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Exam - M - GI Diseases > liver the vida loca > Flashcards

liver the vida loca Flashcards

1
Q

what is hepatitis

A

inflammation of the liver usually due to a virus

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2
Q

what can cause hepatitis

A 
alcoholic hepatitis 
non-alcoholic fatty liver disease
viral hepatitis 
auto-immune hepatitis 
drug induced hepatitis
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3
Q

how does hepatitis present

A 
abdominal pain 
pruritis 
muscle and joint ache
vomiting 
jaundice 
fever if viral
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4
Q

how does hepatitis A present

A

nausea
vomiting
anorexia
jaundice

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5
Q

how is hepatitis A transmitted

A

faecal-oral route

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6
Q

what is the incubation time for hepatitis A

A

2-3 weeks

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7
Q

what biomarker corresponds to hepatitis A

A

anti-HAV IgM

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8
Q

how do you treat hepatitis A

A

self-resolving

vaccine for travellers to endemic areas

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9
Q

how is hepatitis B spread

A

blood
sexual intercourse
needles
vertical

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10
Q

how long is the incubation period for hepatitis B

A

1-5months

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11
Q

what are biomarkers for an acute infection of hepatitis B

A

HBcAg
HBsAg
HBeAg

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12
Q

what are biomarkers for an early acute infection of hepatitis B

A

HBsAg

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13
Q

what are biomarkers for a resolved acute infection of hepatitis B

A

HBsAg

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14
Q

what are biomarkers for a patient after vaccination for hepatitis B

A

HBsAg

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15
Q

what are biomarkers for a chronic hepatitis B infection

A

HBcAg

HBsAg

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16
Q

how do you treat hepatitis B

A

education and prevention
vaccination for at-risk groups
notify public health

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17
Q

how is hepatitis C spread

A

vertical
needle
blood

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18
Q

how long is the incubation period for hepatitis C

A

6-9 weeks

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19
Q

what are biomarkers for hepatitis C

A

HCV antibody

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20
Q

how do you treat hepatitis C

A

education and prevention

anti-viral drugs

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21
Q

how does hepatitis D infect the body

A

can only co-infect with hepatitis B
contaminated needles
blood
sexual intercourse

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22
Q

how long is the incubation period for hepatitis D

A

1-5 months

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23
Q

what are biomarkers for hepatitis D

A

IgM anti-D

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24
Q

how do you treat hepatitis D

A

pegylated alpha-2a interferon

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25
how does hepatitis E spread
faecal-oral, associated with dirty water
26
what is the incubation period for hepatitis E
2-3 weeks
27
what are biomarkers for hepatitis E
IgG and IgM anti-HEV
28
what is cirrhosis
irreversible scarring of the liver | blood vessels are disrupted and secreting cells are destroyed
29
what can cause cirrhosis
alcoholic liver disease drugs bile duct obstruction genetics
30
what is primary biliary cholangitis
when the body attacks the interlobular bile ducts which blocks them and builds up pressure in the liver leading to fibrosis, scarring and cirrhosis
31
how does cirrhosis present
``` weakness fatigue weight loss nausea vomiting jaundice upper abdominal pain easy bruising ```
32
what clinical signs does cirrhosis have (hands and chest)
``` clubbing palmar erythema spider navei hair loss hepatomegaly white nails with redness at distal 1/3rd ```
33
what investigations could you do for cirrhosis
``` LFTs bloods - bilirubin US MRI biopsy ```
34
how could you manage cirrhosis
``` alcohol reduction stop NSAIDS, opiates, sedatives liver transplant treat underlying cause e.g. hepatitis B good nutrition ```
35
what is alcoholic liver disease
alcohol disrupts fat metabolism in the liver and results in fatty change of the liver build up of fat (steatosis) > alcoholic hepatitis (steatohepatitis) > cirrhosis
36
how does alcoholic liver disease present
``` hepatomegaly tender liver jaundice malaise anorexia nausea vomiting haematemesis fever weight loss ```
37
what investigations could you do for alcoholic liver disease
bloods - elevated prothrombin, U&Es, LFT, FBC AAT:ALT >2 CT MRI biopsy fibroscan for fatty changes CAGE questions for alcohol screening (cut down, annoyed, guilty, eye opener) drinking audit - score of 20+ is possible dependence
38
how can you treat alcoholic liver disease
alcohol abstinence - detox regime nutritional support liver transplant manage symptoms
39
what are the two types of primary liver cancer
hepatocellular 80% | cholangiocarcinoma
40
what are risk factors for liver cancer
hepato - HVB, HVC, alcohol, fatty liver disease | cholang - associated with primary biliary sclerosis
41
how does liver cancer present
``` weight loss abdominal pain jaundice nausea vomiting pruritis anorexia ```
42
what are tumour markers in liver cancer
HC - alpha-fetoprotein | CA - CA19-9
43
what investigations could you do for liver cancer
CT US ERCP biopsy
44
how do you manage liver cancer
poor prognosis lifestyle liver transplant stent in bile duct for primary sclerosing cholangitis
45
what is hepatic encephalopathy
as liver fails nitrogenous waste builds up in circulation and passes to brain, astrocytes clear it and glutamine is formed, has osmotic pull and causes cerebral oedema
46
what can cause hepatic encephalopathy
``` drugs infection constipation GI bleed electrolyte disturbance ```
47
how does hepatic encephalopathy present
altered mood/behaviour sleep disturbance dyspraxia poor arithmetic drowsy confused slurring liver flap coma
48
what investigations should you do for hepatic encephalopathy
CT - exclude intercranial bleed exclude infection blood sugar - exclude hypoglycaemia
49
how do you manage hepatic encephalopathy
laxatives - gets rid of ammonia before it can be absorbed antibiotics - rifaximin nutritional support
50
what is spontaneous bacterial peritonitis
infection of the ascitic fluid – an increased volume of peritoneal fluid
51
what causes SBP
e.coli klebsiella strep
52
what are warning symptoms for SBP
ascites with sudden deterioration
53
how do you manage SBP
IV abx ascitic fluid drainage IV albumin infusion
54
what is alcoholic hepatitis
inflammation caused by alcohol
55
how does alcoholic hepatitis present
``` maliase increased TPR anorexia diarrhoea vomiting hepatomegaly jaundice ascites encephalopathy ```
56
what investigations can you do in alcoholic hepatitis
bloods - increased WCC, decreased platelets, low albumin, raised prothrombin time, raised bilirubin, raised GGT ascites tap - screen for infection
57
how do you manage alcoholic hepatitis
stop alcohol consumption vitamin supplementation nutritional support - VK, thiamine airway protection treat infection, encephalopathy if present steroids in severe disease (jaundice/encephalopathy/coagulopathy)
58
what is non-alcoholic fatty liver disease
fat gets deposited in liver cells | can lead to hepatitis and cirrhosis
59
what are risk factors for non-alcoholic fatty liver disease
``` Obesity Poor diet and low activity levels Type 2 diabetes High cholesterol Middle age onwards Smoking High blood pressure ```
60
what Ix can you do for NAFLD
usually asymptomatic fatty liver on US biopsy raised AAT
61
how do you manage NAFLD
lifestyle changes - weight loss, diet and exercise

Exam - M - GI Diseases (35 decks)

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