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Hepatology > Phtn First 6 Only > Flashcards

Phtn First 6 Only Flashcards

1
Q

When is hematemis is emergency

A

When the liver is the cause of

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2
Q

P htn triad

A

Splenomegaly الاهم
Ascites
Hematemsis الاخطر

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3
Q

Contra of vasopressin

A

Preg
Hf

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4
Q

Bud chiari triad

A

Pain
Rapid filling ascites
Jaundice

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5
Q

Liver biospsy is done after

A

Correction of coagulapthy when pt more 60%q

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6
Q

Whcich is more compication sclerotherapy or ligation for esophageal varices

A

Sclerotherapy

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7
Q

Metion surgical measures of portal htn and prefered use

A

Porto systemc shunt for pre-hepatic causes
Tipss for hepatic causes
Liver transplantion end stage liver dx

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8
Q

What are the potential complications of esophageal varices?

A

Complications include hematemesis (vomiting of blood), which can be life-threatening, and anemia due to chronic blood loss.

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9
Q

Describe the treatment options for esophageal varices.

A

Treatment includes beta-blockers to reduce portal pressure, endoscopic band ligation, and in severe cases, transjugular intrahepatic portosystemic shunt (TIPS) or surgery.

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10
Q

What investigations are recommended for diagnosing portal hypertension?

A

Investigations include ultrasound with Doppler, CT or MRI of the abdomen, endoscopy to detect varices, and liver function tests.

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11
Q

What are the causes of ascites in liver disease?

A

Causes include portal hypertension, hypoalbuminemia, and sodium retention due to liver dysfunction.

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12
Q

How is ascites managed in patients with liver disease?

A

Management includes sodium restriction, diuretics (e.g., spironolactone), paracentesis for symptomatic relief, and treatment of the underlying liver disease.

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13
Q

What are the prehepatic causes of portal hypertension?

A

Prehepatic causes include portal vein thrombosis and splenic vein thrombosis.

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14
Q

What are the hepatic causes of portal hypertension?

A

Hepatic causes include cirrhosis, hepatitis, and hepatic fibrosis.

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15
Q

What are the posthepatic causes of portal hypertension?

A

Posthepatic causes include Budd-Chiari syndrome and right-sided heart failure.

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16
Q

What is the significance of caput medusae in portal hypertension?

A

Caput medusae refers to dilated periumbilical veins and is a sign of severe portal hypertension.

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17
Q

What is the role of albumin in managing ascites?

A

Albumin helps maintain oncotic pressure and can be used in conjunction with paracentesis to prevent circulatory dysfunction.

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18
Q

What are the indications for a transjugular intrahepatic portosystemic shunt (TIPS)?

A

Indications include refractory ascites, recurrent variceal bleeding, and hepatorenal syndrome.

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19
Q

What are the complications of TIPS?

A

Complications include hepatic encephalopathy, shunt stenosis, and infection.

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20
Q

What is hepatorenal syndrome, and how is it managed?

A

Hepatorenal syndrome is a type of kidney failure in patients with severe liver disease. Management includes albumin infusion, vasoconstrictors (e.g., terlipressin), and liver transplantation.

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21
Q

What are the common causes of hematemesis in liver disease?

A

Common causes include bleeding from esophageal varices, gastric ulcers, and portal hypertensive gastropathy.

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22
Q

What is the management of acute variceal bleeding?

A

Management includes resuscitation, vasoactive drugs (e.g., octreotide), endoscopic therapy, and antibiotics to prevent infection.

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23
Q

What is the role of beta-blockers in preventing variceal bleeding?

A

Beta-blockers reduce portal pressure and are used for primary and secondary prevention of variceal bleeding.

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24
Q

What are the signs of chronic liver disease on physical examination?

A

Signs include jaundice, spider angiomas, palmar erythema, ascites, and caput medusae.

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25
Q

What are the laboratory findings in chronic liver disease?

A

Findings include elevated liver enzymes, low albumin, prolonged prothrombin time, and thrombocytopenia.

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26
Q

What is the significance of thrombocytopenia in liver disease?

A

Thrombocytopenia is often due to splenomegaly and decreased production of thrombopoietin by the liver.

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27
Q

What are the causes of pancytopenia in liver disease?

A

Causes include hypersplenism, bone marrow suppression, and nutritional deficiencies.

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28
Q

What is the management of hypersplenism in liver disease?

A

Management focuses on treating the underlying liver disease. In severe cases, splenectomy may be considered.

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29
Q

What are the complications of cirrhosis?

A

Complications include portal hypertension, ascites, hepatic encephalopathy, hepatorenal syndrome, and hepatocellular carcinoma.

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30
Q

What is hepatic encephalopathy, and how is it managed?

A

Hepatic encephalopathy is a neuropsychiatric complication of liver disease. Management includes lactulose, rifaximin, and treatment of precipitating factors.

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31
Q

What are the precipitating factors for hepatic encephalopathy?

A

Factors include infection, gastrointestinal bleeding, electrolyte imbalances, and constipation.

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32
Q

What is the role of lactulose in hepatic encephalopathy?

A

Lactulose reduces ammonia absorption in the gut and is used to treat and prevent hepatic encephalopathy.

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33
Q

What are the indications for liver transplantation in cirrhosis?

A

Indications include decompensated cirrhosis, hepatocellular carcinoma within Milan criteria, and acute liver failure.

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34
Q

What are the contraindications for liver transplantation?

A

Contraindications include active infection, severe cardiopulmonary disease, and extrahepatic malignancy.

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35
Q

What is the MELD score, and how is it used in liver transplantation?

A

The MELD score predicts survival in patients with liver disease and is used to prioritize patients for liver transplantation.

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36
Q

What are the common causes of hepatocellular carcinoma (HCC)?

A

Common causes include chronic hepatitis B and C, alcoholic liver disease, and non-alcoholic steatohepatitis (NASH).

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37
Q

What are the screening recommendations for hepatocellular carcinoma?

A

Screening includes ultrasound every 6 months in patients with cirrhosis or chronic hepatitis B.

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38
Q

What are the treatment options for hepatocellular carcinoma?

A

Treatment options include surgical resection, liver transplantation, radiofrequency ablation, and systemic therapies like sorafenib.

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39
Q

What is the significance of alpha-fetoprotein (AFP) in hepatocellular carcinoma?

A

AFP is a tumor marker used in the diagnosis and monitoring of hepatocellular carcinoma.

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40
Q

What are the common causes of acute liver failure?

A

Causes include viral hepatitis, drug-induced liver injury (e.g., acetaminophen), and autoimmune hepatitis.

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41
Q

What is the management of acute liver failure?

A

Management includes supportive care, treatment of the underlying cause, and consideration for liver transplantation.

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42
Q

What are the signs of acute liver failure?

A

Signs include jaundice, coagulopathy, encephalopathy, and hypoglycemia.

43
Q

What is the role of N-acetylcysteine in acute liver failure?

A

N-acetylcysteine is used as an antidote for acetaminophen overdose and may have benefits in other causes of acute liver failure.

44
Q

What are the common causes of chronic hepatitis B?

A

Causes include perinatal transmission, unsafe injection practices, and unprotected sex.

45
Q

What is the management of chronic hepatitis B?

A

Management includes antiviral therapy (e.g., tenofovir, entecavir), regular monitoring, and vaccination of close contacts.

46
Q

What are the complications of chronic hepatitis B?

A

Complications include cirrhosis, hepatocellular carcinoma, and liver failure.

47
Q

What is the significance of HBeAg in chronic hepatitis B?

A

HBeAg indicates active viral replication and infectivity in chronic hepatitis B.

48
Q

What are the common causes of chronic hepatitis C?

A

Causes include injection drug use, unsafe medical practices, and blood transfusions before 1992.

49
Q

What is the management of chronic hepatitis C?

A

Management includes direct-acting antiviral agents (e.g., sofosbuvir, ledipasvir) and regular monitoring.

50
Q

What are the complications of chronic hepatitis C?

A

Complications include cirrhosis, hepatocellular carcinoma, and liver failure.

51
Q

What is the significance of HCV RNA in chronic hepatitis C?

A

HCV RNA is used to diagnose active infection and monitor response to treatment.

52
Q

What are the common causes of alcoholic liver disease?

A

Causes include chronic alcohol abuse, genetic predisposition, and nutritional deficiencies.

53
Q

What is the management of alcoholic liver disease?

A

Management includes abstinence from alcohol, nutritional support, and treatment of complications like cirrhosis.

54
Q

What are the complications of alcoholic liver disease?

A

Complications include alcoholic hepatitis, cirrhosis, and hepatocellular carcinoma.

55
Q

What is the significance of AST:ALT ratio in alcoholic liver disease?

A

An AST:ALT ratio greater than 2:1 is suggestive of alcoholic liver disease.

56
Q

What are the common causes of non-alcoholic fatty liver disease (NAFLD)?

A

Causes include obesity, diabetes, hyperlipidemia, and metabolic syndrome.

57
Q

What is the management of non-alcoholic fatty liver disease?

A

Management includes lifestyle modifications (diet, exercise), control of metabolic risk factors, and monitoring for disease progression.

58
Q

What are the complications of non-alcoholic fatty liver disease?

A

Complications include non-alcoholic steatohepatitis (NASH), cirrhosis, and hepatocellular carcinoma.

59
Q

What is the significance of liver biopsy in non-alcoholic fatty liver disease?

A

Liver biopsy is the gold standard for diagnosing NASH and assessing fibrosis.

60
Q

What are the common causes of autoimmune hepatitis?

A

Causes include genetic predisposition, environmental triggers, and immune dysregulation.

61
Q

What is the management of autoimmune hepatitis?

A

Management includes immunosuppressive therapy (e.g., prednisone, azathioprine) and regular monitoring.

62
Q

What are the complications of autoimmune hepatitis?

A

Complications include cirrhosis, liver failure, and hepatocellular carcinoma.

63
Q

What is the significance of autoantibodies in autoimmune hepatitis?

A

Autoantibodies like ANA, SMA, and anti-LKM1 are used in the diagnosis of autoimmune hepatitis.

64
Q

What are the common causes of primary biliary cholangitis (PBC)?

A

Causes include autoimmune destruction of intrahepatic bile ducts, genetic predisposition, and environmental factors.

65
Q

What is the management of primary biliary cholangitis?

A

Management includes ursodeoxycholic acid (UDCA), obeticholic acid, and liver transplantation in advanced cases.

66
Q

What are the complications of primary biliary cholangitis?

A

Complications include cirrhosis, portal hypertension, and hepatocellular carcinoma.

67
Q

What is the significance of anti-mitochondrial antibodies (AMA) in primary biliary cholangitis?

A

AMA is a hallmark serological marker for primary biliary cholangitis.

68
Q

What are the common causes of primary sclerosing cholangitis (PSC)?

A

Causes include autoimmune processes, genetic predisposition, and association with inflammatory bowel disease.

69
Q

What is the management of primary sclerosing cholangitis?

A

Management includes ursodeoxycholic acid, endoscopic therapy for strictures, and liver transplantation in advanced cases.

70
Q

What are the complications of primary sclerosing cholangitis?

A

Complications include cholangiocarcinoma, cirrhosis, and liver failure.

71
Q

What is the significance of MRCP in primary sclerosing cholangitis?

A

MRCP is used to visualize bile duct abnormalities and diagnose primary sclerosing cholangitis.

72
Q

What are the common causes of hemochromatosis?

A

Causes include genetic mutations (e.g., HFE gene), excessive iron intake, and chronic liver disease.

73
Q

What is the management of hemochromatosis?

A

Management includes phlebotomy, iron chelation therapy, and treatment of complications like cirrhosis.

74
Q

What are the complications of hemochromatosis?

A

Complications include cirrhosis, diabetes, cardiomyopathy, and hepatocellular carcinoma.

75
Q

What is the significance of transferrin saturation in hemochromatosis?

A

Elevated transferrin saturation is a key diagnostic finding.

76
Q

What is the significance of transferrin saturation in hemochromatosis?

A

Elevated transferrin saturation is a key diagnostic finding in hemochromatosis.

77
Q

What are the common causes of Wilson’s disease?

A

Causes include genetic mutations (e.g., ATP7B gene), leading to copper accumulation in the liver and other organs.

78
Q

What is the management of Wilson’s disease?

A

Management includes copper chelation therapy (e.g., penicillamine, trientine), zinc supplementation, and liver transplantation in severe cases.

79
Q

What are the complications of Wilson’s disease?

A

Complications include cirrhosis, neurological symptoms, and psychiatric disorders.

80
Q

What is the significance of ceruloplasmin in Wilson’s disease?

A

Low ceruloplasmin levels are a hallmark of Wilson’s disease.

81
Q

What are the common causes of alpha-1 antitrypsin deficiency?

A

Causes include genetic mutations leading to abnormal alpha-1 antitrypsin production and accumulation in the liver.

82
Q

What is the management of alpha-1 antitrypsin deficiency?

A

Management includes avoiding smoking, augmentation therapy, and liver transplantation in severe cases.

83
Q

What are the complications of alpha-1 antitrypsin deficiency?

A

Complications include emphysema, cirrhosis, and hepatocellular carcinoma.

84
Q

What is the significance of alpha-1 antitrypsin levels in diagnosis?

A

Low serum levels of alpha-1 antitrypsin are diagnostic for the deficiency.

85
Q

What are the common causes of Budd-Chiari syndrome?

A

Causes include hepatic vein thrombosis, hypercoagulable states, and myeloproliferative disorders.

86
Q

What is the management of Budd-Chiari syndrome?

A

Management includes anticoagulation, thrombolysis, and transjugular intrahepatic portosystemic shunt (TIPS) or liver transplantation in severe cases.

87
Q

What are the complications of Budd-Chiari syndrome?

A

Complications include liver failure, portal hypertension, and hepatocellular carcinoma.

88
Q

What is the significance of Doppler ultrasound in Budd-Chiari syndrome?

A

Doppler ultrasound is used to detect hepatic vein thrombosis and assess blood flow.

89
Q

What are the common causes of portal vein thrombosis?

A

Causes include hypercoagulable states, abdominal infections, and cirrhosis.

90
Q

What is the management of portal vein thrombosis?

A

Management includes anticoagulation, thrombolysis, and treatment of underlying causes.

91
Q

What are the complications of portal vein thrombosis?

A

Complications include portal hypertension, variceal bleeding, and mesenteric ischemia.

92
Q

What is the significance of CT angiography in portal vein thrombosis?

A

CT angiography is used to visualize the thrombus and assess the extent of thrombosis.

93
Q

What are the common causes of hepatic encephalopathy?

A

Causes include liver failure, portosystemic shunts, and precipitating factors like infection or gastrointestinal bleeding.

94
Q

What is the management of hepatic encephalopathy?

A

Management includes lactulose, rifaximin, and treatment of precipitating factors.

95
Q

What are the complications of hepatic encephalopathy?

A

Complications include coma, brain edema, and death in severe cases.

96
Q

What is the significance of ammonia levels in hepatic encephalopathy?

A

Elevated ammonia levels are associated with hepatic encephalopathy, though levels do not always correlate with severity.

97
Q

What are the common causes of hepatorenal syndrome?

A

Causes include advanced liver disease, portal hypertension, and renal vasoconstriction.

98
Q

What is the management of hepatorenal syndrome?

A

Management includes albumin infusion, vasoconstrictors (e.g., terlipressin), and liver transplantation.

99
Q

What are the complications of hepatorenal syndrome?

A

Complications include acute kidney injury, multi-organ failure, and death.

100
Q

What is the significance of creatinine levels in hepatorenal syndrome?

A

Elevated creatinine levels indicate renal dysfunction in hepatorenal syndrome.

101
Q

What are the common causes of hepatocellular carcinoma?

A

Causes include chronic hepatitis B and C, alcoholic liver disease, and non-alcoholic steatohepatitis (NASH).

102
Q

What is the management of hepatocellular carcinoma?

A

Management includes surgical resection, liver transplantation, radiofrequency ablation, and systemic therapies like sorafenib.

103
Q

What are the complications of hepatocellular carcinoma?

A

Complications include liver failure, metastasis, and death.

Hepatology (5 decks)

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