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F1 and Stage 5 > HPB conditions > Flashcards

HPB conditions Flashcards

1
Q

Best blood tests to check liver function

A

Albumin

PT, APTT

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2
Q

How does excessive alcohol consumption show up on bloods: FBC, LFTs

A

FBCs: Macrocytosis
LFTs: Raised GGT

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3
Q

What is the significance of a high vs low SAAG gradient

A

High = transudate from portal hypertension

Low = Exudate

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4
Q

Definition of a high SAAG gradient

A

> 11g/L

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5
Q

Causes of high SAAG gradient

A
  • Liver cirrhosis
  • Liver failure
  • Portal vein thrombosis (Budd-Chiari)
  • Fatty liver of pregnancy
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6
Q

Causes of low SAAG gradient

A
  • Cancer
  • Infection
  • Pancreatitis
  • Nephrotic syndrome
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7
Q

What does hepatomegaly with a firm, smooth, tender, pulsatile liver suggest

A

R heart failure

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8
Q

Pre-hepatic causes of portal hypertension

A

Portal vein thrombosis

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9
Q

Hepatic causes of portal hypertension

A
  1. Cirrhosis
  2. Sarcoidosis
  3. Schistosomiasis
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10
Q

Post-hepatic causes of portal hypertension

A
  1. R heart failure
  2. Constrictive pericarditis
  3. Budd-Chiari (hepatic vein thrombosis)
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11
Q

“Beaded” duct appearance on MRCP suggests what condition

A

Primary sclerosing cholangitis (PSC)

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12
Q

What conditions is Primary Biliary Cirrhosis (PBC) associated with

A

Autoimmune diseases: Coeliac’s
Thyroid dz
T1DM
Autoimmune hepatitis

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13
Q

What conditions is Primary Sclerosing Cholangitis (PSC) associated with

A

Ulcerative Colitis

Autoimmune hepatitis

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14
Q

What cancers does Primary Sclerosing Cholangitis (PSC) increase the risk of

A
  1. Cholangiocarcinoma

2. Colon cancer

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15
Q

Pathophysiology of PBC vs PSC

A

PBC = chronic inflammation cause bile duct destruction -> primary biliary cirrhosis

PSC = fibrosis of intra n extra hepatic ducts -> biliary obstruction -> secondary biliary cirrhosis

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16
Q

Components of Child-Pugh grading for cirrhosis

Presence of which signs are associated with poor prognosis

A 
Albumin
Bilirubin
Clotting: prolonged PT
Distention: ascites
Encephalopathy

Presence of ascites/ encephalopathy = poor prognosis

17
Q

Risk factors for pancreatitis

A

GET SMASHED

Gallstones
Ethanol
Trauma
Steroids
Mumps
Autoimmune
Scorpion sting
High cholesterol/ calcium/ PTH
ERCP
Drugs
18
Q

What drug for a bowel condition can lead to pancreatitis

A

Mesalazine (used in UC)

19
Q

In the modified glasgow score, what features increase the risk of severe pancreatitis

A

PANCREAS

PaO2 <8
Age >55
Neutrophils >15
Calcium low
Renal: Urea high >16
Enzymes: LDH high >600, AST high >200
Albumin low <32
Sugar: BM>10
20
Q

Best tumour marker for patients with HCC

A

AFP

21
Q

Risk factors for cholangiocarcinoma

A
  • Ulcerative colitis
  • PSC
  • typhoid
  • liver flukes
22
Q

Tumour marker for cholangiocarcinoma

A

Ca 19-9

23
Q

How does a TIPPS work

A

transjugular intra-hepatic porto-systemic shunt

Creates channel between hepatic vein and portal vein, reduces portal pressure

24
Q

Causes of high amylase

A
  • Acute pancreatitis
  • Pancreatic pseudocyst
  • Acute cholecystitis
  • Mesenteric infarct
  • Perforated viscus
  • DKA
25
Q

What investigation is used to diagnose carcinoid syndrome

A

urinary 5-HIAA

26
Q

What investigation is used to diagnose liver cirrhosis

A

Transient elastography

27
Q

What would RUQ pain + ascites suggest

A

Budd Chiari (hepatic vein obstruction)

28
Q

What 2 medications are used in for prophylaxis of hepatic encaphalopathy

A

Lactulose and rifaximin

29
Q

Causes of hepatomegaly

A

COMMON

  1. Cirrhosis
  2. Cancer
  3. Right heart failure (liver may be pulsatile)
  4. Hepatitis

OTHERS

  1. PBC
  2. Infections eg malaria, glandular fever, abscess
  3. Haemochromatosis
  4. Sarcoidosis, amyloidosis
30
Q

What percentage of Hep B becomes chronic

What percentage of Hep C becomes chronic

A

10percent Hep B becomes chronic

90percent Hep C becomes chronic

31
Q

Best blood marker of severity of pancreatitis

A

CRP

32
Q

Most common cause of HCC

  • worldwide
  • in Europe
A

Worldwide: Hep B

in Europe: Hep C

F1 and Stage 5 (29 decks)

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