Med B - Jaundice and ascites Flashcards
34 y/o female
pc: jaundice, used to use recreational drugs, recently travelled to the far east.
dx: given co-amoxiclav for infected scratch
possible causes of painless jaundice in this woman?
Hep A - faecal oral
Hep E - increasing in incidence
Hep C - unusual, presentation would require parenteral drug use
Drug induced liver injury
autoimmune: chronic active hepatitis, primary biliary cirrhosis
obstructive: stones, pancreatic cancer
34 y/o female
pc: jaundice, used to use recreational drugs, recently travelled to the far east.
dx: given co-amoxiclav for infected scratch
investigations:
‘Liver function tests’
Viral serology
Clotting tests
FBC
Imaging - USS
which part of the LFTs would suggest hepatitis?
- markedly elevated transaminases
IF
- ALP were majorly increased then need to check for evidence of chronic liver disease, US liver
which viruses can cause acute hepatitis?
- A, B, E (delta)
34 y/o female
pc: jaundice, used to use recreational drugs, recently travelled to the far east.
dx: given co-amoxiclav for infected scratch
clotting screen markedly deranged.
what is the significance of this:
- patients with abnormal clotting, in setting of acute liver injury, should be referred to liver unit and or transplant unit
The need for transplant is assessed using
the King’s College criteria for acute transplant
48 y/o female
pc: ED w/ progressive abdominal swelling over several weeks.
what are the 5Fs?
Fat
Flatus
Fluid - ascites or cysts
Faeces - constipation
Foetus - pregnancy
what investigation can help distinguish between the 5Fs?
- urgent abdominal ultrasound
48 y/o female
pc: ED w/ progressive abdominal swelling over several weeks.
US: shows ascites
Paracentesis.
what does the protein concentration tell you?
Exudate
- excess protein
- infection / malignancy
Transudate
- cirrhosis
- cardiac failure
- nephrotic syndrome
