LIVER DISORDERS

Question 1

Cholestasis

Answer 1

Impaired bile formation or flow

Question 2

Cholestasis - symptoms

Answer 2

fatigue
pruritus
dark urine
pale
jaundice

Question 3

Cholestatic pruritus - treatment

Answer 3

cholestyramine
ursodeoxycholic acid
rifampicin

Question 4

Cholestyramine MOA

Answer 4

• anion-exchange resin that is not absorbed from GI tract
• forms insoluble complex in intestine with bile + other compounds
• reduction of serum bile = reduction of excess deposition in dermal tissue with resultant decrease in pruritus

Question 5

Intrahepatic cholestasis - pregnancy

Answer 5

During late pregnancy - adverse fetal outcomes
Treatment of pruritus associated - ursodeoxychollic acid

Question 6

Gallstones

Answer 6

Hard mineral or fatty deposit forming stones in the gallbladder bile duct

Question 7

Gallstones - asymptomatic

Answer 7

majority of pts asymptomatic
don’t need to treat

Question 8

Gallstones - symptoms

Answer 8

Irritated/blocked gall bladder
pain
infection
inflammation

Question 9

Gallstones - if left untreated

Answer 9

biliary colic
cholecystitis
cholangitis
pancreatitis

Question 10

Gallstones - treatment

Answer 10

If symptoms develop
surgical removal

Drug treatment
Mild-mod pain: paracetamol/ NSAID

Severe pain: IM diclofenac
Alt: morphine or pethidine