Passmed/pastest Flashcards
Isolated hyperbilirubinaemia in asymptomatic person?
Gilbert syndrome
In Gilbert syndrome why is bilirubin not seen in the urine?
Disorder of bilirubin conjugation; causes build-up of unconjugated bilirubin which is not water-soluble
Sudden onset abdominal pain, tender hepatomegaly and ascites due to hepatic vein thrombosis
Budd-Chiari syndrome
What test is used to distinguish between ascites due to portal hypertension or other causes?
Serum-ascites albumin gradient (SAAG). Raised SAAG indicates portal hypertension
Budd-Chiari syndrome is usually seen in the context of…
Underlying pro-coagulant condition e.g. thrombophilia, pregnancy, malignancy
Transaminitis (elevated ALT and AST) in the 10,000s is most commonly caused by…
Paracetamol overdose
Treatment of paracetamol overdose?
Acetylcysteine if:
staggered overdose/doubt over time of ingestion;
plasma paracetamol concentration is above the treatment line from 4hrs-15hrs
How is the number of units of alcohol in a drink calculated?
Volume in ml * ABV / 1000
Guidelines for alcohol intake?
Men and women- max 14 units, ideally spread over 3 days or more
Autosomal dominant condition characterised by multiple telangiectasia over the skin and mucuous membranes
Hereditary haemorrhagic telangiectasia (Osler-Weber-Rendu syndrome)
Most common cause of liver disease in the developed world?
Non-alcoholic fatty liver disease (NAFLD)
NAFLD associations?
Obesity, hyperlipidaemia, T2DM (metabolic syndrome)
Describe the spectrum of NAFLD?
Steatosis –> steatohepatitis –> fibrosis –> cirrhosis
Test results in NAFLD? (2)
Elevated transaminases (ALT usually greater than AST) Increased echogenicity on USS
Management of NAFLD?
Lifestyle changes and monioring
? possible role for gastric banding/metformin
