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Gastro Medicine > Liver Disease > Flashcards

Liver Disease Flashcards

1
Q

What is the function of the liver?

A

Nutrition

  • stores glucose
  • glycogenolysis
  • absorbs fats, fat soluble vitamins and iron
  • manufactures cholesterol

Produces bile salts

Produces clotting factors

Drug excretion

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2
Q

What are important history points in patients with liver disease?

A 
Blood transfusions prior to 1990
IV drug use
Sexual exposure
Medications 
FH 
Obesity 
Alcohol 
Foreign travel
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3
Q

What is acute liver injury?

A

Liver disease occurring in previously healthy liver

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4
Q

What can cause acute liver injury?

A 
Hep A
Hep E
CMV
EBV
Drug induced liver injury
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5
Q

What is chronic liver disease?

A

On-going liver disease for more than 6 months

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6
Q

What can cause chronic liver disease?

A

Alcohol
Hep C
Non-alchoholic steatohepatitis
Autoimmune

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7
Q

What are the symptoms of liver disease?

A 
Jaundice
Hepatic encephalopathy 
Malaise
Spider-naevi
Ascites
Fetor hepaticus
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8
Q

What is the normal number of spider naevi?

A

3 in men

5 in women

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9
Q

What is hepatic encephalopathy?

A

Swelling in the brain due to liver failure

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10
Q

How does hepatic encephalopathy occur?

A

Nitrogenous waste builds up in blood and crosses BBB

Astrocytes clear it - process involves conversion of glutamate to glutamine

Glutamine causes an osmotic imbalance and fluid moves into cells

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11
Q

What is the grading system for hepatic encephalopathy?

A

Grade 1 = altered mood, sleep disturbance

Grade 2 = increasing drowsiness, confusion, slurred speech

Grade 3 = drowsy stupor, incoherence

Grade 4 = coma

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12
Q

What is fetor hepaticus?

A

Pear drops smelling breath

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13
Q

How is liver disease investigated?

A

Bloods

  • FBC
  • U+Es
  • LFTs
  • Coag
  • hepatitis serology

Blood cultures

USS

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14
Q

What will the bloods show in liver disease?

A

Thrombocytopenia

Deranged LFTs

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15
Q

What do the LFTs show in hepatocyte damage?

A

Raised ALT

Raised AST

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16
Q

What do the LFTs show in ductal damage?

A

Raised conjugated bilirubin
Raised ALP
Raised GGT

17
Q

How do you differentiate between viral and alcoholic hepatitis?

A

Viral = ALT>AST

Alcoholic = AST>ALT

18
Q

How is liver disease managed?

A

Treat underlying cause

Drain ascites

19
Q

What is NASH?

A

Non-alcoholic steatosis

Liver inflammation caused by build up of fat

20
Q

What is decompensated liver disease?

A

Acute deterioration in liver function in a patient with cirrhosis

21
Q

What are the signs of decompensated liver disease?

A 
Jaundice 
Increasing ascites
Hepatic encephalopathy 
Renal impairment 
GI bleeding 
Signs of sepsis
22
Q

What can cause decompensated liver disease?

A 
GI bleeding 
Infection 
Alcoholic hepatitis 
Acute portal vein thrombosis 
Hepatocellular carcinoma 
Dehydration 
Constipation

Gastro Medicine (20 decks)

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