Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Gastrointestinal System > Liver Disease/Disorders > Flashcards

Liver Disease/Disorders Flashcards

1
Q

define spontaneous bacterial peritonitis (SBP)

A

a bacterial infection of ascitic fluid that cannot be attributed to any intra-abdominal, ongoing inflammatory or surgical correctable condition

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

what are the values that define SBP

A

an ascitic fluid absolute neutrophil count >250 cells/mm3 regardless of culture growth

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

what organisms are involved in SBP

A

e.coli, streptococci and enterococci

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

risk factors of SBP

A

decompensated hepatic state (e.g. cirrhosis)
low ascitic protein
GI bleed
endoscopic sclerotherapy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

clinical features of SBP

A 
abdominal pain/tenderness
signs of ascites 
fever
vomiting 
tachycardia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

investigations for SBP

A

ascitic fluid tap and absolute neutrophil count (ANC)

leukocyte esterase reagent strip test

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

management of SBP

A 
IV cefotaxime 
prophylactic antibiotics (if high risk with low albumin)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

requirements of providing prophylactic antibiotics to those with SBP

A 
previous episode of SBP
fluid protein <15g/L
high risk 
low albumin
child-pugh score = 9
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

define non-alcoholic fatty liver disease (NAFLD)

A

excessive accumulation of fat within the liver, causing hepatocytes to contain >5% of triglycerides

not associated with excessive alcohol consumption or other secondary causes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

how is NAFLD best described?

A

as a spectrum of liver disease that increases in severity:

  • hepatic steatosis
  • non-alcoholic steatohepatits (NASH)
  • fibrosis to cirrhosis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

causes of NAFLD

A

not fully understood but linked to insulin resistance, obesity and metabolic syndromes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

risk factors of NAFLD

A 
obesity 
type II diabetes 
hyperlipidaemia 
hypetension 
smoking 
poor lifestyle
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

clinical features of NAFLD

A

often asymptomatic or non-specific symptoms such as:

fatigue and malaise
dull RUQ pain
hepatomegaly

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

first line investigation of NAFLD

A

enhanced liver fibrosis (ELF) test

- assess fibrosis measuring HA, PIIINP and TIMP-1

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

define the results of an ELF investigation for NAFLD

A

< 7.7 = none/mild fibrosis
>7.7-9.8 = moderate fibrosis
>9.8 = severe fibrosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

blood tests for NAFLD

A 
LFTs - ⬆️ bilirubin, high AST:ALT
FBC - ⬇️ low platelets and issues with clotting 
hep B + C viral serology
autoimmune antibodies 
fasting glucose and lipids
17
Q

imaging investigations for NAFLD

A

US of liver
CT scan
liver biopsy

18
Q

management of NAFLD

A

advise that no drug treatment available and condition progression managed via lifestyle alterations
ensure associated conditions are optimally managed
offer advice on lifestyle changes (e.g. weight loss, smoking, healthy diet, regular exercise and avoiding alcohol)

19
Q

when should those with NAFLD be referred to a specialist?

A

when there is indication of fibrotic progression

20
Q

common complications of NAFLD

A

portal hypertension
liver cirrhosis and failure
variceal haemorrhage
hepatocellular carcinoma

21
Q

define cirrhosis

A

a chronic and progression inflammation and damage of the liver over a number of years

22
Q

define the two types of cirrhosis

A

compensated - liver can still function effectively with minimal symptoms
decompensated - liver damaged to point where it cannot function adequately

23
Q

risk factors of cirrhosis

A

chronic alcohol misuse
hepatitis B + C infection
obesity

24
Q

clinical features of cirrhosis

A 
hepato + splenomegaly
spider naevi 
palmar erythema 
leukonychia 
jaundice 
fatigue
ascites 
weight loss and muscle wasting
25
Q

blood tests if suspect cirrhosis

A

LFTs, albumin, FBC, RFTs, U+E, folate, ferritin coagulation and hepatitis serology screen

26
Q

investigations for cirrhosis

A 
US of liver 
CT/MRI
CXR - elevated diaphragm
liver biopsy 
ascitic tap
27
Q

common results of bloods in cirrhosis

A

⬆️ AST, ALT, ALP, GGT and albumin

⬇️ WCC and platelet

28
Q

general management of cirrhosis

A 
regular 6mnth US and alpha-fetoprotein check for malignancy development 
adequate management of nutrition
advice on support for alcohol misuse 
treat with zinc supplements 
recommend regular exercise 
referral for liver transplant
29
Q

management of cirrhosis with varices

A

3mnth endoscopy
prescribe propanolol
perform elastic band ligation if necessary

30
Q

common complications in cirrhosis

A

hepatocellular carcinoma
pericarditis
ascites
haemorrhage

31
Q

define hepatocellular carcinoma

A

a primary tumour of the liver

32
Q

risk factors of hepatocellular carcinoma

A 
chronic viral hepatitis 
cirrhosis 
NAFLD 
alcohol misuse 
obesity 
Type II diabetes
33
Q

investigations in hepatocellular carcinoma

A 
bloods (FBC, U+E, CRP and LFTs)
liver screening 
AFP (alpha-fetoprotein)
abdominal US 
CT chest, abdomen + pelvis
34
Q

management of hepatocellular carcinoma

A

hepatic resection
radiofrequency ablation
liver transplantation

35
Q

what tumour marker is used to monitor for HCC and germ-cell tumours

A

alpha-fetoprotein (AFP)

Gastrointestinal System (9 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions