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GI > Week 6 Part 2 > Flashcards

Week 6 Part 2 Flashcards

1
Q

What is the definition of chronic liver disease?

A

Liver disease that lasts longer than 6 months

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2
Q

What does chronic liver cirrhosis progress to?

A

Cirrhosis

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3
Q

What is the 2 hit hypothesis for NAFLD?

A

1st - Excess fat accumulation

2nd - Intrahepatic oxidative stress, lipid peroxidation, TNF-alpha, cytokine cascade

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4
Q

What are some of the associated conditions with NAFLD?

A

Type II diabetes

Obesity

Triglycerides

Hypertension

HDL cholesterol

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5
Q

How is simple steatosis diagnosed?

A

Ultrasound

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6
Q

What is the treatment for NAFLD?

A

Weight loss and exercise

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7
Q

How is NASH diagnosed?

A

Liver biopsy

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8
Q

A 45 year old woman comes into your clinic complaining of tiredness. She has also noticed that she has a full body itch but no rash. On examination there are no real findings a part from xanthesalmas. What is your differential?

A

Primary biliary cirrhosis

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9
Q

What is the treatment for Primary Biliary Cirrhosis?

A

Urseo-deoxycholic acid

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10
Q

HLA-DR3 and HLA-DR4 are predisoposers to what condition?

A

Auto-immune hepatitis

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11
Q

What is the treatment for autoimmune hepatitis?

A

Corticosteroids

Azathioprine

e.g. prednisolone + azathioprine

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12
Q

What condition gives an increased risk of developing cholangiocarcinoma and colo-rectal cancer?

A

Primary sclerosing cholangitis

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13
Q

If a patient has piecemeal necrosis and lobular involvement with numerous plasma cells, what do they have?

A

Chronic hepatitis

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14
Q

If a patient comes in with raised AST and ALT levels and IgG with the presence of autoimmune antibodies, what do they have?

A

Autoimmune hepatitis

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15
Q

How would you diagnose autoimmune hepatitis?

A

Bloods
Serology
Liver biopsy

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16
Q

How is primary sclerosing cholangitis diagnosed?

A

MRCP or ERCP

imaging of the biliary tree

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17
Q

What is the treatment for primary sclerosing cholangitis?

A

Maintain bile flow, monitor for cholangiocarcinoma and colo-rectal cancer

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18
Q

What gene mutations predispose to haemochromatosis?

A

C282Y
H63D
HFE mutations

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19
Q

What type of patient is known as the ‘bronzed diabetic’?

A

Haemochromatosis patient

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20
Q

What is the treatment for haemochromatosis?

A

Venesection

removing blood

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21
Q

What is the treatment for Wilson’s disease?

A

Copper chelation drugs

22
Q

A 20yr old smoker has developed COPD which is continuing to worsen. What do they have?

A

Alpha-1-antitrypsin deficiency

23
Q

What is Budd-Chiari syndrome?

A

Thrombosis of the hepatic veins, leading to reduced blood flow to the liver causing:
Acutely: Jaundice + hepatomegaly

Chronically: ascites

24
Q

What is the treatment for Budd-Chiari syndrome?

A

Recanalization or TIPS

25
Q

What does methotrexate do; what does it do to the liver and why does it have to be monitored?

A

Used for rheumatoid arthritis andpsoriasis

Progressive fibrosis of the liver

26
Q

What makes up the portal system/portal vein?

A

Superior mesenteric

Splenic vein

Gastric

Part from inferior mesenteric

27
Q

Where does the portal vein carry outflow from?

A

Spleen

Oesphagus

Stomach

Pancreas

Small and large intestines

28
Q

What is pre-hepatic portal hypertension due to?

A

Thrombosis or occlusion of the portal vein before the liver due to a thrombosis or abnormality

29
Q

What is intra-hepatic portal hypertension?

A

Due to distortion of the liver architecture

e.g. Budd Chiari syndrome

30
Q

What are some clinical signs of compensated cirrhosis?

A

Spider naevi

Palmar erythema

Clubbing

Gynaecomastia

Hepatomegaly

Spleenomegaly

or none

31
Q

What are some signs of decompensated cirrhosis?

A

Jaundice

Ascites

Encephalopathy

Bruising

32
Q

What is the nutritional treatment for decompensated cirrhosis?

A

Small frequent meals to reduce fasting gluconeogenesis and muscle catabolism

33
Q

What is the difference between compensated cirrhosis and decompensated cirrhosis?

A

Compensated - usually clinical finding, incidental, lab test abnormalities etc

Decompensated - Liver failure

34
Q

What is the treatment for ascites?

A

Improve underlying liver disease

Look for and treat any infections

No NSAIDS

Reduce salt intake

Diuretics - spironolactone

Paracentesis

35
Q

What does TIPS stand for?

A

Trans-jugular Intra-hepatic Porto-system Shunt

36
Q

In hepatitis B, what causes liver damage?

A

Antiviral immune response

37
Q

What is a councilman body?

A

Cell that represents a dying hepatocyte

38
Q

Which biliary condition is associated with females?

Which with males?

A

Primary Biliary Cirrhosis

Primary Sclerosing Cholangitis

39
Q

Which biliary condition is associated with autoantibodies to mitochondria?

A

Primary biliary cirrhosis

40
Q

How is primary biliary cirrhosis staged?

A

Biopsy

41
Q

What biliary condition is associated with Ulcerative Colitis?

A

Primary sclerosing cholangitis

42
Q

What liver storage disease causes cytoplasmic globules of unsecreted globules of protein in liver cells?

A

Alpha-1-antitrypsin deficiency

43
Q

What is cholelithiasis?

A

Gallstones

44
Q

What makes up normal bile?

A

Micelles of cholesterol

Phospholipids

Bile salts

Bilirubin

45
Q

Where is bile released into the duodenum?

A

Through the ampulla of Vater (controlled by the sphincter of Oddi)

46
Q

What is a common component of gallstones?

A

Cholesterol

47
Q

What is cholecystitis?

A

Inflammation of the gallbladder

48
Q

What conditions increase the risk of cholangiocarcinoma (carcinoma of the bile ducts)

A

Ulcerative colitis

Primary sclerosing cholangitis

49
Q

An elevated serum amylase and sudden onset abdominal pain is a sign of what?

A

Acute pancreatitis

50
Q

What are the causes of acute pancreatitis?

A 
GET SMASHED
Gallstones
Ethanol
Trauma
Steroids
Mumps
Autoimmune
Scorpion bites/stings
51
Q

What do lipases do to the pancreas to cause acute pancreatitis?

A

Intra- and peripancreatic fat necrosis

52
Q

What do proteases do to cause acute pancreatitis?

A

Tissue destruction and haemorrhage

GI (22 decks)

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