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Gastroenterology > Liver disease > Flashcards

Liver disease Flashcards

1
Q

Causes of cirrhosis

A

Alcohol, Hepatitis, Non-alcoholic steatosis, PSC, PBC, Autoimmune hepatitis, Wilson’s disease, Haemochromatosis, Alpha-1-antitrypsin deficiency, Amiodarone, Methyldopa, Methotrexate, Blood transfusions

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2
Q

Drugs that can cause cirrhosis

A

Amiodarone, Methyldopa, Methotrexate, Alcohol

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3
Q

Sequelae of cirrhosis

A

Liver failure, Hepatocellular carcinoma, Portal hypertension

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4
Q

Signs of liver disease

A

Spider naevi, Leukonychia, Clubbing, Dupuytren’s contracture

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5
Q

Investigations for cirrhosis

A

Bloods: FBC, LFTs, Clotting, Viral serology, Auto-antibodies

Liver biopsy, USS

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6
Q

Blood findings in cirrhosis

A

FBC: Low PLT, WCC, Ferritin
Clotting: Raised INR
LFTs: Elevated

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7
Q

Management of cirrhosis

A

Conservative: Avoid alcohol and NSAIDs, Lose weight
Medical: Spironolactone
Surgical: Transplantation

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8
Q

Pathology of primary sclerosing cholangitis

A

Fibrosis of the bile duct

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9
Q

Complications of primary sclerosing cholangitis

A

Cirrhosis, Cholangiocarcinoma, Hepatocellular carcinoma

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10
Q

Risk factors for primary sclerosing cholangitis

A

Male, Young, IBD

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11
Q

Symptoms of primary sclerosing cholangitis

A

Asymptomatic, Intermittent jaundice, Puritis, Abdominal pain

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12
Q

Signs of primary sclerosing cholangitis

A

Jaundice, Hepatomegaly

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13
Q

Investigations for primary sclerosing cholangitis

A

Bloods: LFTs, Antibodies

ERCP, Liver biopsy, Colonoscopy

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14
Q

Blood findings with primary sclerosing cholangitis

A

LFTs: Raised ALP, Bilirubin
Antibodies: ANA, SMA, ANCA, Immunoglobulins

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15
Q

Management of primary sclerosing cholangitis

A

Medical: Colestyramine, Ursodeoxycholic acid
Surgical: Endoscopic stenting, Transplant

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16
Q

Risk factors for primary biliary cirrhosis

A

Female, 50yr old

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17
Q

Pathology of primary biliary cirrhosis

A

Granulomatous inflammation of the bile ducts

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18
Q

Symptoms of primary biliary cirrhosis

A

Asymptomatic, Lethargy, Pruritis, Jaundice

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19
Q

Signs of primary biliary cirrhosis

A

Jaundice, Hepatosplenomegaly, Ascites, Xanthelasma, Xanthoma

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20
Q

Sequelae of primary biliary cirrhosis

A

Osteoporosis, Cirrhosis, Decreased vitamin absorption

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21
Q

Investigations for primary biliary cirrhosis

A

Bloods: LFTs, Antibodies

Liver biopsy

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22
Q

Blood findings with primary biliary cirrhosis

A

LFTs: Raised ALP, GGT, AST, ALT, Bilirubin
Antibodies: AMA, IgM

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23
Q

Management for primary biliary cirrhosis

A

Medical: Colestryramine, Ursodeoxycholic acid, Bisphosphinates
Surgical: Transplant

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24
Q

Risk factors for autoimmune hepatitis

A

Female, Under 50yrs

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25
Q

Symptoms of autoimmune hepatitis

A

Asymptomatic, Jaundice, Decreased appetite, Abdominal pain

26
Q

Signs of autoimmune hepatitis

A

Jaundice, Signs of liver disease

27
Q

Investigations for autoimmune hepatits

A

Bloods: LFTs, Antibodies

Liver biopsy

28
Q

Blood findings with autoimmune hepatitis

A

LFTs: Raised AST, ALT, ALP, Bilirubin
Antibodies: ANA, SMA, IgG

29
Q

Management of autoimmune hepatitis

A

Medical: Prednisolone, Azathioprine
Surgical: Transplant

30
Q

Pathology of haemochromatosis

A

Iron overload

31
Q

Symptoms of haemochromatosis

A

Lethargy, Arthalgia, Diabetes, Cardiomyopathy, Hypogonadism, Osteoporosis

32
Q

Signs of haemochromatosis

A

Grey skin, Hepatomegaly

33
Q

Investigations for haemochromatosis

A

Bloods: LFTs, FBC, Glucose

Liver biopsy, Echocardiogram

34
Q

Blood findings with haemochromatosis

A

LFTs: Raised ALT, AST
FBC: Raised iron
Raised glucose

35
Q

Management of haemochromatosis

A

Conservative: Low iron diet
Surgical: Venesection

36
Q

Pathology of Wilson’s disease

A

Copper overload

37
Q

Symptoms of Wilson’s disease

A

Hepatitis, Depression, Hypoparathyroidism, Tremor, Dysphagia, Dysarthria, Dementia, Ataxia

38
Q

Investigations for Wilson’s disease

A

24hr urine copper, Liver biopsy, MRI

39
Q

Management of Wilson’s disease

A

Conservative: Low copper diet
Medical: Penicillamine
Surgical: Transplant

40
Q

Symptoms of Alpha-1-antitrypsin deficiency

A

SoB, Jaundice

41
Q

Investigations for Alpha-1-antitypsin deficiency

A

Bloods: serum alpha-1-antitrypsin

Liver biopsy, Phenotyping

42
Q

Management of Alpha-1-antitrypsin deficiency

A

COPD management, Liver transplant

43
Q

Causes of liver failure

A

Hepatitis, Leptospirosis, Paracetamol, Isoniazaid, PSC, PBC, Haemochromatosis, Wilson’s disease, Cirrhosis, Hepatocellular carcinoma

44
Q

Sequelae of liver failure

A

Bleeding, Hypoglycaemia, Renal failure, Encephalopathy, Cerebral oedema

45
Q

Symptoms of liver failure

A

RUQ pain, Nausea, Vomiting, Encephalopathy, Sequelae

46
Q

Symptoms of hepatic encephalopathy

A

Mood changes, Drowsiness, Confusion, Coma

47
Q

Signs of liver failure

A

Jaundice, Asterixis, Ascites, Signs of liver disease

48
Q

Investigations for liver failure

A

Bloods: FBC, LFTs, Clotting, Glucose, Viral serology, Paracetamol
CXR

49
Q

Blood findings in liver failure

A

FBC: Infection, Low PLT
LFTs: Deranged
Clotting: Raised INR
Glucose: Hypoglycaemia

50
Q

Management of liver failure

A

Conservative: Fluid restriction
Medical: Vitamin K, Dextrose, Mannitol, Regular laxatives

51
Q

Common origins for liver metastases

A

Lung, Breast, Colon, Stomach

52
Q

Risk factors for hepatocellular carcinoma

A

Hepatitis, Cirrhosis, Afalatoxin, Anabolic steroids, Parasites

53
Q

Symptoms of liver tumour

A

RUQ pain, Weight loss, Fever, Jaundice

54
Q

Signs of liver tumour

A

Hepatomegaly, Jaundice, Ascites, Signs of liver disease

55
Q

Investigations for liver tumours

A

Bloods: LFTs, FBC, U+Es, Clotting, Viral serology, Alpha-feta protein
CT CAP, ERCP, Biopsy

56
Q

Blood findings in liver failure

A

LFTs: Raised ALT, AST, Bilirubin, Low albumin
FBC: Low PLTs
Clotting: Raised INR

57
Q

Management of liver failure

A

Medical: Chemo
Surgical: Resection, Tumour embolisation

58
Q

Cause of pre-hepatic jaundice

A

Haemolysis

59
Q

Causes of hepatic jaundice

A

Hepatitis, Liver disease, Gilbert’s syndrome, Paracetamol, Rifampacin, Contrast

60
Q

Causes of post-hepatic jaundice

A

Ascending cholangitis, Pancreatic cancer, Cholangiocarcinoma, PBC, PSC

Gastroenterology (3 decks)

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