Liver 2 Flashcards
name 5 causes of hepatitis
1) Viral hepatitis
2) alcoholic hepatitis
3) Autoimmune hepatitis
4) Drug induced hepatitis e.g. paracetamol
5) Non alcoholic fatty liver disease
most common Viral hepatitis worldwide?
Hepatitis A
How is Hep A transmitted
oral-faecal route
how is Hep B transmitted
direct contact with blood/bodily fluids
&
vertical transmission
antibody for Hep A that appears soon after symptoms develop
IgM
antibody for Hep A that becomes positive 5-10 days after symptoms develop & remains lifelong
IgG
what does
surface antigen for Hep B
HBsAg indicate?
active infection
what does E antigen for Hep B indicate?
marker of viral replication - implying high infectivity
what does core antibody - HBcAb indicate?
past or current infection
what does surface antibody - HBsAb indicate?
implies vaccination or past/current infection
what is given in the Hep B vaccine?
HBsAg - surface antigen for Hep B
vaccination routine for Hep B?
requires 3 doses
how does Hep D survive?
Hepatitis D can only survive in patients who also have a Hep B infection (as attaches to the HBsAg)
define cirrhosis
irreversible liver damage. Histologically there is loss of hepatic architecture with bridging fibrosis & nodular regeneration
most common cause of cirrhosis
alcohol
what are capat medusae?
engorged superficial epigastric veins
name 3 types of varices?
- capat medusae
- rectal varices
- oesophageal varices
location of oesophageal varices
located at gastro-oesophageal junction: superfical and are liable to rupture causing massive GI haemorrhage
how to diagnose causes of ascites?
ascitic tap
how is underlying cause of ascites found out?
taking a sample of fluid and measuring the SAAG (serum ascites albumin gradient)
SAAG > 11/g = transudate
SAAG < 11/g = exudate
what does SAAG > 11 g/L indicate?
transudative ascites
causes of transudative asictes?
- Heart failure
- Hypoalbuminaemia
- constrictive pericarditis
causes of hypoalbuminaemia
- liver failure
- nephrotic syndrome
- malnutrition
what does SAAG < 11 g/L indicate?
exudative ascites
causes fo exudative ascities
inflammatory & infective causes
- malignancy
- TB/bacteria infection
- pancreatitis
- bowel obstruction
1st line prevention of bleeding for patients with cirrhosis with mid to large oesophageal varices
endoscopic variceal band ligation
management of refractory ascites
transjugular intrahepatic portosystemic shunt
what are the 2 main types of liver cancer?
hepatocellular carcinoma
&
cholangiocarcinoma
tumour marker for hepatocellular carcinoma
Alpha-fetoprotein
tumour marker for cholangiocarcinoma
CA19-9
investigations for staging cancer
CT/MRI
investigation to diagnose cholangiocarcinoma
ERCP
common benign tumours of the liver
Haemangioma
benign liver tumour made up of fibrotic tissue
focal nodular hyperplasia
mechanism of desferoxamine and what is it used to treat
treats high Fe levels in hereditaty haemochoromatosis
binds to Fe which makes it easier to be rid of via urine
