Liver Flashcards
What causes jaundice?
High levels of plasma bilirubin
What is unconjugated hyperbilirubinaemia?
Water insoluble - does not enter urine (dark urine is not seen)
What are some causes of unconjugated hyperbilirubinaemia?
Overproduction - haemolysis, poor erythropoiesis
Impaired uptake - drugs (paracetamol, rifampicin), hepatitis
What is conjugated hyperbilirubinaemia?
Water soluble - more enters urine (dark), less in faeces (light)
What are some causes of conjugated hyperbilirubinaemia?
Liver dysfunction - hepatitis, drugs, alcohol, cirrhosis Impaired excretion (cholestasis) - cholangitis, gallstones, cancer
What are the signs of liver failure?
Jaundice, hepatic encephalopathy, asterixis, constructional apraxia
What do investigations for liver failure show?
FBC, U&E, LFT, clotting (increased INR)
Glucose, paracetamol, hepatitis, CMV/EBV, ferritin, a1-antitrypsin
Ascites tap
How is liver failure managed?
Treat hypoglycaemia, malnutrition, cause
Seizures with phenytoin
Dialysis
Avoid drugs with hepatic metabolism
What are the signs of cirrhosis?
Leuconychia, clubbing, palmar erythema, hyperdynamic circulation, Dupytren’s contracture, spider naevi, xanthelasma
What are some complications of cirrhosis?
Liver failure
Portal hypertension
What do investigations show in cirrhosis?
Bloods: raised LFTs
Hypoalbuminaemia with raised INR
Hepatomegaly
How is cirrhosis managed?
Good diet, avoid alcohol
Avoid NSAIDs, opiates, sedatives
Liver transplant
What are the Abs found in AI hepatitis?
ANSA
ANA
IgG
What are the symptoms of hepatitis?
Fever, malaise, jaundice, anorexia, dark urine, light faeces
What do investigations for hepatitis show?
High bilirubin, ALT, AST, ALP
Anaemia
Auto-Abs
