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My1 GI > liver disease > Flashcards

liver disease Flashcards

1
Q

what is the livers biggest blood supply

A

portal vein ( and portal hepatic artery)

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2
Q

what are the main LFT’s

A

ALP, AST, ALT, gGT, PT, bilirubin, albumin

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3
Q

what are true liver indicators

A

PT, bilirubin and albumin

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4
Q

what is acute liver disease

A

any injuring to a previously healthy liver lasting less than 6 months that causes encephalopathy and prolonged coagulation

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5
Q

name some symptoms of acute liver disease

A

jaundiced, drowsiness –> confusion, pain/ tenderness, nausea itch ABNORMAL LFT’s

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6
Q

What are some causes of acute liver disease

A

viruses eg Hep, HIV, alcohol, drugs eg paracetamol, cholangitis, malignancy

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7
Q

what is Budd chari syndrome

A

clotting in hepatic vein in women on the pill

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8
Q

what are some investigations for acute liver failure

A

LFT’s, USS, virology, rarely biopsy

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9
Q

what is the treatment for acute liver failure

A

rest, fluids (no alcohol), increase calories

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10
Q

what can be done for the itch associated with liver disease

A

sodium bicarbonate bath, Cholestryamine and

Uresodeoxycholic acid

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11
Q

what is filament liver failure

A

hypoglycaemia as liver can’t break down glucose or build new ones

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12
Q

what is chronic liver disease

A

lasts for more than 6 months

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13
Q

what are some common causes of chronic liver disease

A

Alcohol-related liver disease, NAFLD, Hep C, primary biliary cholangitis (PBC), automimmune hep

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14
Q

what is jaundice

A

yellowing of the skin from bilirubin

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15
Q

what are some unncommon causes of chronic liver disease

A

heamochromatitis, wilson’s, antitrpsin deficiency, PSC, budd chairi

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16
Q

what is prehepatic jaundice

A

anything that causes increased heamolysis

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17
Q

what is hepatic jaundice

A

inability to break down bilirubin

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18
Q

what is posthepatic jaundice

A

impaired drainage of bile into large bowel

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19
Q

what are the guidelines on alcohol consumption

A

no more than 14 units of alcohol per week

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20
Q

what is the mechanism of alcoholic liver disease

A

increased release of fatty acids and triglycerides, cells become swollen with alcohol (steotosishepatitis), this leads to collagen deposits and eventually cirrhosis

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21
Q

what cells are involved in cirrhosis

A

hepatic stellate cells (HSC’s)

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22
Q

what is the mechanism of NAFLD and NASH

A

1) increased fatty acids and trigylcerides (steatosis) 2) non-alcoholic steatohepatitis (NASH) 3) fibrosis 4) cirrhosis

23
Q

what is the biggest cause of NAFLD

A

obesity, most common disease in the world

24
Q

how do you diagnose NAFLD and NASH

A

ulstrasound

25
Q

how do you diagnose NASH

A

liver biopsy

26
Q

how do you treat alcoholic liver disease

A

stop alcohol and give diazepam

27
Q

what does NASH and alcoholic liver disease lead to

A

fibrosis and cirrhosis

28
Q

what is cirrhosis

A

end-stage of liver disease irreversible band of fibrosis

29
Q

describe macrondular or microndular

A

microndular is alcoholic

30
Q

describe compensated and uncompensated

A

uncompensated liver cannot function, compensated it can

31
Q

what can cause cirrhosis

A

alcohol, NAFLD, hep B/C, storage disease, primary biliary cirrhosis (PBC)

32
Q

what are symptoms of cirrhosis

A

spider navi, palmar erythema, clubbing, hepatomegaly –> jaundice, ascites, encephalopathy, bruising

33
Q

what are some complications of cirrhosis

A

portal hypertension (caput medusae) –> oesophageal varices, haemorrhoids, ascites, enteropathy, encephalopathy

34
Q

how do you treat ascites

A

no NSAIDs, reduce salt, spironolactone, paracentesis, TIPSS

35
Q

how does encephalopathy arise in liver disease

A

excess ammonia not broken down in liver and travels in normal circulation

36
Q

what are 3 autoimmune liver disease that can cause cirrhosis

A

autoimmune hepatitis, primary biliary cirrhosis, primary sclerosing cholangitis

37
Q

who is more likely to get autoimmune hepatitis and what is it

A

women, a chronic hepatic pattern

38
Q

what are the symptoms of autoimmune hepatitis

A

hepatomegaly, jaundice, splenomegaly, elevated AST, ALT, PT

39
Q

what abnormal histology would be seen with autoimmune hepatitis

A

piecemeal necrosis, interface hepatitis

40
Q

what steroids would you use to treat autoimmune hepatitis

A

azathioprine, prednisolone

41
Q

what is primary biliary cirrhosis

A

damage of hepatic biliary ducts causing a build up of bile leading to cirrhosis

42
Q

who mainly gets PBC and what are the symptoms

A

females, fatigue, itch without rash, xanthelasma, elavated LFTs (ALP)

43
Q

how do you diagnose PBC

A

+ive AMA, LFT’s, liver biopsy (2/3)

44
Q

how do you treat the itch of PBC

A

urseodeoxycholic acid

45
Q

what is primary sclerosing cholangitis and who normally gets it

A

chronic inflammation of bile ducts, more commonly affects males and people with UC

46
Q

what are some symptoms of primary sclerosing cholangitis

A

periductal fibrosis, duct destruction, jaundice, fibrosis

47
Q

what are some autosomal recessive disorders that cause storage diseases

A

haemochromatosis, Wilson’s disease, Alpha 1-antitrypsin deficiency

48
Q

what us haemochromatosis

A

excess iron, can cause cirrhosis and carcinomas diabetes

49
Q

what is Wilson’s disease

A

autosomal recessive disorder, copper in brain and liver

50
Q

which is more common in liver cancer primary or mets

A

mets

51
Q

name some common benign liver tumours

A

hepatocellular adenoma, liver cysts, focal nodular hyperplasia

52
Q

name the most common liver tumour

A

Hepatocellular carcinoma (HHC)/ hepatoma, AFP marker

53
Q

what vitamin to you give to alcoholics with liver disease

A

Vit B - thiamine

My1 GI (26 decks)

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