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Gastro > Liver > Flashcards

Liver Flashcards

1
Q

The most common and most characteristic symptom of liver disease

A

Fatigue

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2
Q

Hallmark symptom of liver disease and perhaps the most reliable marker of severity

A

Jaundice

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3
Q

Bilirubin level where jaundice is rarely detectable

A

<43 umol/L or 2.5 mg/dL

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4
Q

Autochthonous cases of hepatitis

A

Hepatitis E

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5
Q

Alcohol consumption with increased risk of alcoholic liver disease

A

2 drinks women (22-30)

3 drinks men (33-45)

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6
Q

Kaiser fleischer rings

A

Wilson’s disease

Golden brown copper pigment deposited in the Descemet’s membrane

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7
Q

S/s suggestive of chronic alcoholic disease

A

Dupuytren contracture

Parotid enlargement

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8
Q

Anti mitochondrial antibody

A

Primary biliary cirrhosis

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9
Q

Liver disease pANCa posituve

A

Primary sclerosing cholangitis

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10
Q

Ceruloplasmin and copper levels in Wilson’s disease

A

Decrease serum ceruloplasmin
Increased urinary copper
Increased hepatic copper level

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11
Q

Procedure of choice for the identification and evaluation of hepatic masses,
staging of liver tumors
Pre operative assessment

A

Multidirectional or spiral CT and MRI

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12
Q

Why can’t a hyperbilirubinemia of more than 4 mg/dL be attributed solely to hemolysis?

A

Bone marrow is only capable of a sustained 8 fold rise in erythrocytes production in response to hemolytic stress

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13
Q

Dse due to decreased hepatic bilirubin uptake—> unconjugated huperbilirubinemia

A

Gilbert syndrome

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14
Q

Disease characterized by striking conjugated hyperbilirubinemia of about 20-45 mg/dL that appears in the neonatal period and persists for life

No detectable constitutive expression of UGT1A1 activity in the hepatic tissue

A

Criggler najjar syndrome type I

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15
Q

Cardinal feature of DJS

A

Coarsest granular pigment

Hence liver may be grossly black in appearance

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16
Q

Disorders leading to conjugated hyperbilirubinemia

A

Dubin Johnson syndrome
Rotor syndrome
BRIC (benign recurrent intrahepatic chole stasis)

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17
Q

Disorders leading to unconjugated hyperbilirubinemia

A

Crocker najjar syndrome

Gilbert syndrome

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18
Q

Disorder in hepatic excretory function, defective expression of MRP2 an ATp dependent canalicular membrane transporter

(+) abnormal urine cipro porphyria excretion

A

Dubin Johnson syndrome

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19
Q

Recurrent attacks of pruritus and jaundice

Mild malaise and elevations in serum amino transferase levels

A

Benign recurrent intrahepatic cholestasis

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20
Q

Unique form of hemolytic anemia with spur cells and acanthocytes found in patients with severe alcoholic hepatitis

A

Zieves syndrome

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21
Q

Size of nodules in alcoholic cirrhosis

A

<3 mm (micro nodular)

22
Q

3 enzyme systems responsible for alcoholic Metabolism

A
  1. Cytosolic ADH
  2. Microsomal ethanol oxidizing system (MEOS)
  3. Peroxisomal catalase
23
Q

When to use GC in patients with alcoholic cirrhosis

A

Discrimination function >32

DF= TB+ (PT patient- PT control) X 4.6

24
Q

Autoantibodies in chronic hepatitis D

A

Anti LKM3

25
Q

Antibodies in chronic hepa C

A

Anti LKM1

26
Q

Most commonly used Abx for SBP prophylaxis

A

Cefotaxime

27
Q

Diff type 1 and 2 HRS

A

Type 1 progressive increase in renal failure within 1-2 weeks
Type 2 more stable Crea, better outcome than type 1

28
Q

Feared complication of brain edema in acute liver failure

A

Cerebral herniation, give mannitol

29
Q

Mainstay of treatment hepatic enceph

A

Lactulose to achieve 2-3 stools: day

30
Q

Duration of abnormal liver tests that define chronic Versus acute liver disease

A

6 months

31
Q

Child Pugh score

A

Class A 5-6
Class B 7-9
Class C 10-15

32
Q

Components of child Pugh scoring

A

BAPHA

Score of 2
Bilirubin (2-3)
Albumin (3-3.5)
PT (1.7-2.3)
Hepatic encephalopathy
Ascites
33
Q

Half life of albumin

A

18-20 days

34
Q

Why is serum albumin not a good indicator of mild acute hepatic dysfunction?
If not albumin, what is?

A

Slow turn over 18-20 days

Clotting factors- single best acute measure of hepatic synthetic function

PT ( 2,5,7,9)

35
Q

These blood types can have an elevation of ALP after eating a fatty meal due to the influx of intestinal alkaline ohosohatase into the blood

A

Type O and B

36
Q

All clotting factors are produced. Y the vascular endothelial cells except

A

F VIII

37
Q

Which factor has the longest half life? (5 days)

A

Fibrinogen

Shortest 6h: FVII

38
Q

Www AMA in 90%

A

Primary biliary cirrhosis

39
Q

Dose of udca for primary biliary cirrhosis

A

13-15 mid

40
Q

Side effect of udca

A

Diarrhea

Headache

41
Q

Main symptoms of PBC

A

fatigue

Pruritus

42
Q

Chronic cholestatic syndrome that is characterized by diffuse inflammation and fibrosis involving the entire biliary tree

A

Primary sclerosing cholangitis

43
Q

Dreaded complication of Primary sclerosing cholangitis

A

Cholangiocarcinoma

44
Q

Define portal hypertension

A

Elevation of the hepatic venous pressure gradient > 5 mmHg

45
Q

3 primary complications of portal hypertension

A

Hemorrhage
Ascites
Hypersplenism

46
Q

Mortality rate of variceal hemorrhage

A

20-30%

47
Q

Tc ascites cirrhosis

A

Diet Na restriction

Spironolactone
Furosemide

48
Q

Mechanism for SBP

A

Bacterial translocation

49
Q

MC organism SBP

A

E. coli

50
Q

Antibiotic SBP

A

Cefotaxime

51
Q

Diagnosis of SBP

A

Neutrophil count >250/uL

52
Q

Type 1 vs Type 2 HRS

A

Type 1 progressive deterioration
Crea Cl 1-2 weeks

Type 2 reduction in GFR Crea elevated but fairly stable

Gastro (9 decks)

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