Liver & friends

Question 1

What score can be used to assess the severity of acute pancreatitis?

Answer 1

Question 2

What is a first line investigation for acute pancreatitis?

Answer 2

Question 3

Give a simple test for chronic pancreatitis.

Answer 3

Question 4

Give three symptoms of acute pancreatitis.

Answer 4

Question 5

Which hepatitis viruses are spread by IVDU?

Answer 5

(C more common)

Question 6

Which hepatitis viruses are spread by the faecal-oral route?

Answer 6

Question 7

Which hepatitis virus is mostly asymptomatic until the liver becomes noticeably damaged?

Answer 7

Question 8

Which hepatitis can be spread by semen/vaginal fluid?

Answer 8

Question 9

First, second and maintenance line drugs for autoimmune hepatitis?

Answer 9

Question 10

A patient presents with jaundice who also has UC. What should you suspect?

Answer 10

Question 11

What three antibodies can be present in PSC?

Answer 11

Question 12

What structures become damaged by PSC?

Answer 12

Question 13

What ducts are affected in PBC?

Answer 13

Question 14

What antibodies are present in PBC?

Answer 14

Question 15

What drug can be used to slow disease progression in PSC and PBC?

Answer 15

Question 16

What drug can be used to treat pruritis as a complication of PBC/PSC?

Answer 16

Question 17

What investigations would you use for PSC vs PBC?

Answer 17

Question 18

Give three conditions PBC is associated with.

Answer 18

Question 19

Give three conditions PSC is associated with.

Answer 19

note hepatocellular carcinoma also associated with PSC!

Question 20

What can PSC present with?

Answer 20

• Jaundice
• Pruritis
• Fatigue
• IBS symptoms

Question 21

What is xanthelasma and what causes it?

Answer 21

Build up of cholesterol deposits under the skin.

Question 22

What levels of conjugated/unconjugated bilirubin do you see in pre, intra and post hepatic jaundice?

Answer 22

Question 23

What happens to AST, ALT and ALP levels in prehepatic jaundice?

Answer 23

Question 24

What happens to AST, ALT and ALP levels in intrahepatic jaundice?

Answer 24

Question 25

What happens to AST, ALT and ALP levels in posthepatic jaundice?

Answer 25

Question 26

Which types of jaundice do you see darkened urine in?

Answer 26

Question 27

Which type of jaundice do you see pale coloured stools?

Answer 27

Question 28

First line treatment for alcohol withdrawal?

Answer 28

A long acting benzodiazepine. e.g chlordiazepoxide

Question 29

What's the most common cause of liver cirrhosis?

Answer 29

Chronic alcohol abuse

Question 30

Three main bacteria to cause ascending cholangitis?

Answer 30

Question 31

What is Charcot's triad?

Answer 31

Question 32

What is Reynold's pentad?

Answer 32

Question 33

What does Reynold's pentad indicate?

Answer 33

Question 34

Mutation of what gene on what chromosome leads to alpha-1-antitrypsin deficiency.

Answer 34

Question 35

What type of molecule is alpha-1-antitrypsin?

Answer 35

Question 36

What are the two main complications of alpha-1-antitrypsin deficiency and at what ages does it usually manifest?

Answer 36

Question 37

What causes median arcuate ligament syndrome? (MALS)

Answer 37

- Compression of coeliac artery (Median arcuate ligament connects the left and right crura (crus singular) of the diaphragm)

Question 38

Give three first line investigations for NAFLD.

Answer 38

Question 39

Give the two gold standard tests to confirm a diagnosis of NAFLD.

Answer 39

Question 40

Give two causes of pre-hepatic jaundice.

Answer 40

- G6PDH deficiency - Hereditary spherocytosis

Question 41

What's the technical term for gallstones in the common bile duct?

Answer 41

Choledocholithiasis

Question 42

First and second line treatment for high transferrin/ferritin?

Answer 42

Question 43

Give four symptoms of Wilson's disease.

Answer 43

Question 44

Mutation of what gene on which chromosome causes Wilson's disease?

Answer 44

Question 45

What are the rings around the eyes called in Wilson's disease?

Answer 45

Question 46

Gold standard for diagnosis of Wilson's disease?

Answer 46

Question 47

First line treatment for Wilson's disease?

Answer 47

Question 48

What vitamins does chronic pancreatitis put you at risk of developing a deficiency in?

Answer 48

- Fat soluble ones - A,D,E,K

Question 49

Three symptoms of chronic pancreatitis?

Answer 49

Question 50

Give two drugs that can be given for chronic pancreatitis.

Answer 50

Question 51

What tumour marker can be used for HCC?

Answer 51

Question 52

Which two types of hepatitis are risk factors for HCC?

Answer 52

Question 52

Which two types of hepatitis are risk factors for HCC?

Answer 52

Question 53

What antibodies are associated with types 1 and 2 autoimmune hepatitis?

Answer 53

Question 54

Which hepatitis viruses are +ve ssRNA?

Answer 54

Question 55

Which hepatitis doesn't have a vaccine?

Answer 55

Question 56

What are the genome structures of hepatitis B and D?

Answer 56

Question 57

What antibodies imply vaccination against a given hepatitis virus?

Answer 57

Question 58

What antibodies imply previous infection by a given hepatitis virus?

Answer 58

Question 59

Which antibodies imply an acute/chronic infection is present?

Answer 59

Question 60

Which type of gallstone is most common in fertile women and why?

Answer 60

Question 61

Why do black pigmented gallstones usually occur?

Answer 61

Question 62

Why do mixed/brown pigmented stones usually occur?

Answer 62

Question 63

What does an AST:ALT ratio of 2 or more indicate?

Answer 63

Question 64

What does an AST:ALT ratio of less than 1 indicate?

Answer 64

Question 65

What are the two types of ascites?

Answer 65

Question 66

Give three causes of high SAAG ascites?

Answer 66

Question 67

Give three causes of low SAAG ascites?

Answer 67

Question 68

Treatment of ascites?

Answer 68

Question 69

Best investigation to confirm ascending cholangitis?

Answer 69

Contrast-enhanced dynamic CT