liver Flashcards
what LFT ratio is good for alcholic hepatitis
AST:ALT
what AST:ALT ratio is suggestive of alcoholi hapetitis
> 3
treatment for acute episode of alcoholi hepatitis
steroid e.g prednisolone
when are mallory bodies seen
alcoholic hepatitis
most common cause of liver disease in the developed world
non-alcoholic fatty liver disease
Non-alcoholic steatohepatitis is patholigically identicle to…?
alcoholic liver disease
key mechanism for steatosis in NASH is through …?
insulin resistance
associated factors of NAFLD
obestity
T2DM
Hyperlipideamia
sudden weight loss
what is seen on ultrasound in NAFLD
increase echognicity
diagnosis of NAFLD
enhance liver fibrsis (ELF test) - blood test
management of NAFLD
weight loss
diagnostic test for liver cirrhosis
transient elastography
how is hep B spread
exposure to infected blood or body fluids, including vertical transmission from mother to child.
symptoms of hep b
fever jaundice deranged LFT’S
complications of hep B
chronic hepatitis
hepatocellular carcinoma
GN
polyarteritis nodosum
cryoglobinaemia
what hepatitis’ can become chronic
B and C
what Ig is hepatitis B
IgM
how is hep E spread
faceal oral route
if someone has severe heaptitis in preganncy what shoud you thinl
hep E
who gets Hep D
those already infected with Hep B
how is hep C spread
via blood-to -blood
most at risk of Hep c
iVDU
can you breast feed with hep c
yes
is there a vaccine for hep C
NO
features of hep C
fever
arthralgia
diagnostic test for Hep C
HCV RNA
treatment of hepatitis B
pegylated interferon alpha
what is a common feature of autoimmune hepatitis that does not involve liver symptoms
amenorrhoea
antibodies seen in autoimmune heaptitis
ANA
ASMA and
LMK1
what autoimmune hepatitis is only seen in children and what antibody is assoc with this
type 2
LMK1
what Ig is raised in autoimmune hepatitis
IgG
piecemeal necrosis on liver biospy indicates…?
autoimmune heaptitis
treatment of autoimmune hepatitis
steroids
who gets PBC
middle ages women
does PBC involve the intra or extra hepatic ducts
intra
what is the classic presentation of PBC
itching in a middle aged woman
end result of PBC
liver cirrhosisi
what conditions are assoc with PBC
sjogrens
RA
systemic sclerosi s
thyroid disease
what would be seen on immunolgy in PBC
AMA M2 subtype
raised IgM
what test must be doen before diagnosis of PBC and why
a RUQ USS or MRCP to exclude biliary obstruction
management of PBC
urseodeoxycolic acid
what can be given for itch in PBC
cholestyramine
what vitamins need to be supplemented in PBC
fat soluble vitamins eg ADEK
PBC increases risk of what cancer
hepatocellular carcinoma
most common chrons symptom in children versus adults
children - abdo pian
adults - diarrhoea
what is someone injected with in the heaptitis B Vaccine
HBsAg- surface antigen
What is the most specific blood result for progressing to cirrhosis in individuals with chronic liver disease
thrombocytopenia
cardiac effect of carcinoid tumours
affect right side of the heart
pulmonary stenosis and tricupsid regurgitation
complications of enteral feeding
diarrhoea
aspiration
hyperglycaemia and
refeeding
what x-ray is doen for upper abdo pain
erect CXR
what artery is most likely bleeding in a duodenal ulcer
gsatroduodenal ulcer
triad of symptoms in budd chairi
abdo pain
ascites
render heaptomegaly
painless jaundice with palpable gallbladder
cancer - biliary or pancreatic
inheritance pattern in haemochromatosis
auto recessive
what stain is used to identify iron on liver
perls prussian blue
gene involevd in haemochromatosisi
HFE
treatment of haemochromatosisi
venesection
inheritance pattern of wilsons
auto recessive
where does copper accummulate in wilsons
liver and basal ganglia
what test is used to identify wilsons and what would result be
decrease serum ceruloplasmin
what happens to free an bound serum copper in wilsons
free is increased
bound is decreased as most is bound to ceruloplasmin
Tx of wilsons
copper chelating drugs e.g. penacilliamine
gene implicated in wilsons
ATP7B
inheritance of alpha 1
auto recessive
gene implicated in alpha 1
A1AT
symptoms of diverticular disease
PR bleeding
abdo pain
altered bowel habit
bloating
what tests are used to minotr haemochromatosis
transferrinn and derum ferritin
a SAAG level of what indicates a portl hypertension cause in ascites
> 11g/L
in patients with ascites when shoudl prophylactic bacterial peritonitis antibitotics be given and what type
patients who have had an episode of SBP
patients with fluid protein <15 g/l and either Child-Pugh score of at least 9 or hepatorenal syndrome
oral ciprofloxacin
first line antibody testing in coeliac
IgA and IgA TTG
what Hb level warrants blood tranfusion
<70g/l or <80 if IHD
