liver pathology Flashcards
Symptoms of chronic liver disease
none
or weightloss/gain
tiredness
pruritis
pale stools/dark urine
signs of chronic liver disease (8)
Palmar erythema
Spider naevi
Hair loss ( axillary)
Gynaecomastia
Leuchonychia / Clubbing
Proximal wasting
Scratch marks
Xanthelasma
what is sarcopenia
muscle wasting
spider naevi and palmar erythema in same pt
more than llikely chronic liver disease
which two symptoms seen together strongly suggest chronic liver disease
spider naevi and palmar erythema
2 blood tests for liver FUNCTION
albumin and INR (prothrombin time)
2 blood tests for stage of liver disease
(low) platelet count
(high) ALT/AST
alkaline phosphatase can be raised in liver disease but why else might it go up
bone or placenta
raised ALT /AST =
hepatatic
raised Alk Phos / γGT =
cholestatic
AST > ALT =
alcohol
ALT > AST =
eg viruses / NAFLD
what is the more or less max of ALT with alcohol liver disease
500
if ALT >1500, think… not ….
hepatitis virus eg EBV, HIV, drugs, ischaemia
not alchohol
ischaemia of liver associated with
Right sided HF
in susp liver disease, ferritin test for
haemochromotosis
in susp liver disease, caeruloplasmin test for
Wilson disease
what is Wilson’s disease
can’t get rid of copper
Alpha1 antitrypsin does what
inhibits neutrophil elastase, thereby keeping lungs elastic
how does A1antitrypsin defic cause cirrhosis
is improperly coded so doesn’t leave the liver causinng build-up -> fibrosis
what is alphafetoprotein in an adult
tumour marker
first call liver imaging
USS
what is the first knock-on effect of cirrhosis
portal hypertension
3 complications of scirrhosis
portal hypertension
liver failure
malignancy
