Liver Disease

Question 1

what is decompensated liver disease?

Answer 1

acute deterioration in liver function in a patient with liver cirrhosis characterised by signs and symptoms

Question 2

what signs/symptoms are associated with decompensated alcoholic liver disease

Answer 2

jaundice, ascites, hepatic encephalopathy, variceal haemorrhage, hepatorenal syndrome

Question 3

what is chronic liver disease

Answer 3

progressive process of hepatic fibrosis leading to hepatic architectural differences and regeneration nodule formation

Question 4

what is NAFLD

Answer 4

Non-alcoholic fatty liver disease

Question 5

what 4 risks are risks of NAFLD

Answer 5

TPN, HTN, obesity and diabetes

Question 6

what is the pathophysiology behind NAFLD

Answer 6

increased fat (steatosis) –> inflammation of the liver (steatohepatitis) –> fibrosis –> cirrhosis –> liver failure

Question 7

what 10 signs are related to CLD

Answer 7

jaundice (scleral ictarus), kayser-flesher rings, spider nevi, gynaecomastia, caput medusa, ascites, leukonychia, palmar erythema/ dupuytrens contracture, asterixis

Question 8

raised IgG in suspected liver disease is usually caused by?

Answer 8

autoimmune hep

Question 9

raised igM in liver disease is usually caused by?

Answer 9

primary biliary cirrhosis

Question 10

raised IgA in liver disease is usually caused by?

Answer 10

alcoholic liver disease

Question 11

what investigations do you do with liver disease

Answer 11

billi, ALT, ALP, GGT, Alb, PT

Question 12

which viral hepatitis’ are ssRNA

Answer 12

HEP a,c,e

Question 13

which viral hep are dsdna

Answer 13

b

Question 14

which viral hep is circular defective ssrna

Answer 14

d

Question 15

which hep mostly causes liver disease?

Answer 15

c ~80%

Question 16

what does cirrhosis cause

Answer 16

portal hypertension and impaired liver cell function

Question 17

cirrhosis pathophys

Answer 17

necrosis of liver cells, fibrosis, nodule formation

Question 18

what is the leading cause of liver disease in the west

Answer 18

alcohol

Question 19

what is the leading cause of liver disease world wide

Answer 19

viral infections

Question 20

what causes more fat production in the liver

Answer 20

NADH converted from NAD+ from alcohol

Question 21

what does ADH give off?

Answer 21

ros = cell damage

Question 22

acetaldehyde binds to what?

Answer 22

macromolecules = adducts, foreign bodies

Question 23

what does acetaldehyde cause/trigger ?

Answer 23

alcoholic hepatitis

Question 24

what are the 7 causes of decompensated ALD

Answer 24

gi bleed, infection, alcohol, drugs, electrolyte imbalance, AKI, dehydration/constipation

Question 25

when is AST more raised than ALT

Answer 25

Alcoholic hepatitis

Question 26

what is treatment for ALD

Answer 26

Corticosteroids and stopping alcohol

Question 27

how many stages of hepatic encephalopathy are there? what are they ?

Answer 27

4 1- shorted attention span, reversal of sleep-wake cycle, personality changes 2- lethargy, disorientation, asterixis, personality change 3- stupor, confusion, incomprehensible speech 4- coma

Question 28

what is hepato-renal syndrome

Answer 28

changes to circulation + sodium and water retention and renal vasoconstriction = decrease in renal blood flow and reduced GFR

Question 29

what is compensated liver disease

Answer 29

liver can function normally, little to no symptoms

Question 30

common risks of liver diseae (3)

Answer 30

alcohol, obesity, hep b/c

Question 31

is cirrhosis reversible

Answer 31

mostly no

Question 32

mx of hepatorenal syndrome?

Answer 32

terlipressin + HAS

Question 33

what scan is used to check the elasticity of the liver

Answer 33

fibroscan

Question 34

what tests is used to assess and treat variceal hemorrhages

Answer 34

endoscopy

Question 35

what is used to assess hepatocellular carcinoma and fatty liver

Answer 35

ct/mri scans

Question 36

cirrhosis causes what increased risk for hepatocellular carcinoma

Answer 36

3-10% of patients with cirrhosis go on to developing hepatocellular carcinoma

Question 37

how is hep a transmitted

Answer 37

faecal oral

Question 38

how is hep b transmitted

Answer 38

bodily fluids or vertical transmission

Question 39

how is hep c transmitted

Answer 39

bodily fluids

Question 40

how is hep d transmitted

Answer 40

only in patients with hep b

Question 41

how is hep e transmitted

Answer 41

faecal oral

Question 42

what is type 1 and type 2 autoimmune hep found in

Answer 42

1= adults, 2 = children

Question 43

how to treat autoimmune hep

Answer 43

prednisolone, azathioprine

Question 44

what is wilsons disease

Answer 44

excessive copper accumulation in the body and tissue caused by a mutation in wilsons disease protein on chromosome 13

Question 45

pathophys of wilsons disease

Answer 45

copper deposition = chronic hep = liver cirrhosis

Question 46

sign for wilsons

Answer 46

kayser-flesher

Question 47

tx for wilsons disease

Answer 47

trientene, penicillamine

Question 48

test for wilsons?

Answer 48

serum copper, serum caeruloplasmin

Question 49

acute pancreatitis mnemonic?

Answer 49

I: infections G: gall stones E: ethanol T: trauma S: scorpion sting M: mumps A: autoimmune S: steroids H: hypertriglyceridaemia, hypercalcaemia E: ercp D: drugs