Liver histories

Question 1

Presentation of AFLD?

Answer 1

Heavy alcohol consumption, RUQ pain, hepatomegaly. Often undetected, doesnt really prsent with many symptoms. look at risk factors

Question 2

What can fatty liver lead to?

Answer 2

Cirrhosis

Question 3

AST and ALT in AFLD?

Answer 3

AST>ALT 2:1

Question 4

Other key LTFs for diagnosing AFLD?

Answer 4

AST, ALT, ALP raised, GGT raised

Question 5

Treatment for AFLD?

Answer 5

Alcohol cessation is the only treatment. Alcohol withdrawal services can be useful in this context.

Question 6

Presentation of acute pancreatitis?

Answer 6

Epigastric/ LUQ pain, radiates to the back, N+V

Question 7

Causes of acute pancreatitis?

Answer 7

G - gallstones 
E - ethanol 
T - trauma 
S - Steroids 
M - mumps 
A - autoimmune 
S - Scorpion venom 
H - Hyperlipidemia 
E - ERCP
D - Drugs

Question 8

Investigations for acute pancreatitis/

Answer 8

Serum amylase and lipase (lipase more specific)

Question 9

Treatment for Acute pancreatitis?

Answer 9

Crystalloid fluid, NG feeding to avoid pancreatic stimulation, Analgesia, ERCP if jaundice.

Question 10

NAFLD presentation/typical patient.

Answer 10

No alcohol abuse, truncal obesity, Fatigue, hyperlipidemia, metabolic syndrom, Hepatosplenomegaly, RUQ discomfort

Question 11

What would the LFTS show for NAFLD?

Answer 11

ALT>AST
Raised ALP
Low albulmin

Question 12

Treatment for NAFLD?

Answer 12

Diet and exercise, vitamin E, weight loss, Gastric bypass, Liver transplant.

Question 13

Which is more sensitive to liver problems, ALT, AST or ALP?

Answer 13

ALT

Question 14

Sytomtoms of biliary colic?

Answer 14

Steady severe pain in the RUQ, resolves within 8 hours, responds to analgesia.
RUQ tenderness, murphys sign, no guarding or rebound.