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Alimentary System: Pathology SA > Liver Symposium - Non Alcoholic Fatty Liver Disease, Autoimmune Disease and Liver transplantation > Flashcards

Liver Symposium - Non Alcoholic Fatty Liver Disease, Autoimmune Disease and Liver transplantation Flashcards

1
Q

What is the pathology of Non alcoholic fatty liver disease

A

Simple steatosis

causes

Non alcoholic steatoheaptits

which further develops into

Fibrosis and cirrhosis

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2
Q

Define simple steatosis

A

Infiltration of liver cells with fat cells

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3
Q

Define Nonalcoholic steatoheaptits

A

liver inflammation and damage caused by a buildup of fat in the liver

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4
Q

What are the metabolic risk factors of NonAlcoholic Fatty Liver Disease

A

Diabetes mellitus
Obesity
Hypertriglyceridemia
Hypertension

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5
Q

What are the other risk factors for Non alcoholic fatty liver disease

A 
Age
Ethnicity
 (e.g. Hispanics)
Genetic factors
 (e.g. PNPLA3 gene)
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6
Q

What imaging is sued in diagnosis Non alcoholic fatty liver disease

A

Ultrasound (Fibrocan determine how much fibrosis or fat)

MR/CT

MR spectum - see fat

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7
Q

What are the three biomarker used in the diagnosis of nonalcoholic fatty liver disease

A

AST/ALT ratio - see is its alcohol or not (AST.>ALT)

Enhanced Liver fibrosis pannel

Cytokertatin 18

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8
Q

What is the additional test used in the diagnosis of non alcoholic fatty liver disease

A

Liver biopsy

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9
Q

Define a high risk patient for NAFLD

A

> 45 years
Diabettic
BMI >30

> 1 (AST>ALT)

Platelets count low

Low albumin

(3 or more patient at high risk)

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10
Q

What is non drug treatment of Non alcoholic fatty liver disease

A

Diet
Exercise
for weigh reduction

Weight reduction surgeries

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11
Q

What is the drug treatment for non alcoholic fatty liver disease

A

Insulin sensitizers e.g. Metformin, Pioglitazone

Glucagon-like peptide-1 (GLP-1) analogues
e.g. Liraglutide

Farnesoid X nuclear receptor ligand
e.g. Obeticholic acid
Vitamin E

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12
Q

What are three examples of autoimmune diseases of the liver

A

Automimmune hepatitis

Primary Biliary cholangitis

Primary sceloring cholangitis

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13
Q

What is signs of autoimmune hepatitis

A

Elevated IgG

Antibodies:
Type 1: ANA, SMA
Type 2: LKM1
Type 3: SLA

Abnormal liver function test

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14
Q

What treatment doe autoimmune hepatitis respond well to

A

Long term azathioprine

and steroid

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15
Q

What us primary bilary cholangitis

A

Inflammation of the Intrahepatic bile duct

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16
Q

Symptoms primary bilary cholangitis

A

Fatigue

Pruritus - itchy skin

17
Q

What is shown in the biochemical tests for primary biliary cholangitis

A

Antimitochondrial antibody postive

IgM elevated

18
Q

What is the treatment of primary biliary cholangitis

A

Ursodeoxycholic acid - flushes out bile

19
Q

What is primary sectoring cholangitis

A

Inflammation of intra and extra hepatic bile duct

20
Q

What is best used in diagnosis primary sceloring cholangitis

A

Magnetic resonance cholangiopancreatography (MRCP) is a special type of magnetic resonance imaging (MRI) exam that produces detailed images of the hepatobiliary

21
Q

What is a biomarker forprimary sceloring cholangitis

A

pANCA positive

22
Q

What is the treatment forprimary sceloring cholangitis

A

Liver transplant

Biliary stent

23
Q

When conditions require a liver transplant

A

Chronic liver poor predicted survival or poor quality of life

Hepatocellular carcinoma

Acute liver failure

Genetic diseases e.g. primary oxaluria, tyrosemia

24
Q

What is the main contradictions for liver transplantation

A

Active substance or alcohol abuse

25
Q

What score do we use to prioritise liver transplants

A

MEDL/ UKELD

```
Determined by your:
Bilirubin
Creatinine,
INR
sodium also in UKELD
~~~

26
Q

What type of surgery is Liver transplantation

A

Orthoptoic

  • full diseased liver comes out with all blood vessels and new liver is transplanted into empty space
27
Q

What is the drugs given is post operative care of liver transplant

A

Prophylactic antibiotics

Anti fungal drugs

Antirecession drugs
eg.
steroids, azathioprine,
tacrolimus/cyclosporine

28
Q

What is present after liver transplant

A

a multidisciplinary care unit

Alimentary System: Pathology SA (27 decks)

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