Brainscape's Knowledge GenomeTM

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


See full index

Alimentary System > Jaundice and Chronic Liver Disease > Flashcards

Jaundice and Chronic Liver Disease Flashcards

1
Q

What are the production functions of the liver?

A 
Producing:
Clotting factors 
Bile acids 
Glucose control in blood:
Glucagon 
Cholesterol synthesis Lipoprotein and TG synthesis 
Production of hormones
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Which carbohydrate cycles happen in the liver?

A

glucogenesis

glycogenesis

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

What is the production of bile acids essential for?

A

The digestion of fats

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

Which hormones does the liver produce?

A

Angiotensin

Insulin like growth factor

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

What are the detoxification functions of the liver?

A

Urea production from ammonia
Detoxification of drugs
Bilirubin metabolism
Breakdown of insulin and other hormones

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

What are the basic LFTs?

A 
Bilirubin 
Aminotransferases: 
ALT and AST
Alkaline phosphatase 
Gamma GT 
Albumin 
Prothrombin time 
Creatinine 
Platelet count
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What is bilirubin a by product of?

A

Haeme metabolism

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

Where is heme metabolised?

A

Spleen

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

Where is haeme taken to?

A

To the liver

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

What does liver do to haeme?

A

Helps to solubilise it

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

What is a pre-hepatic cause for elevated bilirubin?

A

Haemolysis (excess RBC)

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

What is a hepatic cause for elevated bilirubin?

A

Liver damage (when the problem is actually in the liver)

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

What is a post-hepatic reason for elevated bilirubin?

A

Blockage in the hepatic ducts

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

Where is aminotransferase present?

A

In hepatocytes

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

If there is liver damage what will aminotransferase results show?

A

Elevation of these enzymes

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

What are the 2 types of aminotransferases?

A

AST

ALT

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

Where is alkaline phosphatase?

A

Cells lining bile ducts

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

When is alkaline phosphatase level elevated?

A

When there is obstruction or liver infiltration

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

In what other organs is alkaline phosphatase present?

A

Bone

Placenta

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What is Gamma GT?

A

Non-specific liver enzyme

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

When is gamma GT elevated?

A

With alcohol abuse

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

What drugs can raise gamma GT?

A

NSAID’s

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

What albumin an important test for?

A

Liver function

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

What do low levels of albumin suggest?

A

Chronic liver disease

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

Which LFT is used to determine the stage of liver disease and the qualification for liver transplantation?

A

Prothrombin time

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

What is platelet count an indirect marker of?

A

Portal hypertension

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

What are the 4 main symptoms for liver failure?

A

Jaundice
Ascites
Variceal bleeding
Hepatic encephalopathy

28
Q

What is ascites?

A

Fluid in the abdomen

29
Q

What is jaundice as a symtpom?

A

Yellowing of the skin due excess of circulating bilirubin

30
Q

What is hepatic encephalopathy?

A

Confusion due to ammonia crossing the blood brain barrier

31
Q

At what bilirubin levels is jaundice detectable?

A

When total plasma bilirubin levels exceed 34 umol/L

32
Q

What is a differential diagnosis for jaundice?

A

Carotenemia

33
Q

Which sign determines that is cannot be anything other than jaundice?

A

Yellowing of the sclera

34
Q

What are pre-hepatic clues of jaundice on clinical examination?

A

Pallor
Splenomegaly
History of anaemia
Alcholuric jaundice

35
Q

What are hepatic clues of jaundice on clinical examination?

A

Ascites
Asterixis
Risk factors for liver disease

36
Q

What are post-hepatic clues of jaundice on clinical examination?

A

Palpable gall bladder
Abdominal pain
Colestasis

37
Q

What is the first line investigation for jaundice?

A

USS

38
Q

What are the pros of an ultrasound scan?

A 
Cheap 
No radiation 
Portable and widely available 
Good for gallstone viewing 
Examines organs
39
Q

What are the cons of CT and MRI scans?

A

Expensive - MRI
Radiation - CT
Requires a scanner
High specificty

40
Q

What is ERCP?

A

Endoscopy procedure that travels to the bottom of the bile duct and injects dye

41
Q

What are some complications of ERCP?

A

Pancreatitis

42
Q

What does physical examination with ascites reveal?

A

Dullness in flanks

And shifting dullness

43
Q

What is cirrhosis

A

Repair of liver damage by scar tissue

44
Q

What are some causes of cirrhosis?

A 
Alcohol 
Autoimmnue - PBC, PSC 
Hameochromatosis 
Chronic viral hepatitis 
Non-alcoholic fatty liver disease
Drug 
Cystic fibrosis
45
Q

Why is an USS very good for ascites?

A

It is good at detecting small amounts of fluid in the abdomen

46
Q

What are other signs of chronic liver disease?

A 
Ascites
Spider Neiva 
Palmar erythema 
Abdominal veins 
Fetor hepaticus 
Umbilical nodule 
JVP elevation 
Flank haematoma
47
Q

Is all ascites due to liver disease?

A

No

48
Q

What procedure should be given to all patients with new-onset ascites?

A

Diagnostic paracentesis

49
Q

What is diagnostic paracentesis?

A

Where a needle is inserted into the abdomen to gain a sample of fluid in the abdominal cavity

50
Q

What are the treatments for ascites?

A

Diuretics
Large volume drainage
Aquaretics
Liver transplantation

51
Q

What does SAAG stand for?

A

Serum-ascites albumin gradient

52
Q

What does SAAG >1.1g/dl suggest?

A

Portal hypertension
CHF
Constrictive pericarditis
Myxedema Massive liver metastases

53
Q

What does SAAG <1.1 g/dl suggest?

A 
Malignancy
Tuberculosis 
Pancreatic 
Biliary ascites 
Nephrotic syndrome 
Serositis
54
Q

What are variceal haemorrhages a consequence of?

A

Portal hypertension

55
Q

Where are the porto-systemic anastomoses in the body where variceal haemorrhage can occur?

A

Oesophagus
Umbilicus
Bare area of the liver
Ano-rectal junction

56
Q

What is the management of variceal haemorrhages?

A 
Resuscitation 
Good IV access 
Blood transfusions as required 
Emergency endoscopy 
Band ligation
57
Q

What is hepatic encephalopathy?

A

Confusion due to liver disease

58
Q

What causes HE?

A

Ammonia crossing the blood brain barrier

59
Q

How is HE graded?

A

1-4

60
Q

How is HE treated?

A

By treating the underlying cause

61
Q

What is the commonest cause of HE?

A

Constipation

62
Q

What does hepatocellular carcinoma occur in the background of?

A

Cirrhosis

Chronic HBV and HCV

63
Q

What is the presentation of hepatocellular carcinoma?

A 
Decompensation of liver disease
Abdominal mass
Abdominal pain 
Weight loss 
Bleeding
64
Q

How is the diagnosis for hepatocellular carcinoma made?

A 
Alpha fetoprotein
USS
CT
RI 
Liver biopsy - rarely done
65
Q

What is the treatmet options for hepatocellular carcinoma?

A 
Hepatic resection 
Liver transplantation 
Chemotherapy 
Locally ablative treatments 
Sorafenib 
Hormonal therapy

Alimentary System (29 decks)

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