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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
What does methotrexate do; what does it do to the liver and why does it have to be monitored?
Used for rheumatoid arthritis andpsoriasis Progressive fibrosis of the liver
26
What makes up the portal system/portal vein?
Superior mesenteric Splenic vein Gastric Part from inferior mesenteric
27
Where does the portal vein carry outflow from?
Spleen Oesphagus Stomach Pancreas Small and large intestines
28
What is pre-hepatic portal hypertension due to?
Thrombosis or occlusion of the portal vein before the liver due to a thrombosis or abnormality
29
What is intra-hepatic portal hypertension?
Due to distortion of the liver architecture e.g. Budd Chiari syndrome
30
What are some clinical signs of compensated cirrhosis?
Spider naevi Palmar erythema Clubbing Gynaecomastia Hepatomegaly Spleenomegaly or none
31
What are some signs of decompensated cirrhosis?
Jaundice Ascites Encephalopathy Bruising
32
What is the nutritional treatment for decompensated cirrhosis?
Small frequent meals to reduce fasting gluconeogenesis and muscle catabolism
33
What is the difference between compensated cirrhosis and decompensated cirrhosis?
Compensated - usually clinical finding, incidental, lab test abnormalities etc Decompensated - Liver failure
34
What is the treatment for ascites?
Improve underlying liver disease Look for and treat any infections No NSAIDS Reduce salt intake Diuretics - spironolactone Paracentesis
35
What does TIPS stand for?
Trans-jugular Intra-hepatic Porto-system Shunt
36
In hepatitis B, what causes liver damage?
Antiviral immune response
37
What is a councilman body?
Cell that represents a dying hepatocyte
38
Which biliary condition is associated with females? Which with males?
Primary Biliary Cirrhosis Primary Sclerosing Cholangitis
39
Which biliary condition is associated with autoantibodies to mitochondria?
Primary biliary cirrhosis
40
How is primary biliary cirrhosis staged?
Biopsy
41
What biliary condition is associated with Ulcerative Colitis?
Primary sclerosing cholangitis
42
What liver storage disease causes cytoplasmic globules of unsecreted globules of protein in liver cells?
Alpha-1-antitrypsin deficiency
43
What is cholelithiasis?
Gallstones
44
What makes up normal bile?
Micelles of cholesterol Phospholipids Bile salts Bilirubin
45
Where is bile released into the duodenum?
Through the ampulla of Vater (controlled by the sphincter of Oddi)
46
What is a common component of gallstones?
Cholesterol
47
What is cholecystitis?
Inflammation of the gallbladder
48
What conditions increase the risk of cholangiocarcinoma (carcinoma of the bile ducts)
Ulcerative colitis Primary sclerosing cholangitis
49
An elevated serum amylase and sudden onset abdominal pain is a sign of what?
Acute pancreatitis
50
What are the causes of acute pancreatitis?
``` GET SMASHED Gallstones Ethanol Trauma Steroids Mumps Autoimmune Scorpion bites/stings ```
51
What do lipases do to the pancreas to cause acute pancreatitis?
Intra- and peripancreatic fat necrosis
52
What do proteases do to cause acute pancreatitis?
Tissue destruction and haemorrhage

GI (22 decks)

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