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The patient (Y2-2) > Liver disease > Flashcards

Liver disease Flashcards

1
Q

The liver is the only organ to have two blood supplies. True or false?

A

True

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2
Q

The gall bladder is positioned just outside the liver. True or false?

A

False - within the liver

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3
Q

Where does the bile produced by the gall bladder drain into?

A

The GIT

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4
Q

Why may a large rise in enzymes represent minimal damage to the liver?

A

Because there is a large number of hepatic enzymes present in hepatocytes so when there is damage, the enzymes spill out, leading to an increase in the blood

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5
Q

What is bilirubin a breakdown product of?

A

RBC

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6
Q

Bilirubin is conjugated in the liver and excreted where?

A

In the bile

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7
Q

Following recent alcohol consumption, you may expect a rise in which LFT?

A

GGT (gamma-glutamyl-transferase)

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8
Q

Alkaline phosphates are specific to the liver. True or false?

A

False

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9
Q

What does ALT stand for?

A

alanine aminotransferase

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10
Q

What does AST stand for?

A

Aspartate aminotransferase

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11
Q

If there is hepatocellular damage (damage inside the liver), you may expect a rise in which LFTs?

A

ALT
AST
GGT
Total bilirubin (i.e. conjugated and unconjugated)

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12
Q

Acute liver disease is usually self-limiting. True or false?

A

True

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13
Q

If there is cholestatic damage (blockage of the bile duct etc.) which LFTs would you expect an increase in?

A

Alk phos
total cholesterol
conjugated bilirubin
pruritus is common

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14
Q

What is hepatitis?

A

Inflammation of hepatocytes

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15
Q

What is the latent period for a type A reaction?

A

Hours to weeks

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16
Q

What is the latent period for a type B reaction?

A

Weeks to months

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17
Q

Type A reactions are more frequent than type B. True or false?

A

True

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18
Q

Type A reactions are dose dependent and type B are dose independent. True or false?

A

True

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19
Q

Liver disease lasting more than 3 months is classed as chronic. True or false?

A

False - 6/12 months

20
Q

What are the common causes of chronic liver disease?

A

Alcohol

Chronic viral hepatitis (Hepatitis C)

21
Q

What is meant by steatosis?

A

Fatty deposits around the liver

22
Q

What is the difference between cirrhosis and fibrosis?

A

Cirrhosis is the scarring of liver and fibrosis is death of liver cells

23
Q

Why is pruritus more common in cholestasis?

A

Because of presence of bile salts in skin

24
Q

What is the treatment for pruritis, if caused by bile stones?

A

Surgical removal of bile stones

25
Q

What are the two main treatments for pruritis?

A

Anion exchange resins

Antihistamines

26
Q

How do anion exchange resins work?

A

Bind bile acids in the gut and stop them from being absorbed into the blood

27
Q

What is ascites?

A

Collection of fluid in the abdominal cavity

28
Q

Name 3 drugs that treat ascites?

A

Spironolactone
Furosemide
Metolazone

29
Q

Which two analgesics are used in liver disease for ascitic pain?

A

Paracetamol - with caution 2g daily max

Tramadol

30
Q

Which analgesics should be avoided in liver disease?

A

NSAIDs/Antiplatelets - risk of bleeding

Opioids - decrease clearance

31
Q

Name 4 drugs for the treatment of hepatic encephalopathy

A

Lactulose
Neomycin
Metronidazole
Rifaxamin

32
Q

Why is oesphageal varices a medical emergency?

A

Due to large blood loss

33
Q

How does liver disease lead to bleeding varices?

A

Cirrhosis -> portal hypertension -> varices

34
Q

What happens in oesophageal varices?

A

Small blood vessels form along gastric vein and up towards the oesophagus to release pressure in portal system. However, these are very weak and any increase in pressure causes them to rupture and bleed. Blood spills into oesphagus and patient vomits blood

35
Q

What is the aim of treatment for oesphageal varices?

A

Constrict blood flow - stop bleeding and replace lost blood

36
Q

What is chlordiazepoxide used to treat?

A

Alcohol withdrawal

37
Q

What is menandiol used to treat?

A

Vitamin K deficiency

38
Q

How is hep A transmitted?

A

Faecal-oral route

39
Q

How is hep B transmitted?

A

Blood-borne

40
Q

Vaccination for hep A is recommended for healthcare workers. True or false?

A

False - for travellers

41
Q

Vaccination for hep B is recommended to who?

A

Healthcare workers

42
Q

What is hep B treated with?

A

Entercavir or tenofovir (antiviral)

Interferon alpha a (boosts immune function)

43
Q

What is the treatment for hep A?

A

Supportive treatment, no therapy to eradicate

44
Q

How is hep C transmitted?

A

Blood borne

45
Q

Ribavirin is used to treat which hepatitis?

A

C - combined with interferon alpha 2b

46
Q

Hepatitis A causes hep D. True or false?

A

False - hep B is needed to cause hep D

47
Q

Hep E causes chronic liver disease. True or false?

A

False - self limiting infection, doesn’t cause chronic liver disease

The patient (Y2-2) (8 decks)

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