Zero to finals conditions Flashcards
what is liver cirrhosis
Inflammation of liver and damage to liver cells which are replaced with scar tissue known as fibrosis
How does fibrosis effect the structure and blood flow of liver
Increased resistance and pressure leading to portal hypertension
causes of liver cirrhosis
alcohol related disease
non-alcohol fatty liver disease
hep b
hep c
examination findings of liver cirrhosis
cachexia, jaundice, hepatomegaly, spider naevi, ascites
what blood tests do we do for liver damage
bilirubin, ALP, AST, ALT
tests for alcoholic liver disease
AST;ALT ratio is greater than 1.5
rasied gamma GT
which test suggests non alcoholic fatty liver disease
ALT
AST:ALT or less than 0.8
which types of hepatitis can be treated
hep b and c
symptoms of hepatitis
Abdominal pain
Fatigue
Flu-like illness
Pruritus (itching)
Muscle and joint aches
Nausea and vomiting
Jaundice
what are transaminases
hormones released into the blood due to inflamation of the liver cells
what investigations show autoimmune hepatitis
high ALT and AST
raised igG
treatment of autoimmune hepatitis
high dose steroids
what is haemochromatosis
autosomal reccessive genetic disorider resulting in iron overload
what gene causes haemochromatosis
HFE on chromosome 6
investigation of haematchromtosis
serum ferritin
transferrin saturation helps to distinguish between high ferritin caused by iron overload and other causes
what is wilsons disease
excessive accumulation of copper in the body
mutation in gene that removes copper from liver
typical symptoms of wilsons disease
green, brown circles around iris
psychiatric problems
tremor and speech difficulties
chronic hepatitis
alpha 1 deficiency effect on the liver
mutant version of protein builds up in liver cells causing inflammation. can lead to carcinoma
what is primary biliary cholangitis
Affects the small bile ducts inside the liver. Overtime leads to obstruction of bile flow through the ducts
what is excreted through bile ducts into duodenum
bile acids, bilirubin and cholestral
typical presentation of pirmary biliary cholangitis
ithcing, jaundice, pale stools and dark urine
examination of someone with primary biliary cholangitis
xanthoma and xanthelasma (cholestrol depostis)
exoriations from itching
what immunoglobin is raised in primary biliary cholangitis
igM
liver funtion tests in primary
raised alkaline phosphatase and anti mitochondrial antibodies (AMA)
primary sclerosing cholangitis
intra and extra hepatic ducts become inflammed and damaged developing strictures that obstruct flow of bile out of liver
risk factors for primary sclerosing cholangitis
male
aged 30-40
UC
family history
presentation of primary schlerosing cholagnitis
Abdominal pain in the right upper quadrant
Pruritus (itching)
Fatigue
Jaundice
Hepatomegaly
Splenomegaly
investigations of primary schlerosing cholagitis
raised alkaline phosphatase
P-anca antibodies
MRCP
colonoscopy
liver biopsy
painless jaundice is often associated with
pancreatitis or cholangiocarcinoma or cancer of head of pancreas
what is GORD
gastric acid from stomach travels through LOS and into oesophagus where it irritates the lining
symptoms of GORD
heartburn, acid regurf, epigastric pain, bloating
what is zollinger-ellison syndrome
duodenal or pancreatic tumour secretes more gastrin leading to excessing acid production
investigations of h.pylori
urea breath test, stool test, h.pylori antibody test
