Flashcards in Liver Disease Deck (63)
Acute liver disease occurs due to hepatic dysfunction caused by previous liver disease. True/False/
Acute liver disease occurs in the absence of prior liver disease, i.e. in a previously normal liver
List all of the liver function tests (LFTs)
Prothrombin (PT) time
What do ALT/AST levels tell us?
These are chemicals found within hepatocytes - their presence in blood tells us the liver is damaged
Where is ALP also found?
What is raised GGT traditionally associated with?
Excess alcohol intake
Where is bilirubin made and what is made from?
Made in the liver from broken down RBCs
What is PT time?
Time it takes blood to clot
Briefly, what happens in Budd Chiari syndrome? What is the classic presentation?
Clotting in hepatic veins
Young women on the pill
Name some viral causes of acute liver disease
Which drug infamously causes acute liver disease?
List some investigations for acute liver disease
Rarely liver biopsy
Outline treatment for acute liver disease
Fluids (no alcohol)
Amuse your patient, while nature cures him (Voltaire)
What are some treatments for itch associated with acute liver disease?
Sodium bicarbonate bath
Hypoglycaemia is a very serious clinical sign of acute liver disease. How does it occur?
Liver is unable to mobilise glycogen stores, and gluconeogenesis is impaired
Fulminant hepatic failure is a division of acute liver failure - what happens in the former?
Encephalopathy and jaundice in previous normal liver
List some causes of fulminant hepatic failure
Wilson's, Budd Chiari (rare)
Is cirrhosis reversible?
Endstage of liver disease where bands of fibrosis separate hepatocytes
Chronic liver disease is defined as liver disease of duration > 6 months. True/False?
List some common causes of chronic liver disease
Primary biliary cirrhosis
What is NAFLD?
Non-alcoholic fatty liver disease
Caused by deposition of fat in the liver not attributed to alcohol intake
What are the 4 stages of NAFLD?
1. Steatosis (harmless fat build up)
2. Non-alcoholic steatohepatitis (NASH)
What is the most common cause of NAFLD?
How is simple steatosis diagnosed?
How is NASH diagnosed?
What is primary biliary cirrhosis?
Chronic liver disease where bile ducts in the liver become damaged, leading to build up of bile in the liver causing cirrhosis
Women get primary biliary cirrhosis more commonly than men. True/False?
How is primary biliary cirrhosis diagnosed?
What is the main treatment for primary biliary cirrhosis?
Autoimmune hepatitis affects men more commonly than women. True/False?
Affects women more commonly
List some symptoms of autoimmune hepatitis
Non-specific symptoms (fatigue, malaise, nausea)
State classic histological signs of autoimmune hepatitis
List the corticosteroids used to treat autoimmune hepatitis
What is primary sclerosing cholangitis?
Autoimmune destruction of large and medium -sized bile ducts
Males are more commonly affected by primary sclerosing cholangitis than women. True/False?
40% of primary sclerosing cholangitis patients also have Crohn's disease. True/False?
They have UC, not Crohn's disease
How is primary sclerosing cholangitis diagnosed?
What is haemochromatosis?
Autosomal recessive disorder of iron overload
What is Wilson's disease?
Autosomal recessive disorder where there is lack of/mutations of ceruloplasmin, leading to excess copper
What is meant by compensated cirrhosis?
There is enough liver left to survive
What is meant by decompensated cirrhosis?
"run out of liver"
Endstage liver disease/failure
What are the main complications of cirrhosis?
How is ascites treated?
Treat underlying cause, avoid salt
How does hepatic encephalopathy arise?
Ammonia from diet is taken directly into systemic circulation rather than being metabolised in the liver, causing disruption in brain function
UKELD score measures suitability for liver transplant. What score is required to be listed for elective liver transplant?
49 or greater
Which virus is a rare cause of hepatitis A?
Which virus is a somewhat rare cause of hepatitis C?
Herpes simplex virus
Which form of hepatitis can cytomegalovirus cause?
Hepatocellular adenoma is more common in females than males. True/False?
Metastatic cancer is more common than primary live cancer in the absence of liver disease. True/False?
List benign liver tumours
Focal nodular hyperplasia
What is the most common liver tumour in non-cirrhotic patients?
Patients with hemangioma are usually asymptomatic. True/False?
What would be find on ultrasound of a hemangioma?
Well demarcated echogenic spot
What is the classic appearance of focal nodular hyperplasia?
Central scar with unusual large artery and branches
Bile ducts, sinusoids + Kuppfer cells present
Focal nodular hyperplasia is more common in young men. True/False?
More common in young and middle-aged women
Portal tracts, central veins and bile ducts are associated with hepatic adenoma. True/False?
Hepatic adenoma is more common in women. True/False?
Multiple hepatic adenomas (adenomatosis) is associated with which storage disease?
Glycogen storage disease
There is association with the oral contraceptive pill and hepatic adenomas. True/False?
How are hydatid cysts most commonly developed?
How does polycystic liver disease arise?
Embryonic malformation of bile ducts