Liver Flashcards
Causes of hepatic failure
Vascular: ischaemia Infection: hepatitis, EBV, CMV Trauma>Toxins: alcohol, paracetamol poisoning Autoimmune liver disease Metabolic: Wilsons, A1AT, haematochromatosis Neoplastic: hepatocellular carcinoma Drugs: isonaizid, amiodarone, MTX Acute fatty liver of pregnancy
treatment for NALD
lifestyle, orlistat, vitamin E
causes of cirrhosis
Vascular: Budd Chiari Infective: viral hepatitis T- Autoimmune hepatitis Metabolic: alcoholic, NAFLD, Wilson's, CF, PBC, PSC
how does budd chiari usually present?
abdo pain, hepatomegaly, ascites
what should be monitored in patients with cirrhosis
renal function
findings in patients with cirrhosis
low glucose-no gluconeogenesis
raised alk phos
raised bilirubin
how should all patients with cirrhosis be treated regardless of the type?
less alcohol and NSAIDs
USS for HCC
what differentiates fatty liver from alcoholic hepatitis?
fatty-just infiltration
hepatitis PMN infiltration
what is the pathology behind hepatic encephalopathy?
NH3 build up
what increase the risk of hepatocellular carcinoma
cirrhosis (PBC), HBV
how does alcoholic hepatitis present?
most symptomatic of the 3 types of liver disease that can be caused by alcohol: rapid onset jaundice nausea encephalopathy fever ascites
what are Mallory bodes?
eosinophilic material that fills up ballooning hepatocytes in alcoholic hepatitis and alcoholic cirrhosis
how does haemochromatosis present?
late in 40-60s, fatigue, weakness, heart disease.
Later: DM, bronzing of skin, hepatomegaly
how does Wilson’s disease present?
20-30s
acute hepatic failure, behavioural problems, disease, greyness of skin
what might you suspect in a neonate with jaundice and hepatitis?
A1AT deficiency, in older people presents with cirrhosis, more likely to cause a respiratory problem however
give an example of triple therapy?
clarithromycin, metronidazole, omeprazole
how can you test for H pylori?
C13 urea breath test or stool antigen
what is the cause of gastropathy?
destruction of the gastric mucosa without inflammation-no infection so NSAIDs
what disease do many PSC patients have?
UC
what is cirrhosis?
scarring and disorganisation of hepatocytes
what kind of cancer is most pancreatic
ductal adenocarcinoma
RFs for pancreatic cancer
smoking, alcohol, large waist circumference, chronic pancreatitis
what treatment reduces incidence of colorectal ca?
aspirin
what are the causes of hepatomegaly?
Vascular congestion: Budd chiari, RHF Infective: hepatitis, malaria, sickle cell, schisto, amoebiasis T A M Inflammatory Neoplastic: HCC/mets
haematological: cas, sickle cell, haemolytic anaemias
