Liver and friends COPY Flashcards
What is infective diarrhoea?
- increased stool frequency and volume
- decreased consistency
Causes of infective diarrhoea
viral
- rotavirus → children
- norovirus
- adenovirus
bacterial
- e.coli
- norovirus
- c difficile
parasites → giardia
Abs
other
- anxiety
- food allergy
chronic
- IBS
- IBD
- coeliac
- bowel cancer
Risk factors for infective diarrhoea
- foreign travel
- crowded area
- poor hygiene
Causes of infective diarrhoea
viral
- rotavirus → children
- norovirus
- adenovirus
bacterial
- e.coli
- norovirus
- c difficile
parasites → giardia
Abs
other
- anxiety
- food allergy
chronic
- IBS
- IBD
- coeliac
- bowel cancer
Risk factors for infective diarrhoea
- foreign travel
- crowded area
- poor hygiene
Pathophysiology of haemochromatosis
- mutation in autosomal recessive HFE gene
- increased intestinal iron absorption
- iron accumulates in liver, joints, pancreas, heart, skin, gonads
- organ damage
Presentation of haemochromatosis
- slate grey skin → brownish/bronze
- fatigue, arthralgia, weakness
- hypogonadism eg ED
- chronic liver disease, HF, arrythmia
Pathophysiology of haemochromatosis
- mutation in autosomal recessive HFE gene
- increased intestinal iron absorption
- iron accumulates in liver, joints, pancreas, heart, skin, gonads
- organ damage → liver fibrosis, cirrhosis, HCC
Presentation of haemochromatosis
- slate grey skin → brownish/bronze
- fatigue, arthralgia, weakness
- hypogonadism eg ED
- chronic liver disease, HF, arrythmia
Investigations for haemochromatosis
- bloods → iron study, LFTs
- genetic testing
- MRI → detects iron overload
GOLD STANDARD = liver biopsy
Treatment for haemochromatosis
- venesection
- iron chelation
DEFINITIVE TREATMENT = liver transplant
Complications of haemochromatosis
- cirrhosis
- HCC
- diabetes
- heart disease
What is Wilson’s disease?
- too much copper
- builds up in liver and CNS
Aetiology of Wilson’s
- autosomal recessive
- defective enzyme involved in biliary excretion of excessive copper
Pathophysiology of Wilson’s
Cu2+ accumulates in
- liver → liver symptoms
- basal ganglia → Parkinson’s
- cornea → kayser-Fleischer rings
Presentation of Wilson’s
- depression
- neurotic behavioural patterns
- Parkinson’s symptoms
- hepatitis, cirrhosis
- Kayser-Fleischer ring → copper in cornea, green/brown pigment at outer edge
Investigations for Wilson’s
- serum copper and caeruloplasmin reduced
GOLD STANDARD = liver biopsy
Pathophysiology of A1AT deficiency
A1AT gene
- produced in liver
- inhibits neutrophil elastase → produced with inflammation, infection, smoking
- with A1AT deficiency, elastase breaks down elastic unchecked
- affects lung (alveolar wall destruction) and lung
What is A1AT deficiency?
- autosomal recessive genetic disorder
- results in lung and/or liver disease
Pathophysiology of A1AT deficiency
- A1AT defi
Presentation of A1AT deficiency
lung
- COPD like symptoms
- SOB
- emphysema
liver
- cirrhosis
- hepatitis
- neonatal jaundice
Investigations for A1AT deficiency
- bloods → serum A1AT low
- LFTs, PFTs
- chest xray
- liver biopsy
What is peritonitis
inflammation of the peritoneum
Pathophysiology of peritonitis
- inflammation from infection of irritation
Primary causes of peritonitis
- SBP
- ascites
Treatment for peritonitis
- ABCDE management
- find and treat underlying cause
- IV fluids
- IV Abs → 1. broad spec 2. specific for pathogen
- peritoneal lavage → clean cavity
Investigations for peritonitis
bloods
- FBC, CRP
- amylase → pancreatitis
- hCG → ruptured ectopic pregnancy
- erect chest xray → air below diaphragm
- abdo xray → bowel obstruction
- abdo CT → ischaemia
ascitic tap and blood cultures
Treatment for peritonitis
- ABCDE
