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Phase 2a Lauren > Peer teaching Liver > Flashcards

Peer teaching Liver Flashcards

1
Q

What happens when albumin goes wrong?

A

Hypoalbuminaemia –> oedema –> ascites

Leuconuchia

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2
Q

What happens when regulation of excess oestrogen goes wrong?

A

Gynaecomastia in men
Spider naevi due to dilation of blood vessels caused by oestrogen
Palmar erythema

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3
Q

What happens when production of clotting factors goes wrong?

A

Easy bruising

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4
Q

What happens when regulation of bilirubin goes wrong?

A

Jaundice, pruritus, change in colour of urine and stool

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5
Q

What happens when the urea cycle goes wrong?

A

Hepatic encephalopathy from build up of ammonia that crosses the blood-brain barrier

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6
Q

What happens when the protection against infection via reticuloendothelial system goes wrong?

A

Prone to infection - spontaneous bacterial peritonitis in ascites

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7
Q

When is Gamma-glutamyl transferase raised?

A

Alcoholic liver disease

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8
Q

When is alkaline phosphatase level raised?

A

Anything to do with biliary tree damage

Also in bone resorption eg. mets

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9
Q

When is enzyme aspartate aminotransferase/Alanine aminotransferase raised?

A

Hepatocyte damage

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10
Q

What are causes of chronic liver conditions?

A
  • Infectious (Hep B, Hep C)
  • Autoimmune (AIH, PBC, PSC)
  • Metabolic (iron – haemochromatosis, copper – -Wilson’s, alpha-1-antitrypsin)
  • Alcoholic liver disease
  • Non Alcoholic Fatty Liver Disease (NAFLD)
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11
Q

Explain the progression of chronic liver disease

A

Chronic liver condition –> liver damage –> liver symptoms –> liver cirrhosis if prolonged –> liver failure ultimately + higher risk of hepatocellular carcinoma

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12
Q

Which hepatitis’ are blood-bourne?

A

Hep B, C, D

Hep D combines with B

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13
Q

Which hepatitis’ are spread by faecal-oral route?

A

Hep A, normally with travel history - contaninated food/water
Hep E - contaminated food/water. Endemic in UK - found in undercooked pork

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14
Q

Which of the hepatitis’ are DNA?

A

Hep B

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15
Q

Which of the hepatitis’ are acute?

A

All of them - B, C, D can be chronic

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16
Q

How do you detect viral hepatitis?

A

Total Hep B core antibody = anti-HBc
Igm antibody to Hep B core antigen = IgM anti-HBc
Hep B surface antigen HbsAg
Hep B surface antibody = anti-HBs

17
Q

What is the status of
HBsAg -ve,
anti-HBc -ve,
anti-HBs -ve?

A

Susceptible

18
Q

What is the status of
HBsAg -ve,
anti-HBc +ve,
anti-HBs +ve?

A

Immune due to natural infection

19
Q

What is the status of
HBsAg -ve,
anti-HBc -ve,
anti-HBs +ve?

A

Immune due to hep B vaccination

20
Q 
What is the status of
HBsAg +ve, 
anti-HBc +ve,
IgM anti-HBc +ve
anti-HBs -ve?
A

Acutely infected

21
Q 
What is the status of
HBsAg +ve, 
anti-HBc +ve,
IgM anti-HBc -ve
anti-HBs -ve?
A

Chronically infected

22
Q

What is the status of
HBsAg -ve,
anti-HBc +ve,
anti-HBs -ve?

A

Unclear. Either:

  1. Resolved infection (most common)
  2. False-positive anti-HBc, thus susceptible
  3. “Low level” chronic infection
  4. Resolving acute infection
23
Q

Which hepatitis injection is reccomended for travellers?

A

Hepatitis A

24
Q

What is the treatment for hep A & hep E?

A

Supportive as they are self limiting

25
Q

What is the treatment for chronic hep B?

A

Pegylated interferon-alpha 2a = pegasys (stimulates immune response)

26
Q

What is the treatment for chronic hep C?

A

Velpatasvir/sofosbuvir

27
Q

What is the rhyme for Hep A?

A

A is Acquired by mouth from Anus, is Always cleared Acutely and only ever Appears once

28
Q

What is the rhyme for Hep B?

A

B is Blood-Borne and if not Beaten can Be Bad

29
Q

What rhyme is Hep E?

A

E is Even in England and can be Eaten(sausage from pigs), if not always beaten

30
Q

What rhyme is hep. C?

A

C is usually Chronic but Can be Cured – at a Cost

31
Q

What is the pathophysiological progression of alcoholic liver diease?

A

Alcoholic hepatitis –> alcoholic steatosis –> cirrhosis

Reduced NAD+ –> less fat oxidation –> accumulation of fat in hepatocytes

32
Q

What is the effect of ROS on the liver?

A

Damages hepatocytes

33
Q

What is the effect of acetaldehyde on the liver?

A

Damages liver cell membranes

34
Q

What blood results will you expect in alcoholic liver disease?

A

GGT very raised
AST, ALT mildly raised

FBC: macrocytic anaemia

35
Q

What is the treatment of alcoholic liver disease?

A

Quit alcohol

Treat malnutrition: thiamine

Phase 2a Lauren (15 decks)

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