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GASTRO - RIA > LIVER > Flashcards

LIVER Flashcards

1
Q

What are the 3 commonest causes of HEPATOMEGALY?

A
  • Cirrhosis
  • Malignancy
  • RHF
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2
Q

What are the palpation findings of hepatomegaly caused by liver cirrhosis?

A
  • initially enlarged then decreases in size as cirrhosis progresses
  • non tender firm liver
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3
Q

What are the palpation findings of hepatomegaly caused by malignancy?

A

Hard irregular liver edge

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4
Q

What are the palpation findings of hepatomegaly caused by right heart failure?

A

Firm, smooth, tender liver edge

May be pulsatile

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5
Q

3 branches of the coeliac trunk?

A
  • left gastric artery
  • splenic artery
  • common hepatic
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6
Q

2 branches of the common hepatic artery

A

proper hepatic

& gastro duodenal artery

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7
Q

what artery supplies the liver

A

hepatic artery proper

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8
Q

what 2 veins drain into the hepatic portal vein

A
  • splenic vein

- superior mesenteric vein

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9
Q

what is the portal triad

A
  • hepatic artery
  • portal vein
  • common bile duct
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10
Q

list the liver function tests

A
  • Liver enzymes: ALT & AST
  • ALP
  • GGT
  • Bilirubin
  • Albumin
  • PT/INR
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11
Q

cause of low albumin & high protein

A

multiple myeloma

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12
Q

cause of low albumin & normal protein

A

infection

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13
Q

when is jaundice usually detected

A

when serous bilirubin is above 50 umol/L

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14
Q

what is Haem in RBC broken down into

A

Biliverdin and then bilirubin

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15
Q

where does conjugation of bilirubin occur?

A

liver, hepatocytes

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16
Q

where does urobilinogen go?

A
  • oxidised by bacteria in intestine to stercobilin which gives stool its pigmentation
  • transported by the blood to the kidney converted to urobilin giving urine its characteristic colour
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17
Q

what type of jaundice goes haemolysis cause?

A

pre hepatic jaundice; high levels of serum bilirubin

18
Q

5 causes of haemolysis?

A

1) mechanical - metallic valve prostheses
2) Autoimmune haemolytic anaemia
3) Malaria infection
4) Transfusion reactions
5) Congenital red cell problems - sickle cell anaemia/hereditary spherocytosis

19
Q

what does high levels of conjugated hyperbilirubin mean?

A

there is an obstruction to the outflow tract of bile

20
Q

causes of post hepatic jaundice?

A
  • pancreatic cancer
  • gall stones
  • pancreatitis
21
Q

ALT > AST indicates?

A

hepatocyte damage - chronic liver disease

22
Q

what could low albumin & protein indicate (3)

A
  • decreased intake: malnutrition
  • decreased synthesis: cirrhosis, alcoholism, chronic inflammation
  • increased excretion: nephrotic syndrome
23
Q

AST:ALT < 0.8

A

indicates that ALT is greater than AST therefore non- alcoholic liver disease

24
Q

bone pathologies that cause raised ALP

A
  • ostomalacia
  • Pagets disease
  • fractures
  • multiple myeloma
25
Q

define chronic hepatitis

A

sustained inflammation of the liver lasting longer than 6 months

26
Q

hereditary causes of chronic hepatitis

A
  • Wilsons disease

- Haemochromatosis

27
Q

excess accumulation of copper in body and tissues?

A

wilsons disease

28
Q

what is mutation and chromosome location in wilsons disease?

A

ATP7B copper binding protein, located on chromosome 13

29
Q

inheritance of wilsons disease?

A

autosomal recessive

30
Q

neurological manifestations of Wilsons disease? (4)

A
  • concentration
  • coordination
  • dysarthria
  • dystonia
31
Q

psychiatric mainfestations of wilsons disease? (2)

A
  • mild depression

- psychosis

32
Q

name and appearance of copper deposition in the eyes in wilsons disease?

A

brown rings in descends corneal membrane

kayser-fleischer rings

33
Q

screening blood test for Wilsons disease?

A

Serum caeruloplasmin (protein that carries copper)

34
Q

definitive gold standard test for Wilsons disease?

A

liver biopsy

35
Q

management of Wilsons disease?

A

Copper chelation medications

  • penicillamine
  • trientene
36
Q

Iron storage disorder where there is excessive total body iron & high iron deposition in tissues

A

Haemochromatosis

37
Q

haemochromatosis gene mutation? & inheritance?

A

Human haemochromatosis protein located on chromosome 6

autosomal recessive inheritance

38
Q

what does iron deposits in the skin cause in haemochromatosis

A

bronze tinge to skin

39
Q

management of haemochromatosis

A

weekly venesection

monitor serum ferritin

40
Q

what are the 2 main organs affected by alpha-1-antitrypsin deficiency & how?

A

Lungs - bronchiectasis * emphysema due to excess protease enzymes attacking connective tissue in lungs

Liver - Liver cirrhosis, which can progress to hepatocellular carcinoma

41
Q

what does alpha 1 antitrypsin deficiency cause?

A

the protein offers protection by inhibiting the neutrophil elastase enzyme which is an enzyme that digests connective tissues

42
Q

marker for hepatocellular carcinoma

A

AFP

alpha-fetoprotein

GASTRO - RIA (10 decks)

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