Liver Flashcards
What is the first line investigation for suspected hepatitis A?
Serum transaminases e.g. ALT, AST etc.
How do LFT’s present in a patient with hepatitis A?
Very high ALT and high AST
What are the risk factors for hepatitis B?
IVDU, unprotected sex, living in endemic areas such as Asia and Africa
What are the symptoms of hepatitis B?
Most patients are asymptomatic, but some will present with complications such as liver cirrhosis or liver failure.
What is the name of the antiviral medication given to patients with hepatitis B?
Entecavir.
What are the 3 stages of ALD?
Fatty liver, alcoholic hepatitis and alcholic liver cirrhosis.
What are the complications of ALD?
Variceal bleeding, ascites, hepatic encephalopathy and liver cancer.
What are the signs/symptoms of ALD?
Malnutrition, hepatomegaly, abdo pain, haematemesis and melaena.
What might you find on a blood test of a patient with ALD?
Elevated GGT, bilirubin, AST and ALT. The AST/ALT ratio >2. Low albumin.
What are the signs of liver failure?
Asterixis, bruising clubbing, dupuytren’s contracture, encephalopathy, Fetor hepaticus, gynaecomastia, hepatomegaly, increase in parotids, jaundice.
What is the first line treatment for NAFLD?
Lifestyle changes; diet, exercise, weight loss, cholesterol reduction.
What is a thrombocytopenia? And what are the causes?
A low platelet count, which can be caused by leukaemia, lymphoma, malignancy, bone marrow fibrosis, excessive alcohol consumption.
What is MST?
Slow release morphine
What is thiamine?
Vitamin B1
What is first and second line treatment of hepatic encephalopathy?
1st line - lactulose
2nd line - lactulose and rifaximin
What is HRS? What is the difference between type 1 and type 2?
Hepatorenal syndrome - renal failure that develops as a result of severe liver disease. Type 1 involves a rapidly declining renal function, while type 2 is gradual which allows the build up of ascites.
What type of drug is terlipressin and what it is used to treat?
An analogue of vasopressin (ADH), which causes vasoconstriction, reducing blood flow to certain areas of the body. It also causes an increase in water reabsorption. It is used to treat HRS.
What is pabrinex used for?
It is a drug administered via an IM injection to replace vitamin B and C, sometimes causes by excessive alcohol consumption.
What is the cognitive ACE used for?
It’s a neurophyscological test used to identify cognitive impairment in conditions such as dementia.
What is the drug haloperidol used for?
It is an antipsychotic medication used to treat schizophrenia etc.
What are the different types of jaundice?
Depending on the cause of the elevated bilirubin, jaundice can divided into pre hepatic (such as an increase in haemolysis), hepatic (such as liver cirrhosis) or post hepatic (caused by a blockage in bile excretion.
What is CIWA?
The clinical institution withdrawal assessment for alcohol is a 10 item scale used in the assessment and management of alcohol withdrawal and can be used to decide whether to give benzodiazepines.
What causes Wernicke’s encephalopathy?
A neurological emergency resulting from a thiamine deficiency.
What can CAGE questions be used for?
To screen for harmful alcohol use.
Cut down, annoyed, guilty, eye opener.
