirubin

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

tests for biosynthesis

A

Glucose
INR
Albumin
Cholesterol

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

Bilirubin soluble when? How much in this form?

A

Conjugated, 30%

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

Unconjugated bilirubinemia caused by?

A

Gilbert’s syndrome - impaired uptake/conjugation
Intravascular hemolysis
Newborns

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

Conjugated Hyperbilirubinemia due to?

A

Liver disease
Obstructive
Sepsis
Conjenital

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

AST/ALT normal serum levels?

A

30-40 U/L

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

Correlated AST/ALT and liver cell dmg?

A

POOR

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

AST or ALT found more in live? Which more specific for liver dmg?

A

ALT

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

If Alkaline Phosphatase is high, check what next?

A

Check GGT, GGT high = liver source

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

Cholestatic liver diseases?

A

Bile duct obstruction
Biliary cirrhosis
Sclerosing cholangitis

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

Albumin synthesized?

A

exclusively in liver

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

Albumin half life?

A

20 days

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

Albumin levels in liver disease/cirrhosis?

A

normal in acute, lower in cirrhosis

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

Albumin levels specific for liver disease?

A

noo

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

Most liver clotting factors are what dependent?

A

vit K

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

> 1000 elevation of LFT can mean (big 5)

A
  1. Drug/toxin
  2. Ischemic
  3. Acute viral Infection
  4. autoimmune hepatitis
  5. Wilson’s disease
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

250-1000 elevation LFT can mean?

A
  1. Drug - NSAIDS
  2. alpha antitrypsin
  3. Viral EBV/HSV
  4. Autoimmune Hepatitis
  5. Wilsons disease
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Mild elevation

A

many things
steatosis
alcohol

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

Pattern of LFT abnormalities

A

Cholestasis Hallmark elevated AP and bilirubin

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

Acute liver failure defined as?

A

Previously normal liver, develops within 6mo

Impaired synthetic function and encephelopathy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Most important prognostic factor of Acute LIver Failure

A

INR

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

AST can be found in where else besides liver?

A

skeletal and cardiac muscle

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Patients with preexisting liver disease/drink max dose of acetaminophen?

A

2g

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Hepatotoxicity from converting Acetaminophen to what?

A

NAPQI

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Acetaminophen overdose treatment?

A

GI decontamination with charcoal

Antidote: N-Acetylcysteine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

Tylenol > NSAIDS in liver failure b/c

A

NSAIDS worsen underlying coagulopathy

Can interact with diuretics used to treat ascites

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

Transmission of HBV?

A

vertical

blood - mucosal, blood, c7uts

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

HBV incubation period?

A

2-6mo

32
Q

What % adults exposed to HBV resolve infection?

A

90%

33
Q

% of people who get persistent infection get chronic?

A

1-3%

34
Q

7 Markers for HBV infection?

A 
sAg - present infection
sAB immunity
Core IgM - acute infection
Core IgG - current or previous infection
HBV Viral DNA - active infection
e antigen - no replication
e antibody - replication
35
Q

HBV treatment?

A

tenofovir

entecavir

36
Q

HCV tests?

A

Hep C antibody, then RNA viral load

37
Q

HCV highest path of transmission?

A

parenteral - hemophiliacs, dialysis patients, IV drug users

38
Q

HCV incubation

A

3 mo

39
Q

% patients with HCV develop chronic hepatitis

A

85%

40
Q

HCV chronic liver disease symptoms?

A

cryoglobulinemia
Porphyria cutanea tarda
Oral: Lichen Planus, Sjogrens, Xerostomia
Peripheral neuropathy’

41
Q

HCV stable at room temp for?

A

5 days

42
Q

Needle stick % for HIV, HBV, HCV?

A

30% HBV
3% HCV
0.3% HIV

43
Q

3 Pathological stages of alcoholic liver disease?

A

fatty liver
alcoholic hepatitis
alcoholic fibrosis/cirrhosis

44
Q

Treatment for alcoholic liver disease?

A

abstinence

45
Q

Alcoholic hepatitis clinical findings?

A 
Fever
hepatomegaly
leukocytosis
GLossitis, angular chielitis, gingivitis, sialadenosis
AST:ALT greater than 2:1
46
Q

% people progressing ot each stage of alcoholic liver disease?

A

90 to fatty
20 to hepatitis
40 to cirrhosis

47
Q

Instead of progressing through alcoholic hepatitis, fatty liver can do what?

A

pericentral fibrosis then straight to cirrhosis

48
Q

Non-alcoholic steatohepatitis is what?

A

Subset of non-alcoholic fatty liver disease with inflammation

49
Q

Hepatic steatosis is?

A

fatty accumulation without fibrosis or inflammation

50
Q

Two hits of fatty liver disease?

A

INsulin resistance

Oxidative injury

51
Q

Most common cause of abnormal LFTs in US?

A

NAFLD

52
Q

Risk factors for NAFLD?

A

obesity
diabetes
hyperlipidemia

53
Q

Primary biliary cirrhosis most common symptoms?

A

fatigue, pruritis

54
Q

diagnosis of primary biliary cirrhosis?

A

positive anti-mitochondrial Ab

liver biopsy

55
Q

Primary biliary cirrhosis vs Primary Sclerosing Cholangitis?

A

Biliary - intrahepatic bile ducts destroyed

Cholangitis - medium/large bile ducts, MRCP/ERCP

56
Q

Autoimmune hepatitis distinguishing diagnostic factor?

A

positive ANA and anti-smooth muscle Ab

female

57
Q

Wilson’s disease leads to?

A

Accumulation of copper in liver, brain, kidney,s cornea

58
Q

Key diagnosis in Wilson’s disease?

A

Kayser-Fleisher cornea rings
Decreased ceruloplasmin
High urinary copper

59
Q

Treatment for Wilson’s?

A

Copper binding medications (Penicillamine)

60
Q

Clinical signs of Cirrhosis
Early
Portal Htn
Impaired Liver Function

A

Early - thrombocytopenia
portal htn - splenomegaly, ascites, varices
impaired liver fcn - decreased albumin, elevated INR

61
Q

Decompensated Cirrhosis 3 manifestations?

A

jaundice
ascites
encephalopathy

62
Q

Cirrhosis consideration for giving drugs?

A

tylenol

63
Q

Most common complication of cirrhosis?

A

ascites

64
Q

5 things to order for diagnosing ascites?

A

Paracentesis:

gram stain
culture
cell count
albumin
total protein
65
Q

Serum-Ascite Albumin Gradient (SAAG) cutoff?

A

1.1g/dl

66
Q

If SAAG >1.1g/dL…

A

portal Htn

Cirrhosis

67
Q

Management of Ascites

A

Decrease Na intake

68
Q

TIPS is?

A

a shunt across liver

69
Q

Spontaneous Bacterial peritonitis - diagnosis?

A 
paracentesis
gram stain
cell count (if >250, abx and albumin)
culture
albumin
Tprotein
70
Q

Variceal bleeding prognosis?

A

30% mortality with first b leed

60% rebleed in 1 year

71
Q

Variceal bleeding treatment?

A

esophageal banding
blakemore tube
emergent TIPS
Octreotide

72
Q

Hepatic encephalopathy substances from gut into brain?

A

ammonia get into astrocytes

73
Q

Ammonia comes from?

A

Highest in hepatic portal vein, normally converted to urea in urea cycle and excreted, reduced in acute/chronic liver disease.

74
Q

Ammonia mainly acts on what in brain?

A

agonizing GABA –> cerebral failure

75
Q

Diagnosis for HE?

A

NO ammonia levels

Rule out precipitating factors - dehydration, constipation, primary CNS event

76
Q

Treatment for HE?

A

underlying cause

lactulose rifaximin

77
Q

Hepatocellular carcinoma risk factors?

A

Cirrhosis
Non-Cirrhotic Hep B
NASH

Meds 2 (7 decks)

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