Specific Causes of Cirrhosis Flashcards

1
Q

Alcoholic Liver Disease The most accurate

test

A

liver biopsy.

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2
Q

Alcoholic Liver Disease Labs

A

greater elevation in AST
compared to ALT
drinking
gives a sudden rise in GGTP.

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3
Q

Primary Biliary Cholangitis (PBC) CxFx

“most likely diagnosis”=

A
“most likely diagnosis”=
Woman in 40s or 50s
Fatigue and itching
Jaundice
hepato-splenomegaly
Normal bilirubin with an elevated alkaline phosphatase
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4
Q

Primary Biliary Cholangitis (PBC) Most unique features

A

Xanthelasma/xanthoma

Osteoporosis

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5
Q

Primary Biliary Cholangitis (PBC) most accurate test.

A

liver biopsy

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6
Q

Primary Biliary Cholangitis (PBC) The most accurate blood test

A

antimitochondrial antibody.

N.B: Bilirubin and IgM levels do not elevate until the
disease is very far advanced.

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7
Q

Primary Biliary Cholangitis (PBC) tx

A

ursodeoxycholic acid OR

obeticholic acid that decreases fibrosis.

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8
Q

Primary Sclerosing Cholangitis asoc.!

A

80% of them w inflammatory bowel disease.

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9
Q

Primary Sclerosing Cholangitis Cx Fx

A

Signs of cholestasis: like Jaundice and Pruritus

Symptoms of chronic IBD

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10
Q

Primary Sclerosing Cholangitis lab test show:
alkaline phosphatase
GGTP
bilirubin level

A

Elevated alkaline phosphatase and GGTP as well as elevated bilirubin level

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11
Q

Primary Sclerosing Cholangitis most accurate test

A

MRCP or ERCP that shows **beading, narrowing, or **strictures in the biliary system

Liver biopsy is:
Not an essential part of the workup; usually done if small duct PSC is suspected

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12
Q

Primary Sclerosing Cholangitis tx

A

cholestyramine or ursodeoxycholic acid, the same as PBC

THO if there is IBD, it wont improve EVEN after colectomy. Transplant when needed

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13
Q

Alpha 1-Antitrypsin Deficiency CxFx

A

liver disease + emphysema (COPD)+ young

patient <40) and NONsmoker

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14
Q

Alpha 1-Antitrypsin Deficiency Hx

A

family history of

COPD at an early age.

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15
Q

Alpha 1-Antitrypsin Deficiency tx

A

replacing the enzyme. tho onlmed says u can do transplant

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16
Q

Hemochromatosis Patho

A

genetic disorder leading to overabsorption of iron in the duodenum.
The mutation is the C282y gene.

17
Q

Hemochromatosis epidem

A

Men present earlier than women because menstruation delays the onset of liver
fibrosis and cirrhosis.

Look for a patient in his 50s

18
Q

Hemochromatosis lab tests

A

mildly
abnormal liver function tests (LFTs), alkaline
phosphatase,
or iron levels.

19
Q

Hemochromatosis Cx Fx

A
Fatigue and joint pain (pseudogout)
Erectile dysfunction in men, and amenorrhea in women (from pituitary
involvement)
Skin darkening
Diabetes
Cardiomyopathy
20
Q

Hemochromatosis asoc. infections

A

Vibrio vulnificus, (it is killed by normal human blood but grows rapidly in blood from patients with hemochromatosis)

Yersinia, and Listeria

21
Q

Hemochromatosis best initial test

A

iron studies that show:

Increased serum iron and ferritin
Decreased iron binding capacity

22
Q

Hemochromatosis most accurate test

A

liver biopsy for increased iron BUT

MRI and HFE (C282y) gene testing can be done instead!!!!!

23
Q

Hemochromatosis Cardio tests

A

EKG may show
conduction defects and the echocardiogram can show dilated or restrictive
cardiomyopathy.

24
Q

Hemochromatosis Treatment

A

Phlebotomy is clearly the best therapy for those with overabsorption of iron. this can prevent cirrhosis!

25
transferrin saturation= (formula)
(iron divided by TIBC)
26
Iron chelation therapy is used in hemochromatosis for those who:
1.- Cannot be managed with phlebotomy 2.- Are anemic and have hemochromatosis from overtransfusion such as thalassemia
27
Iron chelation agentes
Deferasirox and deferiprone PO, acutelly Deferoxamine has to be given lifelong by injection. DElete the IRON si? ROXanne Delete the Iron PROffesional DElete the IRON of MINE
28
Alpha 1-Antitrypsin Deficiency Dx
Serum: decreased antitrypsin protein levels ``` Bx shows (Periodic acid–Schiff stain) PAS + macrophages might be definitive ```
29
PSC sclerosis colangitis is asoc w
Ucerative colitis or IBD in general
30
PSC sclerosis colangitis epidem and CxFx n patho
man 30-50y. (sons of bitches) pruritus + jaundice extrahepatic ducts
31
PSC sclerosis colangitis first test and BX
MRCP:shows beads on a strain | bx shows onion skin fibrosis
32
PSC sclerosis colangitis tx
NO STENT transplant ursodeoxicholic? acid while waiting for transplant
33
PBC epidemiology and location of the lession
women . | intrahepatic ducts