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Clin med A 2 > Trigger - LIver 1 > Flashcards

Trigger - LIver 1 Flashcards

1
Q

what is the result of accumulation of bile salts in liver disease

A

pruritus

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2
Q

what is the result of the excess estrogen seen in liver disease

A

spider nevi and palmar erythema

also menstrual irregularities in women

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3
Q

impaired cholesterol synthesis seen in liver disease results in what

A

testicular atrophy and gynecomastia in males

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4
Q

symptoms include confusion, tremor, coma

A

hepatic encephalopathy d/t build up of ammonia

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5
Q

AST>ALT OF >2

A

Chronic alcoholic liver disease

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6
Q

AST>ALT of 1-1.99

A

chronic NASH/ non alcoholic cirrhosis

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7
Q

ALP>4x UNL

A

hepatic cholestasis

less than 4x is non hepatic/non cholestatic cause

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8
Q

elevated ALP and GGT

A

hepatobilliary obstruction

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9
Q

first enzyme to rise in obstructive billiary disease

A

ALP

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10
Q

elevated GGT but normal ALP

A

alcohol/medication

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11
Q

elevated AST/ALT compared to ALP
elevated total billirubin
elevated direct billirubin
normal GGT

A

hepatocellular damage

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12
Q

elevated ALP compared to AST/ALT
elevated GGT
elevated or normal total bilirubin
elevated direct bilirubin

A

obstructive disease of the liver

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13
Q

albumin and PT are markers of what

A

synthetic hepatic function

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14
Q

elevated serum globulin levels

A

autoimmune hepatitis

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15
Q

MC in young to middle aged women

A

autoimmune hepatitis

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16
Q

insidious onset of fulminant hepatitis after viral illness, drug exposure or postpartum

A

autoimmune hepatitis

  • otherwise healthy person w spider nevi, cutaneous striae, acne and hepatomegaly
  • may have arthritis/thyroiditis or other auto conditions
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17
Q

otherwise healthy person w spider nevi, cutaneous striae, acne and hepatomegaly

A

autoimmune hepatitis

  • insidious onset of fulminant hepatitis after viral illness, drug exposure or postpartum
  • may have arthritis/thyroiditis or other auto conditions
18
Q

AST/ALTRR elevations of 1.5x-50x ULN
elevated total bilirubin

A

autoimmune hepatitis

also see:
Elevated ANA
PANCA
Anti-SLA

19
Q

occasionally co-exists w primary biliary cirrhosis or sclerosing choalngitis

A

autoimmune hepatitis

20
Q

Tx w prednisone +/- azothiaprine

A

autoimmune hepatitis

liver transplant is last resort

21
Q

NV, diaphoresis, pallor, lethargy and malaise w normal lab findings

A

stage 1 of acetaminophen induced hepatitis

22
Q

RUQ pain w hepatomegaly and tenderness.
ALT>AST elevation.
PT elevated
Bilirubin elevated

A

stage 2 acetaminophen induced hepatitis

23
Q

AST/ALT > 10k
Prolong PT/INR
Hyperammonemia
Hypoglycemia

A

stage 3 acetaminophen induced hepatitis.

also see reappearance of stage 1 s/s with hepatic encephalopathy. acute renal failure, multi organ failure and death can occur

24
Q

NV, diaphoresis, pallor, lethargy and malaise w proolonged PT/INR, AST/ALT >10 and hypoglycemia

A

stage 3 acetaminophen induced hepatitis

also see hyperammonemia
acute renal failre
death

25
Q

treat with N-acetylcysteine or activated charcoal

A

acetaminophen induced hepatitis

26
Q

macrocytic anemia

A

steatohepatitis

also see mild AST/ALT elevations

27
Q

AST/ALT elevations
hypoalbuminemia
anemia

A

alcoholic cirrhosis

also see:
- elevated total bilirubin >10
- PT/INR prolongation
- later on see lyte abnorm and elevated BUN Cr

28
Q

Biopsy showing macrovesicular fat and PMN infiltration with hepatic necrosis

A

definitive diagnosis for alcoholic liver disease

29
Q

Treat with methylprednisolone

A

alcoholic hepatitis

if severe can use pentoxifyline

30
Q

tx with pentoxifylline

A

alcoholic hepatitis (severe)

normal tx w methylprednisolone

31
Q

MC risk factor is obesity

A

NA fatty liver disease

32
Q

tx includes Vit E and TZDs

A

Non alcoholic fatty liver disease

also use metformin and weight loss agents

33
Q

tx inludes metformin and weight loss agents

A

non alcoholic fatty liver disease

also includes Vit E and TZDs

34
Q

liver w fibrosis and nodules

A

cirrhosis

35
Q

ascities with Worsening abd pain, Fever and Leukocytosis

A

bacterial peritonitis (caused by e coli)

36
Q

tx w cefotaxime

A

bacterial peritonitis

treat prophylactically w FQs

37
Q

treat with oral flouroquinolones

A

prophylaxis of bacterial peritonitis

tx for bacterial peritonitis is cefotaxime ( caused by ecoli)

38
Q

tx includes dereasing protein and taking lactulose

A

hepatic encephalotpathy

also take abx such as rifamixin or metro

39
Q

tx includes rifaximin or metro

A

hepatic encephalopathy

also:
eat less protein
take lactulose to metabolize ammonia

refiaxiMIN because you MINIMIZE ammonia build up

40
Q

coffee, tea and statins

A

reduce risk of rapid decompensation from cirrrhosis

41
Q

didnt do the last like 10 cards

A

Clin med A 2 (30 decks)

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