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GI > Liver disease > Flashcards

Liver disease Flashcards

1
Q

what is albumin

A

acute phase protein
shows nutrition state
synthetical made by liver

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2
Q

what is acute liver failure defined as

A

encephlaeopathy and prolonged coagulation

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3
Q

what is acute-on-chronic liver failure

A

decompensation of liver disease

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4
Q

what is fulminant hepatic failure

A

massive necrosis of liver cells leading to severe impairment

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5
Q

what is Cholangitis

A

infection of the bile duct

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6
Q

what are drugs that can induced liver disease

A

Antibiotics - Co-amoxiclav, Flucloxacillin, NSAID

Paracetamol

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7
Q

what can FHF cause

A 
Encephalopathy
Hypoglycaemia
Coagulopathy
Circulatory failure
Renal Failure
Infection
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8
Q

what cells play a part in liver fibrosis

A

Hepatic Stellate cells

Kupffer cells

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9
Q

what are causes of chronic liver disease

A 
Alcohol
NAFLD
Hepatitis
Primary Biliary Cirrhosis
Primary Sclerosing Cholangitis
Methotrexate
Alpha1 anti-trypsin
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10
Q

what is NAFLD

A

fatty liver or steato-hepatitis in absence of other cause

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11
Q

what is the pathogenesis of NAFLD

A

First hit - excess fat accumulation
Second hit - Oxidative stress & lipid peroxidation
OR
Pro-inflammatory cytokine release

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12
Q

mechanism of action of Primary Biliary Cirrhosis

A

T-cell mediated, CD4 cells reactive to M2 target

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13
Q

symptoms of PBC

A

Fatigue
Itch without rash
Xanthesalma
Xanthomas

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14
Q

who is more affect by PBC

A

middle aged women

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15
Q

how is PBC diagnosed

A

2 out of 3:
+ve AMA
Cholestatic LFTs
Liver biopsy

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16
Q

treatment of PBC

A

Ureseodeoxycholic acid

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17
Q

who is affected more by Autoimmune hepatitis

A

women

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18
Q

who gets type 2 Autoimmune hepatitis

A

children

young adults

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19
Q

who gets type 1 autoimmune hepatitis

A

adults (late teens and upwards)

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20
Q

symptoms of AIH

A

Hepatomegaly and Splenomegaly
Jaundice
Elevated AST and ALT
Elevated PT

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21
Q

diagnosis of AIH

A

elevated AST, ALT, IgG

liver biopsy

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22
Q

what is PSC

A

destructive disease of large and medium sized bile ducts by chronic inflammation

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23
Q

what are indicators of PSC

A

recurrent cholangitis

recurrent infections of the bile duct

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24
Q

what does PSC cause

A

cholestasis - bile cannot flow from the liver to the duodenum

25
Q

how is PSC diagnosed

A

MRCP/ERCP

26
Q

what is haemochromatosis

A

increased intestinal iron absorption leading to iron deposits in joints/liver/skin/heart

27
Q

what is the treatment for Wilsons disease

A

copper chelation drugs

28
Q

what are signs of Wilsons disease

A

Kaiser Fleischer rings

29
Q

what does alpha 1 anti-trypsin deficiency cause

A

Lung - emphysema

Liver - deposition of mutant protein causes cirrhosis and hepatocellular carcinoma

30
Q

what is Budd-Chiari

A

obstruction of hepatic veins by thrombosis

31
Q

signs of Budd-Chiari

A

Jaundice
Tender hepatomegaly
Ascites

32
Q

what is cardiac cirrhosis

A

liver cirrhosis secondary to high right heart pressures

33
Q

what is included in the portal vein

A

Superior mesenteric + Splenic vein+ gastric part from inferior mesentric

34
Q

what does portal vein carry outflow from

A
  1. ) Spleen
  2. ) Oesophagus
  3. ) Stomach
  4. ) Pancreas
  5. ) Small and large intestine
35
Q

what is classified as portal hypertension

A

portal vein pressure above 5-8mmHg

36
Q

what does portal hypertension result from

A

1 - increased resistance to portal flow

2 - increased portal venous inflow

37
Q

what is meant by a pre hepatic cause of portal hypertension

A

blockage of the portal vein before the liver

38
Q

what causes pre-hepatic hypertension

A

portal vein thrombosis or occlusion secondary to congenital portal venous abnormalities

39
Q

what is meant by intrahepatic hypertension

A

due distortion of the liver architecture, either pre sinusoidal or post sinusoidal

40
Q

what are post sinusoidal causes

A

cirrhosis, alcoholic hepatitis, congenital hepatic fibrosis

41
Q

what are compensated cirrhosis signs

A

spider naevi
planar erythema
clubbing
gynecomastia

42
Q

what are decompensated cirrhosis signs

A

jaundice
ascites
encephalopathy
bruising

43
Q

what are the risks of ascites paracentsis

A

risk of infection
encephalopathy
hypovolemia

44
Q

causes of post hepatic hypertension

A

Budd Chiari

45
Q

what is the treatment pathway for acute vatical bleeding

A

1 - Resuscitate
2 - IV Terlipressin
3 - Endoscopic banding
4 - Ballon tamponade

46
Q

what are solid liver lesions in the elderly likely to be

A

malignant with metastases more common than primary liver cancer in the absence of liver disease

47
Q

what are liver lesions in people with chronic liver disease likely to be

A

primary liver cancer

48
Q

what is the most common solid liver tumour in non cirrhotic patients

A

hemangioma

49
Q

what are the types of primary liver cancer

A

hepatocellular carcinoma
Fibrolamellar carcinoma
Hepatoblastoma

50
Q

what are the types of benign liver cancers

A

Hemangioma
Focal nodular hyperplasia
Adenoma
Liver cysts

51
Q

what is hepatic adenoma

A

Benign neoplasm composed of normal hepatocytes no portal tract, central veins, or bile ducts

52
Q

what is the risk factor of Hepatocellular carcinoma (HCC)

A

liver cirrhosis

53
Q

what are the features of HCC

A

Wt loss
RUQ pain and mass
Acute liver failure

54
Q

where does HCC metastases to

A 
Rest of the liver
Portal vein
Lymph nodes
Lung
Bone
Brain
55
Q

what is a HCC tumour marker

A

Alfa feto protein

AFP

56
Q

what is the best treatment for HCC

A

Liver transplant

57
Q

what are other treatment options for HCC

A

Resection
Local Ablation
Chemoembolisation

58
Q

what carcinoma presents in young people

A

Fibro-Lamellar Carcinoma

GI (12 decks)

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