Jaundice and Chronic Liver Disease

Question 1

What are the different types of jaundice?

Answer 1

Hepatic - Defective uptake of Bilirubin

Pre-Hepatic - Increased quantity of Bilirubin

Post-Hepatic - Defective transport of Bilirubin by the biliary ducts

Question 2

What are the causes of chronic liver disease?

Answer 2

1) Alcohol
2) Autoimmune Hepatitis
3) Viral Hepatitis B&C
4) Non Alcoholic Fatty Liver Disease (NAFLD)

Question 3

What is the presentation of chronic liver disease?

Answer 3

• Spider Naevi
• Leuconychia (white nails)
• Clubbing
• Palmar erythema
• Caput medusae
• Abnormal LFT’s
• Jaundice
• Ascites

Question 4

What are the investigations of chronic liver disease?

Answer 4

1) Bloods (abnormal LFT’s, increased Bilirubin, increased alkaline phosphate
2) Liver USS (hepatomegaly, liver lesions)
3) MRI (Caudate lobe size increased)

Question 5

What is the management of chronic liver disease?

Answer 5

General:

• Good nutrition
• Alcohol abstinence
• Stop NSAID’s & sedatives

Ascites:

• Bedrest
• Fluid restriction
• Low salt diet
• Spironolactane