Liver Disorders Flashcards
Which liver mass is characterized by a solitary mass with a hypodense central stellate scar or “spoke wheel” vascular pattern on CT imaging?
Focal nodular hyperplasia (FNH)
Up to 50% of cases of hepatocellular carcinoma (HCC) occur secondary to:
Chronic HBV infection
What is the most likely diagnosis in a patient with the following serology: - HBeAg: + - Anti-HBc IgG: + - HBsAg: + - LFTs:
Mild ↑ Active chronic HBV
HBeAg in inactive carriers with chronic hepatitis B virus (HBV) infections is:
Undetectable
What are the agents used to lower NH3 levels in hepatic encephalopathy?
First-line: Lactulose
Second-line: Rifaximin
What is the next step in management for a patient found to have positive HCV antibodies?
HCV RNA testing
What is the likely underlying infection in a patient with recurrent blisters on sun-exposed areas with fatigue, nausea, and elevated LFTs?
Chronic hepatitis C infection
What combined antiviral therapy is effective against most strains of hepatitis C (e.g. genotypes 1-6)?
Sofosbuvir-velpatasvir
Options for antiviral therapy against immune-active chronic HBV include:
Tenofovir, entecavir, and pegylated interferon alpha (IFN-α)
All patients with cirrhosis should have a screening:
ultrasound every 6 months ± alpha-fetoprotein
What serologic markers should be measured to diagnose acute HBV infection?
HBsAg and anti-HBc IgM
All patients with cirrhosis should be regularly screened for major complications, in particular:
Esophageal varices and hepatocellular carcinoma (HCC)
Patients with resolved HBV infection after acute phase
will have:
- HBsAg:
- Anti-HBs:
- Anti-HBc:
- Anti-HBe:
- Negative
- Positive
- Positive
- Positive
Chronic HBV infection, which is characterized serologically by:
- HBsAg :
- Anti-HBs:
- IgG anti-HBc:
- Positive for a period of ≥ 6 months,
- Negative
- Positive
First-line treatment for patients with Early-stage hepatocellular carcinoma (A solitary hepatocellular carcinoma > 2 cm in size or up to three small (≤ 3 cm) tumors confined to the liver, with no evidence of portal hypertension or macrovascular invasion in patients with preserved liver function)
Surgical resection of the affected hepatic lobe
What is the likely diagnosis in a young woman that presents with sudden RUQ pain, hypovolemic shock, and a solid liver mass with free fluid in the abdomen on U/S?
Ruptured hepatic adenoma
What is the recommended management for a pregnant patient with chronic hepatitis C infection and no immunity to hepatitis A/B?
Administer hepatitis A and B vaccines (prevent further liver damage)
Immunization against HBV is characterized serologically by:
- HBsAg :
- Anti-HBs:
- IgG anti-HBc:
- Negative
- Positive
- Negative
What is the treatment for acute cases of HBV?
Supportive
What is the likely diagnosis in a cirrhotic patient with decreasing GFR, normal urinalysis, lack of improvement with IV fluids, and no other renal dysfunction?
Hepatorenal syndrome
Amebic liver abscess symptoms:
Fever, bloody diarrhea, RUQ pain, smooth/cystic subcapsular liver mass
Amebic liver abscess caused by Entamoeba histolytica appears on ultrasound as a(n):
Hypoechoic lesion
Hemochromatosis classically presents with a triad of:
- Cirrhosis
- Diabetes mellitus
- Bronze skin
What is the underlying cause of impotence in a middle-aged male with hepatomegaly and arthropathy?
Hypogonadism (due to hereditary hemochromatosis)
What is a common cause of death in hemochromatosis?
Hepatocellular carcinoma
What is the most common condition that causes chylous ascites?
Lymphoma
What is the likely diagnosis in a young patient that has hepatosplenomegaly, resting tremor, dysarthria, parkinsonism, and dementia?
Wilson disease
The presence of a fluid filled cavity in the liver in conjunction with fevers, chills, and RUQ pain is suggestive of a(n):
Hepatic abscess
Pyogenic liver abscess is managed with:
Broad spectrum IV antibiotics + percutaneous drainage
Recurrent GI bleeding from esophageal varices is managed with:
TIPS
What is the likely diagnosis in a patient with cirrhosis and ascites who presents with low-grade fever, diffuse abdominal discomfort, and altered mental status (AMS)?
Spontaneous bacterial peritonitis
Spontaneous bacterial peritonitis is diagnosed by paracentesis with ascitic fluid absolute neutrophil count:
≥ 250 cells/mm3
Which diuretics are commonly co-administered to cirrhotic patients with volume overload and ascites?
Furosemide and spironolactone
Pyogenic bacteria typically gain access to the liver through either a(n)______or ______
biliary tract infection (ascending cholangitis)
portal vein pyemia
Common cardiac complications in patients with hemochromatosis:
- Paroxysmal atrial fibrillation
- Dilated cardiomyopathy
- Restrictive cardiomyopathy
- Heart failure.
Alcoholic hepatitis typically has what AST/ALT ratio?
> 2
