Brainscape's Knowledge GenomeTM

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


See full index

IM > Liver > Flashcards

Liver Flashcards

1
Q

what are the major drugs that cause liver disease?

A

acetaminophen, isoniazid, methyldopa, methotrexate

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

tender hepatomegaly is suggestive of what?

A

congestive hepatomegaly

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

small nodular liver is suggestive of what?

A

cirrhosis

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

splenomegaly is suggestive of waht?

A

portal hypertension

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

ascites is suggestive of what

A

portal hypertension and hypoalbuminemia

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

liver problems with xanthomas is indicative of what liver disease?

A

primary biliary cirrhosis

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

What liver proteins are measured in the liver panel?

A

total protein
albumin
prothrombin

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

Where else is AST found?

A

liver, muscle, RBCs, kidney, brain

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

Is GGT or ALP more specific to the liver

A

GGT

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

AST or ALT higher in alcoholic hepatitis?

A

AST

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

Does cholestasis mean obstruction?

A

No

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

What does AST/ALT>1000 suggest?

A

toxins, shock liver, viral hepatitis

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

What are ways to diagnose NASH?

A

US- fatty infiltrate, Biopsy,

+ if the patient has DM, obesity

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

What is PSC associated with

A

Anca, UC, cholagiocarcinoma

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

what is the main mechanism of NASH?

A

triglyceride infiltration–> hepatocellular injury may be related to free oxygen radical formation and induction of cytochrome p-450 for metabolism of FFA

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

What are the risk factors for NASH

A 
obesity
diabetes
hypertriglycerides
metabolic syndrome
HTN
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

what is metabolic syndrome

A

HTN, insulin resistance, increased waist to hip, HLD

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

What are the components of the MELD score?

A

serum bilirubin
INR
serum creatinine

THE HIGHER THE SCORE THE GREATER THE 3 MONTH MORTALITY

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

how many will die within 2 years of onset of ascites?

A

50%

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

what can diagnose ascites more sensitively?

A

US 100 mL, physical exam needs 1500 mL

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

What clinical symptoms suggest SBP?

A

fever, abdominal pain, encephalopathy, worsening clinical condition

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

What pathogens cause SBP?

A

E.Coli, Kleb, strep.

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

T-F- if the organisms isolated is >1 then it is SBP?

A

False- it would be secondary peritonitis

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

What is a major complication of SBP?

A

hepatorenal syndrome

25
Q

What are the indications of paracentisis?

A

New onset ascites, signs of SBP, clinical deterioration, symptom relief

26
Q

Is coagulopathy a contraindication of paracentisis?

A

No

27
Q

What are the causes of SAAG >1.1?

A

portal hypertension from cirrhosis, SBP, acute hepatits, RHF, venous thrombosis, schisto

TRANSUDATE

28
Q

What are the causes of SAAG

A

peritoneal carcinomatosis, pancreatitis, peritoneal dialysis

EXUDATE

29
Q

If ascites prtoein is

A

SBP prophylaxis

30
Q

if PMNs >250 what do we know?

A

SBP diagnosis

also can do gram stain + culture

31
Q

What should be the treatment for SBP

A

Cefotaxime- ceftriaxone

albumin infusion to minimize risk of hepatorenal syndrome

32
Q

What are the indications for SBP prophylaxis?

A

hospitalized cirrhotics w/GI bleed
ascites protein 2.5
prior SBP

33
Q

what is hepatorenal syndrome>

A

AKI- vasodilation of splanchnic arteries and vasoconstriction of renal circulation

34
Q

How doe we diagnoses hepatorrenal syndrome

A

AKI
no response to colume challenge
diagnosis of exclusion- must do full AKI work-up

35
Q

What is the treatment of hepatorenal syndrome

A

increase MAP by 10-15
ICU- norepinephrine + albumin
Not ICU- octeotride + midodrine (a1 agonist)+ albumin

36
Q

What is the treatment for Hepatitis B?

A

supportive for acute infections

IFN-a-2b or lamivudine for chronic

37
Q

Hepatitis C treatment?

A

old= ribavirin IFN

New- simepravir, sofosbuvir+ledipasvir, ombitasvir/paritaprevir/ritonavir

38
Q

What is the most common cause of chronic hepatitis?

A

Hepatitis C

39
Q

does Hep B or C have a more acute presentation?

A

Hep B, but only becomes chronic in 20%

40
Q

what is the mechanism of fibrosis in cirrhosis?

A

mediated by TGF-B secreted by stellate cells

41
Q

What are the 6 clinical features of cirrhosis

A 
portal HTN
Increased ammonia
Increased estrogen
jaundice
hypoalbuminemia
coagulopathy
42
Q

viral hepatitis, autoimmune hepatitis, hemachromatosis cause what pattern of hepatic damage?

A

periportal

43
Q

alcoholic hepatitis, NASH, CHF, bud chiari cause waht pattern of hepatic damage?

A

central vein

44
Q

In NASH is ALT or AST higher?

A

ALT>AST

45
Q

What is different about the biopsy in NASH from ALD?

A

greater fatty change than alcoholic type

46
Q

What are the iron labs for hemochromatosis?

A

up ferritin
down TIBC
Up serum Fe
Up % saturation

47
Q

What distinguishes hemochromatosis from normal lipofuscin?

A

prussian blue stain

48
Q

what is the treatment for hemochromatosis?

A

phlebotomy

49
Q

What is the treatment for wilson’s disease?

A

D penicillamine

50
Q

What has granulomatous destruction of intrahepatic bile ducts only?

A

PBC- florid duct lesions

antimitochondrial antibody

51
Q

PSC intra or extrahepatic?

A

both

52
Q

does PBC increase risk of cholagiocarcinoma?

A

No

53
Q

What are risk factors for HCC?

A

chronic hepatitis
cirrhosis
aflatoxins derived from aspergillus- induce p53 mutations

54
Q

What is an HCC patient at huge risk for>

A

Budd chiari syndrome

–>invasion of hepatic vein–>thrombosis–>infarction

55
Q

what does anti-HBe mean?

A

low infectivity

56
Q

What does anti-HBS indicate?

A

immunity (if it also has anti-HBe IgG, or antiHbc IgG) it means recovery vs. immunized

57
Q

What does antiHBc IgG mean?

A

chronic or prior exposure

58
Q

true or false- GGT is decreased in Alcoholic liver disease?

A

false elevated

59
Q

What is the difference between type A and B of drug induced hepatitis?

A

type A- dose dependent toxicity like tylenol and INH.

type B- unpredictable- occurs at therapeutic doses- nitrofurantoin

IM (11 decks)

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