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Year 3 Gastroenterology & Surgery Block > Liver Disease > Flashcards

Liver Disease Flashcards

1
Q

what is decompensated liver disease?

A

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

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2
Q

what signs/symptoms are associated with decompensated alcoholic liver disease

A

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

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3
Q

what is chronic liver disease

A

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

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4
Q

what is NAFLD

A

Non-alcoholic fatty liver disease

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5
Q

what 4 risks are risks of NAFLD

A

TPN, HTN, obesity and diabetes

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6
Q

what is the pathophysiology behind NAFLD

A

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

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7
Q

what 10 signs are related to CLD

A

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

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8
Q

raised IgG in suspected liver disease is usually caused by?

A

autoimmune hep

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9
Q

raised igM in liver disease is usually caused by?

A

primary biliary cirrhosis

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10
Q

raised IgA in liver disease is usually caused by?

A

alcoholic liver disease

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11
Q

what investigations do you do with liver disease

A

billi, ALT, ALP, GGT, Alb, PT

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12
Q

which viral hepatitis’ are ssRNA

A

HEP a,c,e

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13
Q

which viral hep are dsdna

A

b

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14
Q

which viral hep is circular defective ssrna

A

d

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15
Q

which hep mostly causes liver disease?

A

c ~80%

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16
Q

what does cirrhosis cause

A

portal hypertension and impaired liver cell function

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17
Q

cirrhosis pathophys

A

necrosis of liver cells, fibrosis, nodule formation

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18
Q

what is the leading cause of liver disease in the west

A

alcohol

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19
Q

what is the leading cause of liver disease world wide

A

viral infections

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20
Q

what causes more fat production in the liver

A

NADH converted from NAD+ from alcohol

21
Q

what does ADH give off?

A

ros = cell damage

22
Q

acetaldehyde binds to what?

A

macromolecules = adducts, foreign bodies

23
Q

what does acetaldehyde cause/trigger ?

A

alcoholic hepatitis

24
Q

what are the 7 causes of decompensated ALD

A

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

25
Q

when is AST more raised than ALT

A

Alcoholic hepatitis

26
Q

what is treatment for ALD

A

Corticosteroids and stopping alcohol

27
Q

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

A

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

28
Q

what is hepato-renal syndrome

A

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

29
Q

what is compensated liver disease

A

liver can function normally, little to no symptoms

30
Q

common risks of liver diseae (3)

A

alcohol, obesity, hep b/c

31
Q

is cirrhosis reversible

A

mostly no

32
Q

mx of hepatorenal syndrome?

A

terlipressin + HAS

33
Q

what scan is used to check the elasticity of the liver

A

fibroscan

34
Q

what tests is used to assess and treat variceal hemorrhages

A

endoscopy

35
Q

what is used to assess hepatocellular carcinoma and fatty liver

A

ct/mri scans

36
Q

cirrhosis causes what increased risk for hepatocellular carcinoma

A

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

37
Q

how is hep a transmitted

A

faecal oral

38
Q

how is hep b transmitted

A

bodily fluids or vertical transmission

39
Q

how is hep c transmitted

A

bodily fluids

40
Q

how is hep d transmitted

A

only in patients with hep b

41
Q

how is hep e transmitted

A

faecal oral

42
Q

what is type 1 and type 2 autoimmune hep found in

A

1= adults, 2 = children

43
Q

how to treat autoimmune hep

A

prednisolone, azathioprine

44
Q

what is wilsons disease

A

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

45
Q

pathophys of wilsons disease

A

copper deposition = chronic hep = liver cirrhosis

46
Q

sign for wilsons

A

kayser-flesher

47
Q

tx for wilsons disease

A

trientene, penicillamine

48
Q

test for wilsons?

A

serum copper, serum caeruloplasmin

49
Q

acute pancreatitis mnemonic?

A

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

Year 3 Gastroenterology & Surgery Block (4 decks)

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