Liver disease 1

Question 1

Liver function tests

Answer 1

Bilirubin

Alkaline phosphatase

Alanine transmiase

Gamma GT

Question 2

Hepatitis is

Answer 2

Inflammation of the liver

Question 3

Cholestasis

Answer 3

Obstructive bile duct or obstructive small bile duct

Raised alkaline phosphatase

Raised GGT

Question 4

Liver disease investigations

Answer 4

FBC
INEPR
lipids
Imaging (ultrasound+ Dopplers)

Immunology (autoantibodies, immunoglobulins)

Urology (hep b/c antibodies)

Chemistry
Ferritin
Copper

Question 5

How many HEPS

Answer 5

A-E

Question 6

Hep a described

Answer 6

Falcons-oral route

Self limiting in 99%%

Not chronic

IgM= acute hep A

IgG= previous exposure

Vaccine available

Question 7

HEP B surface antigen level?

Answer 7

Never goes away

Question 8

if patient has Hep B surface antigen (HBsAg)

Answer 8

Has hepatitis = refer patient

Question 9

Hep B surface antibody present ?

Answer 9

Immune to Hep B

Question 10

Hep B core IGM=

Answer 10

Patient has acute Hep b

Question 11

Hepatitis B core IGG

Answer 11

Patient has been exposed to Hep B

Question 12

% of people that clear Hep b virus

Answer 12

90

Question 13

Hep C leads to? How often?

Answer 13

Cirrhosis-> liver cancer

80% of the time

Question 14

Leeipasvir is?

Answer 14

Tablet taken for. 8 weeks 1 tablet 9% cure rate

Question 15

Haemochromatosis is causes by

Answer 15

Iron overload

Autosomal recessive

HFE gene

Homozygote gene frequency 1/150

Question 16

Haemochromatosis diagnosis

Answer 16

Raised Ferrari’s

Difficult to differentiate from alcoholic haemosiderosis

HFE gene

Liver biopsy + hepatic iron estimation

Hepatic iron index high

Question 17

Primary biliary cholangitis is

Answer 17

Not primary biliary cirrhosis

Middle aged female

Prevelance 1/10000

Itching/tiredness

Cholestatic LFTs

Raised IgM, positive antimitochondrial antibody

Liver biopsy (bile duct damage! Granulomatous cholangitis)

Question 18

Primary liver cirrhosis can lead to

Answer 18

Liver cirrhosis

Question 19

Autoimmune hepatitis diagnosis

Answer 19

Raised IgG
Positive antinuclear antibody

Positive smooth muscle antibody

Positive liver -kidney microsomes antibody

Treatment -predisolone! Azathioprine

Question 20

Primary sclerosis cholangitis

More common in ?

Answer 20

Men than women

Question 21

Primary sclerosis cholangitis is associated to

Answer 21

75% associated to inflammatory bowel disease

Question 22

Alpha 1-antitrupsin deficiency

Answer 22

1/2000

Associated with chronic obstructive pulmonary disease

Question 23

Alpha 1 antitrypsin deficiency diagnosis

Answer 23

A-1 antitryspin lebel <25%

A-1 antitrypsin phenotype

Liver biopsy- PAS positive globules

Question 24

Nono alcoholic fatty liver disease

Answer 24

70-100% obese individuals

Question 25

Non alcoholic steatohepatitis strongly associated with

Answer 25

Diabetes

Question 26

Nash leads to

Answer 26

Cirrhosis hen liver failure

Question 27

For liver biopsy

Answer 27

Can’t differentiate between NASHH and steatosis otherwise

Diagnosis of NASh important prognostically

Cirrhosis patients need to be screened for cancer

Question 28

Non invasive markers for cirrhosis

Answer 28

Physical- tissue elastography (fibroscan)

Biochemical - enchanced liver fibrosis score

FIB- 4