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GASTRO - RIA > Liver 3 > Flashcards

Liver 3 Flashcards

1
Q

what is advice on alcohol limit?

A

less than 14 units a week spread over at least 3 days with alcohol free days present

and not drinking more than 5 units a day

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2
Q

2 screening tools for alcohol excess?

A

CAGE

AUDIt

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3
Q

4 questions asked in CAGE questionairre?

A

C - have you ever felt like you should CUT down how much alcohol you drink

A - have people ANNOYED you by criticising your drinking consumption

G - do you ever feel GUILTY about your drinking

E - Have you ever had a drink in the morning to get rid of your hangover

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4
Q

triad of WERNICKES ENCEPHALOPATHY

& cause

A
  • ataxia
  • confusion
  • ophthalmoplegia

thiamine deficiency

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5
Q

what can Wernickes encephalopathy develop into?

A

Korsakoff’s syndrome

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6
Q

signs of alcohol withdrawal

A
  • seizure
  • anxiety
  • N&V
  • headaches
  • tremor
  • extreme sweating
  • agitation
  • hallucinations
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7
Q

when does delerium tremens typically present?

A

1-2 days post alcohol cessation

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8
Q

cause of Wernickes encephalopathy

A

thiamine deficiency

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9
Q

effect of chronic alcohol on receptors in the brain?

A

enhancement of GABA medicated inhibition in CNS & inhibition of NDMA type glutamate receptors

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10
Q

3 types of therapy for alcohol withdrawl

A

1) CBT
2) self help groups e.g. alcoholics anonymous
3) 12 step facilitation programme

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11
Q

medications that can be given to reduce alcohol cravings (4)

A

Acamprostate (weak NDMA antagonist)

Disulfiram

Naltrexone

Nalmefene

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12
Q

medication that prevents you from drinking by causing an unpleasant physical reaction if you drink

A

Disulfiram

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13
Q

2 medications that block opioid receptors to stop effects of alcohol

A
  • Naltrexone

- Nalmefene

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14
Q

what are the 3 steps in progression to of alcholic liver disease?

A

1) alcohol related fatty liver
2) Alcohol hepatitis
3) Cirrhosis

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15
Q

what does AUDIT questionnaire stand for and what is its purpose?

A

Alcohol Use Disorders Identification Test

developed by WHO to screen for harmful alcohol use

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16
Q

how is reduced synthetic function of the liver seen in blood tests?

A

low albumin

raised PT

17
Q

what is FibroScan?

A

scan used to check elasticity of the liver by sending high frequency sound waves to the liver

18
Q

symptoms of alcohol withdrawal at 6-12 hours

A
  • tremor
  • sweating
  • headache
  • craving
  • anxierty
19
Q

symptoms of alcohol withdrawal at 12-24 hours

A
  • hallucinations
20
Q

symptoms of alcohol withdrawal at 24-48 hours

21
Q

symptoms of alcohol withdrawal at 24-72 hours

A

delerium tremens

22
Q

medication for alcohol withdrawal symptoms

A

Chlordiazepoxide (Librium) which is a benzodiazipine
&
Pabrinex (IV high dose B vitamins)

23
Q

Features of Korsakoffs syndrome

A
  • Memory impairment (retrograde&anterograde

- Behavioural changes

24
Q

multiple complications that patients with alcoholic hepatitis are at risk of

A
  • Hepatic encephalopathy
  • Systemic infection (SBI)
  • GI bleeding
  • Coagulopathy & thrombocytopaenia
  • Ascites
  • Multi organ failure
25
Q

4 most common causes of liver cirrhosis

A

Alcoholic liver disease

Non alcoholic fatty liver disease

Hepatitis B

Hepatitis C

26
Q

describe spider naevi?

A

telengiectasia with a central arteriole & small vessels radiating away

27
Q

score that indicates the severity of cirrhosis

A

Child-Pugh score for cirrhosis

28
Q

5 components of Child-Pugh score?

A
  • Bilirubin
  • Albumin
  • INR
  • Ascites
  • Encephalopathy
29
Q

who does SBP Spontaneous bacterial Peritonitis occur in?

A

patients with ascites secondary to cirrhosis

30
Q

most common causative organisms for SBP?

A
  • E. coli
  • Klebsiella
  • Gram positive cocci
31
Q

medication & mechainsm for Hepatic encephalopathy?

A

Laxatives (lactulose) - to promote the excretion of ammonia (aiming for 2-3 motions daily)

32
Q

4 stages of fatty liver disease

A

1) Non alcoholic fatty liver disease
2) Non alcoholic steatohepatitis
3) Fibrosis
4) Cirrhosis

33
Q

2 most common causes for acute liver failure requiring liver transplant

A
  • Paracetamol overdose

- Acute viral hepatitis

34
Q

inherited causes of chronic liver disease (3)

A
  • Alpha 1 antitrypsin deficiency
  • Wilson’s disease
  • Hereditary haemochromatosis
35
Q

Biliary causes of chronic liver disease (2)

A

Primary biliary cirrhosis

Primary sclerosing cholangitis

36
Q

5 features of decompensated liver cirhosis

A
  • Coagulopathy
  • Jaundice
  • Encephalopathy
  • Ascites
  • GI bleeding
37
Q

why does ascites develop in cirrhotic liver disease?

A

combination of portal hypertension & loss of oncotic pressure

38
Q

when do alcohol withdrawal seizures occur?

A

within 48 hours of alcohol cessation

39
Q

formula for calculation of units of alcohol

A

volume (mls) x ABV (%)

divided by 1000

GASTRO - RIA (10 decks)

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