Brainscape's Knowledge GenomeTM

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


See full index

DPD > KM - Liver Disease > Flashcards

KM - Liver Disease Flashcards

1
Q

What do you call the middle of a liver lobule?

A

Central vein

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

What is the portal triad?

A

Hepatic artery
Bile duct
Portal vein

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

Describe blood flow

A

Portal vein via sinusoid to central vein

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

What is the space between the sinusoid and the…?

A

Space of Disse

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

Name the numbering system of the lobule

A

1 is around Portal tract

3 is around the central vein

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

The portal triad is seen where in the hexagon of a liver lobule?

A

Each of the six corners

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

If you think the high bilirubin is due to pre hepatic causes, what do you do?

A

Fbc and film

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

If you think the high bilirubin is due to hepatic

A

Repeat LFTs

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

What reaction is done to see whether the bilirubin is conjugated or

A

Van den Bergh reaction

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

If you think the high bilirubin is due to obstructive cause, what do you do next?

A

Check alkaline phosphatase as it is high in obstructive causes

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

How is Gilbert’s inherited? What percentage are carriers?

A

Recessive, 50% carriers

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

Probability of a both partners

A

25%

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

Why is bilirubin to elevated during fasting in people with Gilbert’s?

A

Increases

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

What’s the faulty enzyme ?

A

UDP glucuronyl transferase

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

What is most representative of the function of the liver?

A

Prothrombin time

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

Why isn’t albumin as representative?

A

Slow to change in liver disease

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

What are ALT, AST and GGT?

A

Enzymes present in certain parts of the liver lobule, leaks out depending on area of liver damage. They are enzymes against certain toxins.

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

In paracetamol overdose, what is high?

A

Prothrombin time goes rapidly high

as well as ALT, AST AND GGT but these don’t correlate with any liver disease

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

When dl you call

A

If it goes up by more than 1 s per hour

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

What are the true markers of liver function?

A

Albumin
Clotting factors
Bilirubin

(Enzymes aren’t really true markers)

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

What is the typical sign of someone with Gilbert’s?

A

High bilirubin, everything else normal, bili worsens with fasting

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

Hepatic causes of high bilirubin

A

Viral hepatitis
Alcoholic HEP
CIRRHOSIS

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

Post hepatic causes

A

Pancreatic cancer

???

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

Causes of pre hepatic jaundice

A

Haemolysis

Gilberts

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

Note

A

Alk phosph isn’t necessarily high

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

Causes of hepatitis

A

Viral
Alcoholic
Autoimmune

27
Q

How is hep A transmitted?

A

Fecal-oral

28
Q

What are the consequences of hep A?

A

Most people are fine and become immune with IgG memory

But some people die if malnourished

29
Q

How is hep B transmitted?

A

Spread by blood, sharing needles

30
Q

Consequences of hep B

A

Incubation period of 1 month

31
Q

Describe what happens after someone gets hep B

A

Two coats
Surface antigen and core (e) antigen
These antigens are excreted in the blood
Immune system mounts a reaction against both e antigen and surface antigen

32
Q

What is the difference in the antibodies of someone exposed to Hep B vs someone who has been vaccinated?

A 
Anti-HBs = people who have been vaccinated 
Anti-HBe = people who have been exposed
33
Q

Consequences of hep B

A

People often don’t know they have it as they’re subclinical, so if their immune system doesn’t clear the hep B, they remain infectious for years unless they have treatment!

34
Q

What is seen on biopsy of an alcoholic liver?

A

Fatty lobules
Malorie’s hyaline pinky strands of material due to hepatocyte damage
Neutrophils
Cholestasis i.e. bile stains

35
Q

Alcoholic fatty liver disease biopsy features

A 
Malorie's hyaline
Blue collagen around hepatocytes
Fibrosis 
Balloon cells 
Fatty change 
Megamitochondria
36
Q

What is a differential for alcoholic fatty liver hepatitis?

A

Non alcoholic steatohepatitis (NASH)

Steato = fat

E.g. Due to obesity, diabetes

37
Q

Treatment for alcoholic fatty liver disease

A

Stop alcohol
Thiamine
B1

38
Q

Thiamine deficiency causes

A

Beri beri

39
Q

What causes pernicious anaemia?

A

B12 deficiency

40
Q

Signs of alcohol use

A

Spider naevi
Palmar erythema
Gynaecomastia
Dupytren’s contracture

41
Q

What do these signs signify?

A

Chronic stable liver disease

42
Q

What sign might be seen on the abdomen of an alcohol user?

A

Visible vein on anterior abdominal wall

43
Q

Why do you seen a visible vein?

A

Occurs because of pressure in umbilical vein due to portal htn

44
Q

What can the visible veins result in?

A

Splenomegaly as they connects to splenic vein

So this is another sign of portal HTN

45
Q

What does shifting dullness suggest?

A

Ascites, another marker of portal htn

46
Q

Signs of portal htn

A

Splenomegaly
Ascites
Visible veins

47
Q

What causes portal htn?

A

Cirrhosis of liver

48
Q

Why can alcoholics vomit blood?

A

Visible vein ruptures, so people start vomiting blood

49
Q

Acute management of oesohageal bleeding

A

Put an NG tube in with a balloon to put pressure on the bleeding
Senc starkin

50
Q

If the pt now develops flapping tremor, what does it suggest?

A

Liver failure

51
Q

Consequences of liver failure

A

Clotting factors and albumin fail so bleeding and bruising common

???

Ammonia irritates brain hence encephalopathy

52
Q

Defining features of cirrhosis

A

Nodules - regenerating liver cells
Fibrosis
Shunting of blood
Whole liver is involved

53
Q

Causes of cirrhosis

A 
Fatty liver disease - micronodular
Viral hepatitis - B, C, D - macronodular
Haemochromatitis
Wilson's disease (copper) 
PBC 
Primary sclerosis cholangitis
54
Q

Difference between fatty liver cirrhosis and hepatitis cirrhosis?

A

Fatty liver - micronodular

Hepatitis - macronodular

55
Q

What happens after alcoholic liver disease before things get bad?

A

Chronic stable liver disease

56
Q

Sites of portal-systemic anastomoses

A

Oesophagus
Rectal
Umbilical vein
Spleno-renal shunt (artificial)

57
Q

What does pruritus suggest?

A

Jaundice caused by OBSTRUCTION

It’s the bile salts that cause the pruritus

58
Q

What blood results would you see in obstructive jaundice?

A

High alk phosph and high bilirubin

59
Q

What is the difference between urobilinogen and stercobilinogen and bilirubin

A

Bacteria convert bilirubin into stercobilirubin, which is reabsorbed and peed out as urobilinogen and excreted as stercobilinogen via faces

60
Q

What kind of liver tumour produces bile?

A

Hepatocellular carcinoma

61
Q

Mucinous cells in the liver might suggest

A

Metastasis of pancreatic cancer

62
Q

Sarcoma features

A

Spindly

63
Q

What is Courvoisier’s law?

A

Palpable gallbladder with jaundice = pancreatic cancer

64
Q

Why is the gall bladder not palpable with gall stones?

A

Gallbladder with gallstones becomes fibrotic and is incapable of becoming enlarged

DPD (38 decks)

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