Noninfectious hepatobiliary disease Flashcards
what does INR test?
concentration of albumin and proteins in the blood
what is the most important part of evaluation of patient with elevated LFTs?
history
INR and albumin are indicative of what type of liver function?
synthetic function
what are the stigmata of liver disease?
spider nevi palmar erythema gynecomastia caput medusa dupuytrens contracture parotid gland enlargement testicular atrophy asterixis virchows node sister mary joseph nodule right pleural effusion jugular venous distension
what sign is indicative of hepatic congestion?
jugular venous distension
in alcoholic liver disease what is the ratio of AST:ALT?
2:1
GGT is induced by what?
alcohol
how is the etiology of ascites determined?
serum ascites - albumin ratio
more than 1.1 - portal HTN
less than 1.1 - no portal HTN
what is the treatment for maintaining an appropriate electrolyte balance in alcoholic liver disease?
spironolactone and furosimide
what drugs should be avoided in alcoholic liver disease?
NSAIDs
what is the treatment for hepatic encephalopathy? what is the mechanism?
titrate lactulose
changes colonic pH
what is a major complication of alcoholic liver disease?
spontaneous bacterial peritonitis
what is the threshold for neutrophil count requiring paracentesis in spontaneous bacterial peritonitis?
250 or greater
what is the treatment of choice for esophageal varices?
endoscopic therapy (scleropathy, banding)
what type of beta blockers can be used for esophageal varices?
nonselective
propanalol
what is the discriminant function used for?
alcoholic hepatitis
in hemochromatosis what color is the skin?
gray
hemochromatosis carries a 25-30% risk of development of what disease?
hepatocellular cancer
in diagnosing hemachromatosis what is the transferrin saturation level?
over 45%
what is NASH?
fat accumulation to hepatic steatosis with inflammatory component
leads to fibrosis and cirrhosis
what is the ALT to AST ratio in NAFLD?
ALT greater than AST
what vitamin can be given for NAFLD?
vitamin E
what test is most useful to determine autoimmune liver disease?
SPEP
gilbert syndrome is due to what cause?
reduced enzyme activity
what type of bilirubin is involved in gilbert syndrome? is there hemolysis?
unconjugated bilirubin
no evidence of hemolysis
gilbert syndrome affects what population?
young white males
men jaundice UC increase ALP beaded appearance of bile ducts
primary sclerosing cholangitis
women
increased ALP
positive AMA
primary biliary cirrhosis
