Jaundice and Chronic liver disease

Question 1

6 things the liver produces

Answer 1

clotting factors

bile acids

carbohydrates

porteins

lipids

hormones

Question 2

detoxification actions of the liver

Answer 2

urea produced from ammonia

detoxifies drugs

bilirubin metabolism

breakdown of insulin and hormones

Question 3

storage function of the liver

Answer 3

stores glycogen

stores vitamin A, D, B12, K

stores iron and copper

Question 4

bilirubin is the product of what?

Answer 4

haeme metabolism

Question 5

alkaline phosphatase is the enzyme present in …….. and is elevated when there is a

Answer 5

bile ducts

obstruction or liver infiltration

Question 6

gamma GT is a non specific

Answer 6

liver enzyme

Question 7

gamma GT is elevated with

Answer 7

alcohol use

Question 8

albumin is an important test for measuring

Answer 8

synthetic function of the liver

Question 9

low levels of albumin suggest

Answer 9

chronic liver disease

Question 10

prothrombin time is an important test for

Answer 10

liver function

tells degree of liver dysfunction

Question 11

creatinine test tells us

Answer 11

kidney function

determines survival from liver disease

Question 12

platelet count is an indirect marker of

Answer 12

portal hypertension

Question 13

symptoms of liver failure

Answer 13

jaundice

ascites

variceal bleeding

hepatic encephalopathy

Question 14

Jaundice definition

Answer 14

yellowing of the skin sclerae and other tissues causes by excess circulating bilirubin

Question 15

Jaundice investigations

Answer 15

LFTs

ultrasound

MRI

Question 16

what is ultrasound so important in liver investigations?

Answer 16

differentiates between extra and intra hepatic obstruction

shows site of obstruction

cause of obstruction is shown

shows any evidence of portal hypertension

can show if there is any cancer spread

Question 17

ERCP

Answer 17

endoscopic retrograde cholangiopancreatography

Question 18

therapeutic ERCP can be used in

Answer 18

dilated biliary tree

acute gallstone pancreatitis

stunting of biliary tract obstruction

post-operative biliary complications

Question 19

cirrhosis

Answer 19

late stage scarring/fibrosis of the liver

can be caused by various different liver conditions

Question 20

clinical presentation of cirrhosis

Answer 20

abnormal LFTs

chronic liver disease

ascites

vatical bleeding

hepatocellular carcinoma

Question 21

Hepatic encephalopathy

Answer 21

Neuro abnormalities in people with liver issues

Question 22

clinical features of ascites

Answer 22

physical exam reveals dullness in flanks and shifting dullness

spider nevi

palmar erythema

abdominal veins

JVP elevated

Question 23

treatment options for ascites

Answer 23

diuretics

large volume paracentesis

aquaertics

liver transplant

Question 24

aquaertics are drugs that allow for the….

Answer 24

excretion of water without electrolyte loss

Question 25

portal hypertension can lead to what 3 conditions?

Answer 25

caput medusae

oesophageal varices

rectal varices

Question 26

management of Variceal haemorrhage

Answer 26

Good IV access

blood transfusion

endoscopy

Question 27

hepatocellular carcinoma is associated with

Answer 27

hep B and C

cirrhosis

Question 28

hepatocellular carcinoma presentation

Answer 28

decompensation of liver disease

abdominal mass

abdominal pain

weight loss

bleeding from tumour

Question 29

diagnosing hepatocellualr carcinoma

Answer 29

tumour markers (AFP)

ultrasound

CT scan

MRI

liver biopsy

Question 30

hepatocellular carcinoma treatment

Answer 30

hepatic resection

liver transplant

chemo