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gastrointestinal > liver disease causes > Flashcards

liver disease causes Flashcards

1
Q

the 12 functions of the liver

A
  1. remove toxins
  2. drug detox CYP450
  3. breakdown blood cells into bilirubin
  4. processes of nutrients from food
  5. produces bile
  6. stores sugar
  7. production of cholesterol
  8. processing and storage of vitamins
  9. maintaining nutrients in blood
  10. protein synthesis of albumin
  11. manufacture hormones
  12. clotting factors
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2
Q

which clotting factors does the liver make

A

all except 8

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3
Q

which vitamins does the liver store

A

b12, d, iron and cooper

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4
Q

risk factors for liver disease

A 
-alcohol
obesity
-viral hepatitis
-paracetamol overdose
-psc
-pbc
-autoimmune hepatitis
-haemochromatosis
-alpha 1 antitrypsin deficiency
-Budd chiari
-wilsons
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5
Q

how many alcoholics get liver disease

A

1 in 5

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6
Q

3 major pathways of alcohol metabolism

A
  • catalase (need h20)
  • alcohol and acetaldehyde dehydrogenase-> NADH
  • CYP450
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7
Q

non hepatic presentations of alcohol abuse

A 
intoxification/withdrawal
injury eg burns,#
epileptic fits
neuropathy
haematemesis
hypertension
cardiomyopathy
pancreatitis
infections eg TB
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8
Q

4 major alcoholic liver disease presentations

A 
alcoholic steatosis
alcoholic hepatitis
cirrhosis
alcoholic
cholestasis
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9
Q

what is alcoholic steatosis

A

inflammation of the liver with fat cells

  • often symptomless
  • tender hepatomegaly
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10
Q

lfts of alcoholic steatosis

A

ggtp and mcv increased

mild increase ALT and ALP

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11
Q

prognosis of alcoholic steatosis

A

increased risk of cirrhosis over 10 yrs

2x mortality rate versus normal population

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12
Q

alcoholic hepatitis symptoms

A 
anorexia
vomiting
RUQ pain
jaundice
tender hepatomegaly
bruising
malnutrition
encephalopathy
ascites
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13
Q

treatment of alcoholic hepatitis 4

A

nutritional support
alcohol withdrawal
steroids
pentoxifylline: tnf alpha blocker

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14
Q

what is alcoholic cholestasis

A

decrease bile flow due to obstruction

  • rare
  • assoc. to hepatitis stage
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15
Q

alcoholic cirrhosis transplantation abstinence period length

A

6 months

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16
Q

genetic link for ALD and NALFD

A

PNPLA3

17
Q

Transplant contraindications

A 
alcohol abuse
IV drug abuse
extra hepatic malignancy
advanced cardiopulmonary disease
alcoholic hepatitis
18
Q

prophylaxis for ascetic infections

A

cotrimoxazole

19
Q

the NAFLD pathway and with years

A

normal
steatosis 8-13 years
steatohepatitis 8-13 years
fibrosis and cirrhosis 10 years

20
Q

metabolic syndrome boundaries 5

A 
waist >102 cm or 88cm m:f
fasting glucose>6.1
BP >130 or 85 diastolic
fasting trig >1.71
HDL cholesterol <1 or 1.3 men and women
21
Q

risks of obesity

A 
osteoarthritis
pulmonary disease
stroke
cancer
gout
endocrine
heart
liver
22
Q

NAFLD lab findings 4

A
  • mild elevation of ALT most common
  • GGT, alk PHOS in 1/3
  • ferritin in1/2
  • transferrin increased
23
Q

patients at risk to develop NASH with fibrosis 3

A

> 45 years
BMI >31
dm

24
Q

treatment NAFLD 5

A

-lifestyle
-weight loss meds
exenatide
-phenoxyfyline TNF-A
-thiazolidenoides on adiponectin
-metformin on trig

25
Q

what drug should be stopped on NAFLD

A

amiodarone as can cause fatty liver

26
Q

autoimmune hepatitis

  • who gets
  • symptoms
  • lfts
  • specific labs
  • treatment
A
  • females
  • pain fatigue and jaundice
  • hepatic LFTs eg AST/ALT
  • elevated IgG
  • positive ASMA,ANF,ANA
  • steroids and then azathioprine
27
Q

haemochromatosis

  • blood results
  • gene
  • treatment
A
  • high in iron, ferritin, and transferrin
  • HFE gene
  • treat: venesection and give blood
28
Q

4 main features of haemochromatosis

A

increased pigmentation
cardiomyopathy
cirrhosis
diabetes

29
Q

what is alpha 1 antitrypsin deficiency and which gene

A

alpha 1
produces abnormal alpha 1 in liver which accumulate and stuck in liver

-piZZ positive
no treatment
SERPINA1 gene

30
Q

budd chiari syndrome what is it

  • what it causes
  • which mutation commonly
  • treatment
A

-thrombosis of hepatic veins
-acute liver failure
-ascites and exudates
-JAK2 mutation
treat
-anticoagulation
-TIPSS
-shunting

31
Q

Wilson disease

  • what is it
  • what is low
  • which gene and ad or ar

-treatment

A

high copper

  • due to low caeruloplasmin which carries cooper
  • ATP7B gene c13
  • autosomal recesive

treat
-penicillamine

32
Q

4 main features of wilsons disease

A
  • kayserfleischer rings
  • cardiomyopathy
  • neuropsychiatic disorders
  • liver disease

gastrointestinal (26 decks)

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