phase 2 liver Flashcards
complications of acute pancreatitis
Pancreatic pseudocyst
Pancreatic abscess
Sepsis
Hypovolemic shock
DIC
Acute respiratory distress syndrome
symptoms of jaundice
Yellowing of the skin
Dark urine
Pale stools
Biliary pain
Rigors
Abdomen swelling
Weight loss
pre hepatic causes of jaundice
G6PD deficiency
spherocytosis
thalassema
vitamin b12 deficincy
intraheparic causes of jaudnice
hepaitis
cirhoosis
PBC
PSC
post hepatic causes of jaundice
bile duct strictures
tumours
inflammation
two clinical signs other than abdominal distention that would help confirm the presence of ascites
Shifting dullness, flank dullness, Fluid thrill, Bulging flanks
clinical signs of chronic liver disease that may be found on examination of the hand
Finger clubbing, palmar erythema, asterixis, oedema, Muscle wasting, cutaneous telangiectasia, Dupuytren’s contracture, liver flap,
Jaundice, easy bruising, hair loss, scratch marks secondary to pruritis, nail changes, white
nails, spider naevi, petechiae purpura
complications of chronic liver disease
varices
HE
HCC
ascites
what sign is present in pancreatic cancer
Courvoisier’s sign (1) – palpable enlarged gallbladder + painless jaundice
blood marker to monitor pancreatic cancer
CA 19-9
diagnostic test for pancreatic cancer
Pancreatic CT protocol
managment and prognosis for pancreatic cancer
Palliative supportive care
Very poor prognosis – only around 5% 3 year survival
how to differentiate between hep b and c presentation
heb b presents with jaundice
hep c presents asymptomatucally
both may cause track marks on arm due to ivdu
first line treatment for autoimmune hepatitis
predinosolone
gold standard treatment for autoimmune hepatitis
Prednisolone and azathioprine
whats used to maintain remission in autoimmune hepatiis
azathriopine
what disease is Cholangiocarcinoma associated with
PSC
what disease is HCC associated with
PBC
causes / rf of hiatal hernia
Lifting heavy weights
Previous abdominal surgery
Chronic cough
Straining whilst defecating
What causes median arcuate ligament syndrome (MALS)
Compression of the coeliac artery
5 causes of HCC
*Alcohol
* Fatty liver
* Haemochromatosis
* Wilson’s disease
*hepatitis
pathophysiology of hepatitis
Something causes liver injury, which leads to activation of the inflammatory response:
o infiltration of inflammatory cells and liver cell necrosis
o if this is chronic it can lead to progressive fibrosis and cirrhosis à chronic liver disease
initial causes of liver injury:
- infection (bacterial/viral/parasite),
- medications
- alcohol
- non-alcoholic fatty liver disease
- autoimmune.
treatment for ruptured appendix
urgent surgery to remove the ruptured appendix and to clean out the cavity
(peritoneal lavage).
- IV antibiotics for at least a few days after the surgery, then they will require 2-4 weeks of oral antibiotics.
where are keyser flecihner rings
Build-up of copper in the iris
clinical features of PBC
Pruritus, with or without jaundice is the most common presenting complaint
* Hepatosplenomegaly
* Xanthelasma
* Raised serum alkaline phosphatase or autoantibodies
* Steatorrhea
* Malabsorption of fat-soluble vitamins
FIRST LINE MANAGEMNT FOr paracetamol overdose
N-acetyl-cysteine AND activated charcoal within 1 hr of ingested substance
immediate management for ruptured oesophageal varices
ABCDE
BP is low so need to improve with IV
access and fluid resuscitation
bloods for ruptured oesophageal varices
Anaemia, (Low ferritin, Low Hb). Raised bilirubin.
Low albumin.
Raised ALT, AST and ALP.
High creatinine.
Increased prothrombin time
methods of spreads of all hepaitis
a & e- oral
b,c,d - percutaneous/permucosal
which hepaitis has a vaccien in uk
hep b
what disease has positive murphs sign
acute cholecystitis
