jaundice and cirrhosis

Question 1

what causes prehepatic jaundice

Answer 1

haemolysis of all causes
haemolytic anaemias
unconjugated bilirubin

Question 2

what is hepatic jaundice caused by

Answer 2

liver cells injured or dead
acute liver failure 
alcoholic hepatitis 
cirrhosis (decompensated)
bile duct loss (atresia, PBC, PSC) 
pregnancy

Question 3

what is post hepatic jaundice caused by

Answer 3

congenital biliary atresia
stricture of the CBD
gallstone blocking the CBD
carcinoma in the head of the pancreas

Question 4

why do you get more infections in cirrhosis

Answer 4

reduced kupffer cell number and function

Question 5

when can you get masons trichrome

Answer 5

alcoholic cirrhosis

Question 6

in alcoholic cirrhosis what is laid down around cells

Answer 6

collagen

Question 7

what are kupffer cells

Answer 7

specialised monocytes found in the liver

Question 8

how do you get NASH

Answer 8

2 hit paradigm, 1st hit exces fat accumulation and 2nd hit, intrahepatic oxidative stress, lipid peroxidation, TNFa, cytokine cascade

Question 9

what is the metabolic syndrome

Answer 9

type II diabetes (fasting glucose above 110mg/dl)
obesity
HDL 150mg/dl

Question 10

how is autoimmune hepatitis treated

Answer 10

treated with corticosteroids and azathioprine
children azathioprine or 6MP in combination therapy
adults prednisolone and azathioprine