Steotic Liver Disease Flashcards
Fat accumulation in the form of TGs within the liver
MASLD
A fat accumulation of >___% of the weight of the liver is needed for diagnosis
5
What are 2 risk factors for MASLD?
- Obesity
- Insulin resistance
The progression of MASH generally occurs when?
Over time if lifestyle modification is ineffective
MASH and MASLD combined are now the ____ cause of liver disease
1
What drug class is used to manage MASLD/MASH?
Statins
What 2 drugs are used to treat MASLD/MASH?
- Atorvastatin
- Pravastatin
What lifestyle modification can be utilized to manage MASLD/MASH?
Weight loss of 10%
What are the 2 types of drug induced liver disease?
- Intrinsic
- Idiopathic
What type of drug induced liver disease is dose dependent?
Intrinsic
What type of drug induced liver disease is usually caused by an allergic reaction?
Idiopathic
What 3 physical findings are used for a diagnosis of exclusion?
- Rash
- Fever
- Signs of chronic liver disease
What is the most common cause of drug induced liver injury?
Acetaminophen
What does acetaminophen have a direct toxic effect on?
Hepatocytes
What metabolite is the hepatotoxic metabolite?
NAPQI
What is the antidote for a Tylenol overdose?
N-acetylcysteine
What 4 drugs are considered Idiopathic?
- Augmentin
- NSAIDs
- Phenytoin
- Nitrofurantoin
What 4 drugs are considered intrinsic?
- Isoniazid
- Valproate
- Azothioprine
- Amiodarone
What organ does amiodarone not effect?
Kidneys
What drug class is 2nd to Tylenol in drug related hepatotoxicity?
Herbals and dietary supplements
What are anabolic steroids associated with?
Prolonged jaundice
Inherited disorder due to high rates of blood transfusions
Hemochromatosis
When is hemochromatosis asymptomatic until?
90% of the liver has iron deposition
What 2 ways can you manage hemochromatosis?
- Weekly phlebotomy
- In sickle cell disease: iron chelation therapy
What metal accumulates with Wilson’s disease?
Copper
What is a sign of Wilson’s disease?
Kayser-Fleischer rings
How would you treat Wilson’s disease?
- Copper chelation therapy
- Penicillamine or trientine
Fulminant liver failure has an acute onset of _______ and impaired ________?
Encephalopathy; synthetic function
What is the most common precipitating factor of fulminant liver failure?
APAP Toxicity
What is fulminant liver failure not usually caused by?
Alcohol
How would you treat fulminant liver failure?
Remove the offending cause
What is listing on the transplant list dependent on?
MELD score
What are 2 contraindications for a liver transplant?
- Life threatening systemic disease
- Active drug and alcohol abuse
What are 4 relative contraindications for a liver transplant?
- HIV
- > 70
- Portal vein thrombosis
- Severe hypoxia
If you get a liver from a living donor, what part of the liver is donated?
Left lobe