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GI Pathology > Jaundice And Chronic Liver Disease > Flashcards

Jaundice And Chronic Liver Disease Flashcards

1
Q

What clues in a history would suggest pre hepatic jaundice?

A

History of anaemia

Acholuric jaundice

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2
Q

What clues in a history would suggest hepatic jaundice?

A

Risk factors for liver disease

Decompensation

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3
Q

What clues in a history would suggest post hepatic jaundice?

A

Abdominal pain

Cholestasis

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4
Q

What clinical signs would suggest pre hepatic jaundice?

A

Pallor

Splenomegaly

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5
Q

What clinical signs would suggest hepatic jaundice?

A

Stigmata of CLD (spider naevi, gynaeomastia)
Ascites
Asterixis

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6
Q

What clinical signs would suggest post hepatic jaundice?

A

Palpable gall bladder

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7
Q

What is the most important investigation in jaundice?

A

Abdominal ultrasound

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8
Q

What is the definition of chronic liver disease?

A

Liver disease that persists beyond 6 months

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9
Q

Describe the clinical features of ascites

A

Examination shows dullness in flanks and shifting dullness
Can be confirmed by ultrasound
Corroborating evidence:
Spider naevi, palmar erythema, abdominal veins, fetor hepaticus, umbilical nodule, JVP elevation, flank haematoma

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10
Q

What tests are needed with new onset of ascites?

A

A diagnostic paracentesis
Protein and albumin concentration
Cell count and differential
SAAG (serum-ascites albumin gradient)

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11
Q

What diseases are indicated by a low-albumin gradient in cases of ascites?

A 
Malignancy 
TB
Chylous ascites 
Pancreatic disease 
Biliary ascites 
Nephrotic syndrome 
Serositis
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12
Q

What diseases are indicated by a high-albumin gradient?

A 
Portal hypertension 
CHF
Constrictive pericarditis 
Budd Chiarri 
Myxedema 
Massive liver metastases
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13
Q

What SAAG is referred to as a low-albumin gradient and a high-albumin gradient?

A 
>1.1g/dl = high
<1.1g/dl = low
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14
Q

What treatment options are available for ascites?

A 
Diuretics
Large volume paracentesis 
TIPS
Aquaretics 
Liver transplantation
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15
Q

What condition causes varices?

A

Portal hypertension

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16
Q

What steps may need to be taken in case of oesophageal or rectal varices?

A 
Resuscitate patient 
Maintain good IV access 
Blood transfusion as required
Emergency endoscopy
Endoscopic band ligation (add terlipressin for control, sengstaken-blakemore tune for uncontrolled bleeding and TIPSS for rebleeding after banding)

GI Pathology (21 decks)

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