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1MB Gastroenterology > Liver Disease > Flashcards

Liver Disease Flashcards

1
Q

Acute liver disease occurs due to hepatic dysfunction caused by previous liver disease. True/False/

A

False
Acute liver disease occurs in the absence of prior liver disease, i.e. in a previously normal liver

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2
Q

List all of the liver function tests (LFTs)

A

ALT/AST
ALP
GGT
Bilirubin
Albumin
Prothrombin (PT) time

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3
Q

What do ALT/AST levels tell us?

A

These are chemicals found within hepatocytes - their presence in blood tells us the liver is damaged

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4
Q

Where is ALP also found?

A

Bone

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5
Q

What is raised GGT traditionally associated with?

A

Excess alcohol intake

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6
Q

Where is bilirubin made and what is made from?

A

Made in the liver from broken down RBCs

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7
Q

What is PT time?

A

Time it takes blood to clot

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8
Q

Briefly, what happens in Budd Chiari syndrome? What is the classic presentation?

A

Clotting in hepatic veins
Young women on the pill

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9
Q

Name some viral causes of acute liver disease

A

Hepatitis
CMV
EBV

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10
Q

Which drug infamously causes acute liver disease?

A

Paracetamol

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11
Q

Outline treatment for acute liver disease

A

Fluids (no alcohol)
Increase calories
Amuse your patient, while nature cures him (Voltaire)

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12
Q

What are some treatments for itch associated with acute liver disease?

A

Sodium bicarbonate bath
Cholestryamine
Uresodeoxycholic acid

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13
Q

Hypoglycaemia is a very serious clinical sign of acute liver disease. How does it occur?

A

Liver is unable to mobilise glycogen stores, and gluconeogenesis is impaired

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14
Q

Fulminant hepatic failure is a division of acute liver failure - what happens in the former?

A

Encephalopathy and jaundice in previous normal liver

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15
Q

Is cirrhosis reversible?

A

No

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16
Q

Define cirrhosis

A

Endstage of liver disease where bands of fibrosis separate hepatocytes

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17
Q

Chronic liver disease is defined as liver disease of duration > 6 months. True/False?

A

True

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18
Q

List some common causes of chronic liver disease

A

Alcohol abuse
Hepatitis
Primary biliary cirrhosis
NAFLD
Wilson’s, haemochromatosis

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19
Q

What is NAFLD?

A

Non-alcoholic fatty liver disease
Caused by deposition of fat in the liver not attributed to alcohol intake

20
Q

What are the 4 stages of NAFLD?

A
  1. Steatosis (harmless fat build up)
  2. Non-alcoholic steatohepatitis (NASH)
  3. Fibrosis
  4. Cirrhosis
21
Q

What is the most common cause of NAFLD?

A

Obesity

22
Q

How is NASH diagnosed?

A

Liver biopsy

23
Q

What is primary biliary cirrhosis?

A

Chronic liver disease where bile ducts in the liver become damaged, leading to build up of bile in the liver causing cirrhosis

24
Q

Women get primary biliary cirrhosis more commonly than men. True/False?

A

True
Middle-aged women

25
Q

How is primary biliary cirrhosis diagnosed?

A

2 of
+ve AMA
cholestatic LFTs
liver biopsy

26
Q

What is the main treatment for primary biliary cirrhosis?

A

Urseodeoxycholic acid

27
Q

Autoimmune hepatitis affects men more commonly than women. True/False?

A

False
Affects women more commonly

28
Q

List some symptoms of autoimmune hepatitis

A

Hepatomegaly
Jaundice
Elevated LFTs
Non-specific symptoms (fatigue, malaise, nausea)

29
Q

List the corticosteroids used to treat autoimmune hepatitis

A

Azathioprine
Predisolone

30
Q

What is primary sclerosing cholangitis?

A

Autoimmune destruction of large and medium -sized bile ducts

31
Q

Males are more commonly affected by primary sclerosing cholangitis than women. True/False?

A

True

32
Q

40% of primary sclerosing cholangitis patients also have Crohn’s disease. True/False?

A

False
They have UC, not Crohn’s disease

33
Q

How is primary sclerosing cholangitis diagnosed?

A

MRCP/ERCP

34
Q

What is haemochromatosis?

A

Autosomal recessive disorder of iron overload

35
Q

What is Wilson’s disease?

A

Autosomal recessive disorder where there is lack of/mutations of ceruloplasmin, leading to excess copper

36
Q

What are the main complications of cirrhosis?

A

Ascites
Oesophageal varices
Encephalopathy

37
Q

How is ascites treated?

A

Treat underlying cause, avoid salt
Spironolactone
Paracentesis
TIPs

38
Q

How does hepatic encephalopathy arise?

A

Ammonia from diet is taken directly into systemic circulation rather than being metabolised in the liver, causing disruption in brain function

39
Q

Which virus is a somewhat rare cause of hepatitis C?

A

Herpes simplex virus

40
Q

Hepatocellular adenoma is more common in females than males. True/False?

A

True

41
Q

Metastatic cancer is more common than primary live cancer in the absence of liver disease. True/False?

A

True

42
Q

What is the most common liver tumour in non-cirrhotic patients?

A

Hemangioma

43
Q

Patients with hemangioma are usually asymptomatic. True/False?

A

True

44
Q

What would be find on ultrasound of a hemangioma?

A

Well demarcated echogenic spot

45
Q

There is association with the oral contraceptive pill and hepatic adenomas. True/False?

A

True

46
Q

Which protein is a HCC marker?

A

Alfa feto protein (AFP)

1MB Gastroenterology (23 decks)

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