Professor Russell Tutorial

Question 1

What is a clinical sign of hepatoma?

Answer 1

Occasionally a systolic arterial bruit is heard over the liver as the hepatoma is highly vascular

Question 2

What finding on Fe studies is diagnostics for haemochromatosis?

Answer 2

A transferrin saturation of >65%

Question 3

What is the diagnostic test for hepatocellular carcinoma?

Answer 3

Serum alpha-fetoprotein may be raised (but is normal within 1/3 of patients)

Question 4

What are the mainstays of treatment for hepatocellular carcinoma?

Answer 4

Surgical resection if possible

Liver transplantation

Chemoembolisation or embolisation alone

Question 5

What is diaphoresis?

Answer 5

Perspiration or profuse sweating

Question 6

What are the signs of acute hepatitis?

Answer 6

Metabolic flap (asterixis)

Foetor hepaticus

Jaundice

Disorientation, drowsiness

Ascites

Right hypochrondrium pain

Question 7

What is Budd-Chiari syndrome? What are some causes of Budd-Chiari syndrome?

Answer 7

Obstruction of the venous outflow of the liver due to occlusion of the hepatic vein.

1/3 of cases unknown cause, other causes include: hypercoagulability states; polycythaemia vera, OCP, leukaemia

Question 8

When does leukonychia occur (biochemistry wise)

Answer 8

Serum albumin <25g/L

Question 9

What clotting factors are produced by the liver?

Answer 9

Factors II, VII, IX and X

Question 10

What is Wilson’s disease?

Answer 10

A rare inborn error of copper metabolism that results in copper deposition in various organs (liver, basal ganglia and cornea)

Defect in copper-transporting ATPase

Question 11

What are the six extragastrointestinal sites of IBD manifestation?

Answer 11

Eyes

Skin

Joints - axial or peripheral

Liver

Brain

Kidneys

Question 12

What are some the 10 causes of colitis?

Answer 12

Crohn’s

UC

NSAIDs

Infection - C. diff, Shigella, Salmonella, campylobacter, Entamoeba histolytica, giarrdia, cryptosporidium, CMV

Radiotherapy

Collagenous colitis

OCP

Vasculitis

CAPs

Ischaemic