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MET 2 > Liver Disease > Flashcards

Liver Disease Flashcards

1
Q

What kind of virus is Hep B

A

Double stranded DNA virus

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2
Q

What is the most common cause of hepatitis

A

Hep B virus

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3
Q

What is HbeAg

A

Antigen secreted by cells infected by hepatitis B (marker for acute infection)

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4
Q

What 3 antigens are involved in hepatitis b virus

A
  • HbsAg= surface antigen
  • HBcAg= core antigen
  • HbeAg= antigen secreted by infected cells
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5
Q

How can hep B be transmitted

A

Horizontal: sexual intercourse, blood, bites from infected people

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6
Q

Describe the clinical presentation of chronic hepatitis

A
  • Acutely presents as flu, anorexia, nausea, fever, malaise, jaundice, ascites
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7
Q

When does hepatitis B become chronic

A

> 6 months

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8
Q

What may chronic hepatitis B progress to

A

Liver fibrosis, cirrhosis, hepatocellular carcinoma

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9
Q

How may you investigate hep B

A

Hep B specific
General liver function tests
Other tests

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10
Q

What do transaminases tell us

A

High= acute hepatitis

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11
Q

What are ALT and AST markers for

A

Biomarkers for liver injury

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12
Q

What are ALP markers for

A

biliary tree pathology

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13
Q

What is HBsAg

A

Hep B surface antigen

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14
Q

What is the first marker to appear in Hep B and what does it imply

A

HBsAg
Implies acute disease (present for 1-6 months)
Implies patient in infective

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15
Q

What do anti-HBs imply

A

Immunity

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16
Q

What is HbeAg

A

Hep B ‘e antigen
Presents 1.5-3 months
Measures infectivity

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17
Q

What is Anti-HbC

A

Implies previous infectious

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18
Q

What are the 2 types of anti-HBc antibodies

A

IgM anti-HBs appear during acute/ recent hep B

IgG anti-HBcs persist for life

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19
Q

What should be avoided in hep B

A

Unprotected sex

Alcohol

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20
Q

How should chronic Hep B infections be treated

A

Treatment is lifelong

Antivirals

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21
Q

Define cirrhosis

A

Irreversible liver damage- the end stage of chronic liver disease

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22
Q

What is the most common cause of cirrhosis in the developed world, and worldwife

A

Developed world= alcohol

Worldwide= HBV

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23
Q

What genetic disorders can lead to cirrhosis

A

Haemochromatosis

Wilsons disease

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24
Q

What drugs can cause cirrhosis

A

Amidarone
Methyldopa
Methotrexate

25
How does cirrhosis come about
Liver cell necrosis leads to fibrosis and regeneration nodule formation
26
What cells are activated due to liver injury and what does this cause
Stellate cell activation | Leads to production of fibrogenic mediators leading to increased collagen and fibrosis
27
What are macronodules and when are they formed
Nodules are large and variable in size | Caused by chronic viral hepatitis
28
What are micronodules and why do they form
Nodules <3mm | Chronic alcohol use
29
What is the difference between compensated and decompensated liver cirrhosis
``` Compensated= liver can still undergo its function Decompensated= liver can't still do function and do normal jobs ```
30
What are the consequences of portal hypertension
Ascites | Congestive splenomegaly and oesophageal varices
31
What are the consequences of hepatic failure
Coagulopathy | Hepatic encepaholopathy
32
Describe the potential clinical presentation of somebody with liver cirrhossi
``` Ascites Splenomegaly Caput medusae Peripheral oedema Hair loss Testicular atrophy ```
33
What would liver function tests of somebody with liver cirrhosis show
Decreased albumin | Prolonged prothrombin time
34
What would the liver biochem tests of somebody with cirrhosis show
Increased bilirubin | Sometimes normal, sometimes increased AST, ALT, ALP, yGT
35
What would a full blood count of somebody with liver cirrhosis show
Decreased white cell count, decreased platelets, anaemia
36
What would an ultrasound of liver cirrhosis show
Hepatomegaly Splenomegaly Reversed flow in portal vein Ascites
37
What are the acute symptoms of hepatitis C
``` Reduced appetite Fatigue Nausea Muscle/ joint pain Weight loss ```
38
What are the chronic symptoms of hepatitis C
``` Weight loss Reduced appetite Fatigue Bleeding Bruising Dark coloured urine Itchy skin Confusion, drowsiness ```
39
What causes hep C
Hep C virus | Spreads when blood infected
40
3 complications of hep C
Cirrhosis Liver failure Liver cancer
41
5 indications for liver transplantation
``` Alcoholic liver disease Hep C/ B Primary biliary cholangitis AI hep Paracetamol overdose ```
42
4 complications of liver transplant
Organ rejection Primary non-function Infections Hepatic artery/ portal vein thrombosis
43
Name 3 biochemical consequences of drinking too much alcohol
- Increase in FA synthesis - Decrease in FA oxidation - Production of reactive oxidative species
44
What is hepatic steatosis
- Increased levels of NADH when drinking leads to increase in fatty acid production - Build up of fat on the liver - This is reversible and asymptomatic
45
What is alcoholic hepatitis
- Reactive oxygen species and cytokines are generated as a result of alcohol consumption - Inflammation leads to damage of hepatocytes - Mallory bodies form
46
What is cirrhosis
- Damaged hepatocytes are replaced by scar tissue forming regenerative nodules - Micronodular
47
How is alcoholic hepatitis treatment
Complete abstience from drinking- life long Vit K/ thiamine supplement Steroids if in severe distress
48
What are cholesterol gallstones
Over saturation of cholesterol in bile | Large stones
49
What are pigment gallstones
Over-saturation of bilirubin with calcium Small anf friable gallstones Due to haemolysis and cirrhosis
50
What mixed gallstones
Combo of pigment and cholesterol gallstones
51
Name 4 complications of gallstones
- Biliary colic - Acute cholecystis - Ascending cholangitis - Acute pancreatitis
52
What is biliary colic
Pain associated with temporary obstruction of CD/ CBD Severe constant pain with crescendo pattern Resolves after 90 minutes
53
What is acute cholecystis
Acute inflammation of gallbladder wall with peritoneal irritation Well localised RUG/ epigastric pain Fever Guarding
54
What is murphys sign
Sharp pain on inspiration with pressure on gallbladder
55
What is ascending cholangitis
Infection of common bile duct | Can result if gallstone passes on its own
56
What is Charcots triad and what is it characteristic of
Severe RUG/ epigastric pain Fever Jaundice Ascending cholangitis
57
What is acute pancreatitis
Intracellular activation of pancreatic enzymes and autodigestion Epigastric pain which radiates to the back
58
What biochemical changes will be present in acute pancreatitis
Increased serum lipase and amylase

MET 2 (32 decks)

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