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Year 1 MBChB Gastrointestinal > Liver Disease > Flashcards

Liver Disease Flashcards

1
Q

Acute liver disease time frame and with/without previous liver disease?

A

< 6 months

No previous liver disease

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2
Q

What do raised ALT and AST levels indicate + which one is specific to the liver?

A

Inflammation and injury

ALT is liver specific

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3
Q

What do ALP and GGT levels indicate?

A

Cholestasis

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4
Q

What is raised GGT traditionally associated with?

A

Excess alcohol intake

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5
Q

What is PT time and is it increased or decreased in liver failure?

A

Time it takes blood to clot

Increased

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6
Q

Which drug infamously causes acute liver disease?

A

Paracetamol

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7
Q

3 investigations for acute liver disease?

A

LFTs
Ultrasound
Virology

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8
Q

2 non-pharmacological treatments for acute liver disease?

A

Fluids

Increase calories

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9
Q

2 drugs that can be used for the itch of acute liver failure?

A

Sodium bicarbonate

Uresodeoxycholic acid

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10
Q

Fulminant liver disease (type of acute) is characterised by what 2 things?

A

Encelopathy

Jaundice

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11
Q

3 treatments for fulminant liver failure?

A

Fluids
Inotropes
Transplant

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12
Q

What is cirrhosis and what type of cells does it affect?

A

Endstage of liver disease with irreversible fibrosis

Hepatic stellate cells

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13
Q

Time frame for chronic liver disease and score used for severity?

A

> 6 months

Child-Turcotte-Pugh

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14
Q

What is NAFLD caused, is it related to alcohol and percent of the population who have it?

A

Fat deposition
No
30%

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15
Q

What are the 4 stages of NAFLD?

A
  1. Steatosis
  2. Non-alcoholic steatohepatitis (NASH)
  3. Fibrosis
  4. Cirrhosis
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16
Q

What is the most common cause of NAFLD?

A

Obesity

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17
Q

How is simple steatosis/NAFLD diagnosed and treated?

A

Ultrasound

Diet and exercise

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18
Q

What is NASH and how is it diagnosed?

A

Inflammation in response to NAFLD

Liver biopsy

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19
Q

What is primary billiary cholangitis (PBC), key WBC and key antibody?

A

Autoimmune destruction of bile ducts
CD4+ T cell
AMA

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20
Q

Classic acute PBC presentation?

A

Middle-aged woman
Fatigue
Itch

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21
Q

Algorithm for PBC diagnosed?

A

2 out of:
+ve AMA
Cholestatic LFTs
Liver biopsy

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22
Q

What is the main treatment for primary biliary cirrhosis?

A

Urseodeoxycholic acid

23
Q

Does autoimmune hepatitis affect women or men more and what LFTs are raised?

A

Women

AST and ALT

24
Q

Key antibodies for type 1 (adult) autoimmune hepatitis and type 2 (child)?

A

Type 1 = ASMA!! and IgG

Type 2 = LKM-1

25
Q

State 2 classic histological signs of autoimmune hepatitis?

A

Piecemeal necrosis

Interface hepatitis

26
Q

State the 2 steroids used to treat autoimmune hepatitis?

A

Azathioprine

Predisolone

27
Q

What is primary sclerosing cholangitis (PSC) and what is the key antibody and histological finding?

A

Autoimmune destruction of the bile ducts
ANCA (cANCA and pANCA)
Onion skinning fibrosis

28
Q

Is PSC more common in males or female and what disease is it associated with?

A

Males

Ulcerative colitis

29
Q

How is primary sclerosing cholangitis diagnosed and what 2 cancer is it monitored for?

A

ERCP

Cholangiocarcinoma and colorectal cancer

30
Q

What is haemochromatosis, effect on males and nickname?

A

Recessive HFE mutation cashing iron overload
No erections
Bronzed diabetic/pigmentation

31
Q

Test and treatment for haemochromatosis?

A

Perl’s stain

Venesection (blood letting)

32
Q

How is ascites diagnosed, 1st line drug, 2 invasive options and key complication?

A

US
Spironolactone
Paracentesis and TIPS
Spontaneous bacterial peritonitis (SBP)

33
Q

What is SBP bloods characterised by and how to treat?

A

Neutrophils > 250

Abx and albumin

34
Q

What is the most common liver tumour?

A

Hemangiomas

35
Q

What is the classic appearance of focal nodular hyperplasia and is it more common in males or females?

A

Central scar
Dilated vessels
Females

36
Q

How to treat a hepatic adenoma + where it usually grows?

A

Stop contraceptive hormone

Right lobe of the liver

37
Q

How are hydatid cysts most commonly developed?

A

Sheep parasites (echinococcus)

38
Q

Hepatocellular carcinoma key protein marker and the 2 Heps it it associated with?

A

Alfa feto protein (AFP)

Hep B and C

39
Q

Mallory hyaline antibodies are seen in?

A

Alcoholic liver disease

40
Q

Cause of Wilson’s disease, loss of what protein, key sign and how to treat?

A

Excess copper
Caeruloplasmin
Kayser-Fleisher corneal ring
Copper chelation drugs

41
Q

What is budd-chiari, deficiency and classic presentation?

A

Thrombosis of hepatic veins
Protein C or protein S
Young women on contraceptive pill

42
Q

Does Budd-chiari present acute or chronic, key test and 2 options for treatment?

A

Acute
US
Recanalization or TIPS

43
Q

What causes hepatic encelopathy + laxative used to treat?

A

Liver unable to metabolise ammonia so it build up in the blood
Lactulose

44
Q

How does TIPS work?

A

Stent between portal vein and hepatic vein allows blood to bypass liver

45
Q

AST/ALT more raised than ALP?

A

Hepatitis

46
Q

ALP more elevated than AST/ALT?

A

Obstruction

47
Q

CT showing stellate scar and radial septa?

A

Fibro-lamellar carcinoma

48
Q

What is a-beta-lipoproteinaemia?

A

Inability to synthesise chylomicrons

49
Q

Cells that line the bile ducts?

A

Cholangiocytes

50
Q

Liver fibroblasts that form connective tissue?

A

Stellate cells

51
Q

Liver macrophages?

A

Kupffer cells

52
Q

Bile is formed in the hepatocytes then flows to gall bladder via?

A

Bile canaliculi

53
Q

Name for the space between sinusoids and hepatocytes?

A

Space of Disse

54
Q

Name 5 things the liver stores?

A 
Fat-soluble vitamins (ADEK)
Vitamin B12
Iron
Copper
Glycogen

Year 1 MBChB Gastrointestinal (15 decks)

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