Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Clinical GI Review > Liver Diseases > Flashcards

Liver Diseases Flashcards

1
Q

What is the primary objective in understanding the pathogenesis of alcoholic liver disease?

A

To utilize knowledge of cause to screen for patients at risk

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

What is the role of alcohol dehydrogenase in alcohol metabolism?

A

Linked to blood alcohol levels but NOT susceptibility to liver disease

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

What is the effect of genetic variability in acetaldehyde dehydrogenase?

A

Results in flushing reaction in populations linked to increased acetaldehyde build up

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

What is considered a direct hepatotoxin?

A

Alcohol

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

What initial condition results from alcohol ingestion?

A

Fatty liver

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Is alcoholic hepatitis reversible with cessation of alcohol intake?

A

Potentially reversible in ~50% of cases

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

What are the clinical findings of alcoholic hepatitis?

A

Ballooning degeneration, spotty necrosis, PMN infiltrate with fibrosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What is the 5-year survival rate for progressive alcoholic liver disease?

A

23%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is the risk factor quantity for men that produces fatty liver?

A

40–80 g/d of ethanol

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

What is the increased susceptibility for women regarding alcohol consumption?

A

Amounts >20 g/d

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is the role of Hepatitis C in alcoholic liver disease?

A

Associated with younger age for severity, more advanced histology, and decreased survival

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

What is the significance of patatin-like phospholipase domain-containing protein 3 (PNPLA3)?

A

Linked to fatty liver

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What is a standard drink defined as?

A

14 gm alcohol (or 0.6 fluid ounces)

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

What screening tool is used to determine alcohol use?

A

CAGE and AUDIT

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

What are common symptoms of alcoholic liver disease?

A

Nausea, RUQ discomfort, reported fever

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

What are some signs of alcoholic liver disease?

A

Hepatomegaly, fever, spider nevi, jaundice, portal hypertension/ascites

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What laboratory test findings are common in alcoholic liver disease?

A

AST increased two- to sevenfold, ALT increased two- to sevenfold, AST/ALT usually >1 (or 2)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What is the significance of alcohol abstinence in treatment?

A

Possibility for reversal of disease in 50% of cases

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What nutritional corrections should be made in patients with alcoholic liver disease?

A

Correct protein malnutrition, replace vitamins/minerals (A, D, thiamine, folate, zinc)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What is the first-line treatment for alcohol withdrawal?

A

Benzodiazepines

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What is the 5-year survival rate following liver transplant for alcohol-related disease?

A

66-72%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What is the global burden of alcoholic liver disease related to?

A

2.5-3.3 million deaths (5.9%) annually

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What countries are seeing an increase in cirrhosis related to alcohol consumption?

A

UK, Russia, Romania, Hungary

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What is the increase in deaths due to alcoholic liver disease in the USA from 2014 to 2017?

A

From 19,388 to 22,246

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
True or False: Alcoholic liver disease is a preventable cause of morbidity/mortality.
True
26
What is hepatitis?
Inflammation of the liver resulting from infection or other causes.
27
Define cirrhosis.
Progressive liver disease with nodular regeneration, fibrosis, interference in function, and ultimately ending in liver failure.
28
What characterizes acute liver failure?
Acute liver injury with hepatic encephalopathy and elevated PT/INR.
29
How is chronic liver failure defined?
Liver failure typically greater than 26 weeks.
30
What is portal hypertension?
Increased resistance to portal blood flow due to obstruction (prehepatic, intrahepatic, or posthepatic).
31
Define ascites.
An accumulation of serous fluid in the peritoneal cavity.
32
What is hepatic encephalopathy?
Neurologic changes ranging from changes in behavior to coma, secondary to elevated ammonia.
33
What does asterixis refer to?
Nonrhythmic, rapid extension-flexion movements of head and extremities.
34
What is steatosis?
Accumulation of fat in the liver.
35
Define steatohepatitis.
Accumulation of fat in the liver with associated inflammation.
36
What does NAFLD stand for?
Non-alcoholic fatty liver disease.
37
What does NASH stand for?
Non-alcoholic steatohepatitis.
38
List the possible causes of acute liver failure.
* Acetaminophen * Hepatitis A * Hepatitis B * Hepatitis C * Drugs/toxins * Hepatitis D * Hepatitis E
39
What are the symptoms of acute hepatic failure?
* Jaundice * Hepatic encephalopathy * Coagulopathy
40
What lab findings are associated with acute hepatic failure?
* Elevated bilirubin * Elevated transaminases * Prolonged prothrombin time with INR >1.5
41
What differentiates acute from chronic hepatic failure?
Acute if <26 weeks in duration, chronic if >26 weeks in duration.
42
What are the leading causes of chronic liver failure?
* Chronic Hepatitis B * Chronic Hepatitis C * Non-alcoholic fatty liver disease * Alcoholic liver disease
43
What is the incubation period for Hepatitis A?
2-6 weeks.
44
What is the transmission route for Hepatitis A?
Fecal-oral transmission.
45
What serological marker is best for detecting acute Hepatitis A?
Anti-HAV (IgM).
46
What does HBsAg indicate?
Hepatitis B infection (acute and chronic).
47
What are the possible outcomes of Hepatitis B infection?
* Acute Hepatitis * Chronic Hepatitis * Asymptomatic Carrier state * Acute Hepatic failure
48
What is the key lab test for identifying active Hepatitis C infection?
HCV RNA testing.
49
What is the incubation period for Hepatitis C?
4 to 26 weeks.
50
What is a significant risk factor for Hepatitis C infection?
IV drug abuse.
51
What is the mode of transmission for Hepatitis E?
Fecal-oral transmission.
52
What is the mortality rate of Hepatitis E in pregnant women?
High (20%) mortality.
53
Hepatitis E is most common in which regions?
* Asia * India * Sub-Saharan Africa * Middle East * Mexico
54
What is the significance of the window period in Hepatitis B infection?
HBsAg drops and Anti-HBs not elevated yet, indicating possible recovery or undetectable chronic infection.
55
True or False: Hepatitis A can lead to chronic hepatitis.
False.
56
Fill in the blank: Chronic Hepatitis C is associated with a risk of _______.
[cirrhosis and hepatocellular carcinoma].
57
What are the associated conditions for liver disease?
* Right-sided heart failure (congestive-hepatopathy) * Diabetes mellitus * Skin pigmentation * Arthritis * Hemochromatosis * Obesity * Pregnancy * Inflammatory bowel disease / Celiac disease
58
What is NASH?
Non-Alcoholic Steatohepatitis ## Footnote NASH is characterized by hepatic inflammation and can lead to cirrhosis.
59
What is the definition of Non-Alcoholic Fatty Liver Disease (NAFLD)?
Hepatic steatosis + exclusion of significant alcohol consumption + exclusion of secondary causes ## Footnote NAFLD includes both NAFL and NASH.
60
What are the risk factors for Non-Alcoholic Fatty Liver Disease?
* Obesity * DM2 * Dyslipidemia * Metabolic syndrome * PCOS * Hypothyroidism * Obstructive Sleep Apnea * Hypopituitarism * Hypogonadism * Previous cholecystectomy ## Footnote These factors increase the likelihood of developing NAFLD.
61
What is the difference between NAFL and NASH?
NAFL: Steatosis without evidence of significant inflammation NASH: Has hepatic inflammation ## Footnote NASH can be histologically indistinguishable from Alcoholic Steatohepatitis.
62
What histological features are present in NASH?
* Hepatic steatosis * Hepatocyte ballooning degeneration * Hepatic lobular inflammation * Prominent in centrilobular regions * Mallory-Denk bodies ## Footnote A liver biopsy is the only way to differentiate NAFL from NASH.
63
What are common clinical manifestations of NAFLD?
* Asymptomatic * Fatigue * Malaise * RUQ abdominal discomfort * Possible hepatomegaly * Aminotransferase elevation ## Footnote The degree of elevation does not predict the degree of inflammation or fibrosis.
64
What imaging techniques can show steatosis in NAFLD?
* Ultrasound * CT * MRI * MRS (spectroscopy) ## Footnote None of these can differentiate NAFL from NASH.
65
When should a liver biopsy be considered in NAFLD?
* Stigmata of chronic liver disease (cirrhosis) * Splenomegaly * Cytopenias * Serum ferritin > 1.5 times upper normal * Age > 45 with associated obesity/DM ## Footnote These factors indicate a higher risk of advanced liver disease.
66
What are the differential diagnoses for NAFLD?
* Alcoholic liver disease * Autoimmune hepatitis * Viral hepatitis * Wilson disease * Medications * Acute fatty liver of pregnancy * HELLP syndrome * Lipodystrophy * Starvation * Parenteral nutrition * Abetalipoproteinemia * Reye syndrome * Inborn errors of metabolism * Hemochromatosis * Alpha-1 antitrypsin deficiency ## Footnote It is important to exclude these conditions before diagnosing NAFLD.
67
What are the main treatment options for NAFLD?
* Weight loss * Lifestyle modification * Bariatric surgery * Medications * Immunizations (hepatitis A, B, pneumococcal) * Address risk factors for CVD * Vitamin E (for advanced fibrosis without DM and CAD) * Avoid alcohol * Thiazolidinediones (insulin sensitizing) * Omega-3 fatty acids ## Footnote Vitamin E may increase mortality in some cases.
68
What laboratory tests are important for diagnosing hepatitis?
* AST * ALT * ALK phosphatase * GGT * Bilirubin * LDH * Albumin * PT ## Footnote Viral serology is also crucial for diagnosis.
69
What are common symptoms of hepatitis?
* Asymptomatic * Fatigue * Malaise * RUQ abdominal discomfort * Nausea * Vomiting * Itching * Fever * Jaundice ## Footnote Acute severe hepatitis can present like acute liver failure but will lack encephalopathy.
70
True or False: Fibrosis is required for the diagnosis of NASH.
False ## Footnote Fibrosis is not a requirement for diagnosing NASH.
71
What is a common misconception about aminotransferase elevation in NAFLD?
The degree of elevation does not predict the degree of inflammation or fibrosis ## Footnote This is important for clinicians to understand when interpreting lab results.
72
Fill in the blank: Hepatitis A cases in Arkansas from February 2018-2021 totaled ______.
482 cases ## Footnote This statistic highlights the prevalence of Hepatitis A in that time frame.

Clinical GI Review (5 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions