Liver

Question 1

Alcoholic Liver disease

Answer 1

Alcohol cessation, hydration, nutrition, reduce salt intake

1) Benzodiazepine - Diazepam
2) IV Thiamine (prevent Wernickes)
Corticosteroid - prednisolone

Question 2

Peritonitis

+septic shock

Answer 2

Cefotaxime (Broad use)

In septic shock:
Piperacillin IV, vancomycin, albumin

Question 3

Wilson’s disease

Answer 3

Copper chelation - D-penicillamine - binds to and facilitates copper excretion

Question 4

Primary sclerosing cholangitis

Answer 4

Healthy lifestyle, vit D

Cholestyramine - for pruritus

Question 5

Primary biliary cholangitis

Answer 5

Ursodeoxycholic acid - bile acid analogue that dampens inflammation
Cholestyramine - for pruritus

Question 6

Ascites

Answer 6

Spironolactone and paracentesis

If resistant - TIPS (transjugular intrahepatic Portosystemic Shunt)

Question 7

Cholescystitis and Biliary colic

Answer 7

MRCP before cholecystectomy. Sepsis protocol in cholecystitis. (NBM, IV Cefuroxime, IV fluids and analgesia)

Question 8

Acute (ascending) cholangitis

Answer 8

• Cefuroxime

- ERCP - Endoscopic retrdograde cholangiopacreatography - remove stone and drain.

Question 9

Pancreatitis

Answer 9

IV Fluid resus, catheterisation, oxygen, opiate analgesia.

ERCP and cholecystectomy

Question 10

Chronic pancreatitis

Answer 10

Stop alcohol and smoking. Fix life and diet.
Pancreatic enzyme replacement: Pancreatin + omeprazole.

Endoscopic stent if fibrosis causes blockage.

Question 11

Wernicke’s encephalopathy

Answer 11

Thiamine