Hepatology random

Question 1

What do you give in stage F3 NAFLD diabetic vs non diabetic

Answer 1

Vitamin E if non diabetic
Pioglitazone/liraglutide if diabetic

Question 2

How rule out SBP

Answer 2

Paracentesis (ascitic tap)

Question 3

What is paracentesis

Answer 3

Ascitic tap (for SBP)

Question 4

What treat SBP with

Answer 4

Ceftriazone, tazocin - BROAD spectrum antibiotic

Question 5

How to prevent ascites/SBP

Answer 5

Spironolactone

Question 6

What ratio suggests alcoholic cause of liver failure

Answer 6

AST:ALT>2 = alcohol
<1 = non alcohol

Question 7

What can cause rise GGT

Answer 7

Alcohol abuse
COPD
renal failure

Question 8

Decompensation in chronic liver disease

Answer 8

Dehydration
HCC
portal vein thrombosis

Question 9

Treatment for encephalopathy hepatic

Answer 9

Oral lactulose prophylaxis for constipation
Rifaxamin - decrease toxins

Question 10

What childs pugh score -> increased variceal bleed risk

Answer 10

> 8

Question 11

What level of platelets do you trasnfuse in

Answer 11

<50

Question 12

Secondary prevention of variceal bleeds

Answer 12

Propanolol

Question 13

What is marker for HCC in blood

Answer 13

AFP

Question 14

Screening for HCC

Answer 14

6 monthly US once diagnosed
AFP to diagnose

Question 15

When transplant and dont with HCC

Answer 15

<5 tumours <3cm
one tumour UP to 5cm

Question 16

PBC what rule use

Answer 16

M rule -
IgM, AMA Middle aged woman

Question 17

PBC what LFT increases

Answer 17

ALP - small intrahepatic ducts affected

Question 18

Markers of AI hep

Answer 18

ANA, ASMS, raised ALT + IgG

Question 19

Treatment for PBC

Answer 19

UHDA
Obeticholific acid + rifampacin

Question 20

Risks of azathioprine

Answer 20

cancer - Basal CC, SCC, lymphoma

Question 21

PSC biochem

Answer 21

ANCA and raised ALP

Question 22

PBC vs PSC biopsy

Answer 22

PBC - granulomatous
PSC - onion skinning

Question 23

What investigation do all autoimmune liver diseases require

Answer 23

Yearly DEXA scan - malabsorption of vit D increase risk osteoporosis

Question 24

Viral hep memory

Answer 24

A - acute
B - blood + se (5% chronic)
C - chronic

Question 25

What is the disease picture if IgM low vs high

Answer 25

low - chronic high - acute

Question 26

What biochem picture in prev infection not current

Answer 26

IgG and HSaG

Question 27

What mutation causes haemochromatosis

Answer 27

C282Y, autosomal recessive

Question 28

Biochem in haemochromatosis

Answer 28

Ferritin, transferrin sats raised

Question 29

Symptoms of haemochromatosis

Answer 29

Joint pain, tired, bronze skin, ED, dysmenorrhea

Question 30

Treat haemochromatosis

Answer 30

Venesect

Question 31

Treating Hyperkalaemi

Question 32

LEARN CHILD PUGH SCORE

Question 33

What is used to determine whether liver transplant in paracetemol overdose

Answer 33

pH <7.3

Question 34

What is present in PBC on biopsy

Answer 34

Granulomas on biopsy

Question 35

M rule with PBC

Answer 35

IgM antibodies seen AMA antibody

Question 36

Where in hepato pathology would cause absent urobilinogen in urine

Answer 36

Posthepatic Urobilinogen is normal present in urine Increased in pre and hepatic

Question 37

What type of AI hepatitis is more severe

Answer 37

Type II

Question 38

What is gallbladder empyema usually a complication of

Answer 38

Cholecysitis

Question 39

What complication is TIPS proecdure most likely ot cause

Answer 39

Hepatic encepahlopathy

Question 40

Key features in a question suggesting herditary haemochromatosis

Answer 40

Hypogonadism T2DM Raised bilirubin, AST,ALT low albumin Hip and knee pain

Question 41

Treatment for wilsons

Answer 41

Penicillaminen

Question 42

Question features wilsons

Answer 42

Ataxic gait - copper infiltration in brain

Question 43

What PT time is indication for liver transplant in non alcoholic liver disease

Answer 43

>100s

Question 44

What does raised IgG and ANA suggest

Answer 44

AI hepatitis

Question 45

What is ascites first line treatment

Answer 45

Spirinolactone/MRA

Question 46

What hep causes high mortality in pregnancy

Answer 46

Hep E

Question 47

WERNICKES Encephalopathy

Answer 47

- Nystagmus, ataxia, confusion - Caused by Vitamin B depletion - Pabrinex to revent - thiamine and vit B

Question 48

What CP score is igher risk of variceal bleeding

Answer 48

>8

Question 49

Haemochromatosis

Answer 49

- Bronzed skin - Diabetes - Cirrhosis