Liver disease investigations (NICE) Flashcards
What blood test looks at advanced fibrosis in NAFLD?
Enhanced liver fibroisis test (ELF)
Who should be offered transient elastography to look for cirrhosis?
People with hepatitis C virus infection
Men who drink over 50 units of alcohol per week and women who drink over 35 units of alcohol per week and have done so for several months
People diagnosed with alcohol-related liver disease
People who have an ELF score indicating advanced fibrosis in NAFLD
Who needs retesting for cirrhosis and how often does this occur?
People diagnosed with alcohol-related liver disease
People with hepatitis C virus infection who have not shown a sustained virological response to antiviral therapy
People with NAFLD and advanced liver fibrosis
Every 2 years
For people who are diagnosed with cirrhosis, what tests need done to look for complications?
Ultrasound +/- AFP testing if don’t have hep B to look for HCC
Endoscopy to look for oesophageal varices
How often are patients with cirrhosis monitored for HCC and varices
Every 6 months of HCC
Every 3 years for varices (if no varices previously detected)
What score is used to determine a patients risk of complications from cirrhosis, and what number indicates high risk?
Model for End‑Stage Liver Disease (MELD) score
12 or above
How often is the MELD score calculated for patients with compensated cirrhosis?
Every 6 months
What is another kind of scan that can diagnose cirrhosis in NAFLD?
Acoustic radiation force impulse imaging
How is cirrhosis investigated in patients unsuitable for fibroscan?
Liver biopsy
Who should not get a fibroscan and what is the exemption for this?
BMI >30 or T2DM
Unless they have NAFLD with advanced liver fibrosis
