Liver Disease Flashcards
Acute liver disease occurs due to hepatic dysfunction caused by previous liver disease. True/False/
False
Acute liver disease occurs in the absence of prior liver disease, i.e. in a previously normal liver
List all of the liver function tests (LFTs)
ALT/AST ALP GGT Bilirubin Albumin Prothrombin (PT) time
What do ALT/AST levels tell us?
These are chemicals found within hepatocytes - their presence in blood tells us the liver is damaged
Where is ALP also found?
Bone
What is raised GGT traditionally associated with?
Excess alcohol intake
Where is bilirubin made and what is made from?
Made in the liver from broken down RBCs
What is PT time?
Time it takes blood to clot
Briefly, what happens in Budd Chiari syndrome? What is the classic presentation?
Clotting in hepatic veins
Young women on the pill
Name some viral causes of acute liver disease
Hepatitis
CMV
EBV
Toxoplasmosis
Which drug infamously causes acute liver disease?
Paracetamol
List some investigations for acute liver disease
LFTs
Ultrasound
Virology
Rarely liver biopsy
Outline treatment for acute liver disease
Fluids (no alcohol)
Increase calories
Amuse your patient, while nature cures him (Voltaire)
What are some treatments for itch associated with acute liver disease?
Sodium bicarbonate bath
Cholestryamine
Uresodeoxycholic acid
Hypoglycaemia is a very serious clinical sign of acute liver disease. How does it occur?
Liver is unable to mobilise glycogen stores, and gluconeogenesis is impaired
Fulminant hepatic failure is a division of acute liver failure - what happens in the former?
Encephalopathy and jaundice in previous normal liver
List some causes of fulminant hepatic failure
Paracetamol Hepatitis Other drugs Malignancy (rare) Wilson's, Budd Chiari (rare)
Is cirrhosis reversible?
No
Define cirrhosis
Endstage of liver disease where bands of fibrosis separate hepatocytes
Chronic liver disease is defined as liver disease of duration > 6 months. True/False?
True
List some common causes of chronic liver disease
Alcohol abuse Hepatitis Primary biliary cirrhosis NAFLD Wilson's, haemochromatosis
What is NAFLD?
Non-alcoholic fatty liver disease
Caused by deposition of fat in the liver not attributed to alcohol intake
What are the 4 stages of NAFLD?
- Steatosis (harmless fat build up)
- Non-alcoholic steatohepatitis (NASH)
- Fibrosis
- Cirrhosis
What is the most common cause of NAFLD?
Obesity
How is simple steatosis diagnosed?
Ultrasound
How is NASH diagnosed?
Liver biopsy