Brainscape's Knowledge GenomeTM

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


See full index

GI > Liver Diseases > Flashcards

Liver Diseases Flashcards

1
Q

4 functions of the liver

A

Synthetic
Detoxification
Immune function
Storage

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

What is synthesised in the liver?

A 
Clotting factors
Bile acids
Carbohydrates - Gluconeogensis, glycogenolysis, glycogenesis
Proteins - Albumin
Lipids - cholesterol, lipoprotein, TG
Hormones - angiotensinogen, ILGF
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Describe detoxification processes in the liver

A

Urea production from ammonia
Drugs
Bilirubin metabolism
Breakdown of insulin and hormones

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

What is stored in the liver?

A

Glycogen
Vitamins A , D, B12 and K
Copper
Iron

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

What is included in Liver Function Tests?

A 
Bilirubin
Aminotransferases
Alklaine phosphatase
Gamma GT
Albumin
Prothrombin time
Creatinine
Platelet count
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What is unconjugated bilirubin bound by?

A

Albumin

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

What leads to bilirubin elevation?

A

Haemolysis
Parenchymal damage
Obstructive causes

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

Which aminotransferase is more specific to liver damage?

A

ALT
AST can rise in heart conditions, muscle damage
AST/ALT ratio can indicate acute liver disease

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

Where is alkaline phosphatase present?

A

Bile ducts
Bone
Placenta
Intestines

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

What leads to an elevated alkaline phosphatase?

A

Obstruction or liver infiltration

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

What leads to gamma GT elevation?

A

Alcohol use

Drugs eg NSAIDs

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

Low albumin indicates?

A

Chronic liver disease
Kidney disorders (loss)
Malnutrition (lack protein to produce)

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

Prothrombin time indicates?

A

Extent of liver dysfuntion

Useful in staging, indication of surgery

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

Why is creatinine useful in liver disease?

A

Indicates renal function which projects survival from liver disease
Assesses need for transplant

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

Platelet count is an indirect marker of what condition in liver disease?

A

Portal hypertension

Cirrhosis - leads to splenomegaly 0 leads to low count

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

Symptoms of liver disease

A

Jaundice
Ascites
Variceal bleeding
Hepatic encephalopathy

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

Differential for jaundice

A

Carotenemia

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

What sign differentiates carotenemia from jaundice?

A

Doesn’t affect the sclera

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

Signs of prehepatic cause of jaundice

A

Spelnomegaly - haemolysis

Pallor

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

Signs of hepatic cause of jaundice

A

Stigmata
Ascites
Asterixis - LIVER FLAP

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

Signs of post hepatic cause of jaundice

A 
Abdominal pain
Pruritus
Pale stools
Dark coloured urine
Palpable gallbladder
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What is Courvoisier’s sign?

A

Palpable gallbladder

23
Q

Investigations of jaundice

A 
Liver Screen
Ultrasound
MRCP, ERCP
Percutaneous Transhepatic Cholangiogram
EUS
24
Q

What tests are included in a liver screen?

A 
Hepatitis B and C serology
Autoantibody profile. serum Igs
Caeruloplasmin and copper
Ferrritin and transferrin 
Alpha 1 Antitrypsin
Fasting glucose and lipids
25
Q

Advantages of MRCP vs ERCP

A

No radiation, complications or sedation

Can image outwith ducts

26
Q

ERCP therapeutic options

A

Dilated biliary tree +/- visible stones or tumour
Acute gallstone pancreatitis
Stenting of bilioary obstruction
Post-op biliary complications

Choledocholithiasis
Sphincterectomy
Stone retrieval

27
Q

Complications of ERCP

A 
Pancreatitis
Perforation
Sedation - respiratory and cardiac
Cholangitis
Sphincterectomy - bleeding and perforation
28
Q

When is PTC indicated instead of ERCP?

A

Previous surgery

Duodenal obstruction

29
Q

Name conditions described as chronic liver disease

A

Chronic hepatitis/cholestasis
Fibrosis and cirrhosis
Steatosis
Liver tumour

30
Q

Causes of cirrhosis

A 
Alcohol
Autoimmune
Haemochromatosis
Chronic viral hepatitis
Non-Alcoholic Fatty Liver Disease
Drugs
CF
Alpha antitrypsin deficiency
Wilson's
Cryptogenic
Portal hypertension
Liver disease
Sarcoidosis
Amyloid
Schistosomiasis
31
Q

Pathological change seen in liver cirrhosis

A 
Infiltrating lymphocytes
ECM proteins
Apoptosis
Activated kupffer cells
Sinusoid resistance to blood flow
32
Q

Signs in compensated liver cirrhosis

A

Abnormal liver screen and lfts

33
Q

Signs in decompensated liver cirrhosis

A

Ascites, Variceal belleding, Encephalopathy

34
Q

3 Stages of liver cirrhosis

A

A - Compensated
B - Decompensated
C - Hepatocellular carcinoma

35
Q

Symptoms that can accompany ascites in liver disease

A 
Spider naevi
Palmar erythema
abdominal veins
fetor hepaticus
umbilical nodule
Rasied JVP
Flank haematoma
36
Q

Diagnostic test for ascites

A

Paracentesis

  • Protein and albumin concentration
  • Cell count and differential
  • Serum Ascites Albumin gradient
37
Q

Components measured in paracentesis

A
  • Protein and albumin concentration
  • Cell count and differential
  • Serum Ascites Albumin gradient
38
Q

What cause of ascites is indicated by a protein and albumin concentration of 1.1g/al

A

Portal hypertension

39
Q

What conditions are associated with portal hypertension>

A 
Congestive Heart Failure
Pulmonary hypertension
Constrictive pericarditis
Budd Chiari
Myxedema
Massive liver metastases
40
Q

What conditions are associated with non-portal hypertension ascites?

A 
Malignancy
TB
Chylous ascites
Pancreatic
Biliary
Nephrpotic syndrome
Serositis
41
Q

Treatment of ascites

A 
Diuretics
Large volume paracentesis
TIPS - Transjugular Intrahepatics Portosystemic Shunt
Aquaretics
Liver Transplant
42
Q

Why do varices occur?

A

Portal hypertension
Leads to systemic anastomoses
- Skin, Oesophagus, Gastric, Rectal, Stomal

43
Q

Management of varices

A

Resuscitation
IV fluid
Blood transfusion
Emergency endoscopy

Endoscopic band ligation
Terlipression
Sengstaken Blakemore tube - bleeding
TIPS - rebleeding

44
Q

How is hepatic encephalopathy scored?

A

Confusion is graded from 1 to 4

45
Q

What are the precipitants of hepatic encephalopathy?

A 
Bleeding
Infection
Constipation
Dehydration
Medication/Sedation
46
Q

Associated symptoms with hepatic encephalopathy?

A

Fetor hepaticus

Asterixis

47
Q

Management of hepatic encephalopathy

A

Treat underlying cause
Laxatives - phosphate enema and lactulose
Neomycin and Rifaximin - Antibiotics
Supportive - airways, NG tube medication

48
Q

Presentation of hepatocellular carcinoma

A 
Decompensated liver disease
Abdominal pain
Mass
Weight loss
 Bleeding
49
Q

Diagnostic investigations of hepatocellular carcinoma

A

Elevated AFP
US
CT
MRI

50
Q

Treatment of hepatocellular carcinoma

A 
Hepatic resection
Transplant
Chemotherapy
Ablation
Sorafenib (TKI)
Tamoxifen (hormone therapy)
51
Q

What may be carried out if a patient has repeated incidents of hepatic encephalopathy?

A

Liver transplant

52
Q

Significant LFT results

A

ALT 10 x normal amount - hepatocellular injury
ALT> AST - most liver diseases
AST>ALT - usually 2:1 ratio: Alcoholic hepatitis
ALP 3 x normal
ALP + GGT high = biliary tree damage (cholestasis)
Isolated high ALP - bone, prenancy, Paget’s
GGT high - alcohol intake or drugs

53
Q 
Painless jaundice
High ALP, High GGT
Lethargy
Loss of appetite
Heavy drinker
Palpable gallbladder
Diangosis?
A

Cholestatic blood results

Pancreatic cancer

GI (8 decks)

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