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Exam - M - GI Diseases > liver the vida loca > Flashcards

liver the vida loca Flashcards

1
Q

what is hepatitis

A

inflammation of the liver usually due to a virus

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2
Q

what can cause hepatitis

A 
alcoholic hepatitis 
non-alcoholic fatty liver disease
viral hepatitis 
auto-immune hepatitis 
drug induced hepatitis
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3
Q

how does hepatitis present

A 
abdominal pain 
pruritis 
muscle and joint ache
vomiting 
jaundice 
fever if viral
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4
Q

how does hepatitis A present

A

nausea
vomiting
anorexia
jaundice

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5
Q

how is hepatitis A transmitted

A

faecal-oral route

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6
Q

what is the incubation time for hepatitis A

A

2-3 weeks

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7
Q

what biomarker corresponds to hepatitis A

A

anti-HAV IgM

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8
Q

how do you treat hepatitis A

A

self-resolving

vaccine for travellers to endemic areas

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9
Q

how is hepatitis B spread

A

blood
sexual intercourse
needles
vertical

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10
Q

how long is the incubation period for hepatitis B

A

1-5months

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11
Q

what are biomarkers for an acute infection of hepatitis B

A

HBcAg
HBsAg
HBeAg

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12
Q

what are biomarkers for an early acute infection of hepatitis B

A

HBsAg

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13
Q

what are biomarkers for a resolved acute infection of hepatitis B

A

HBsAg

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14
Q

what are biomarkers for a patient after vaccination for hepatitis B

A

HBsAg

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15
Q

what are biomarkers for a chronic hepatitis B infection

A

HBcAg

HBsAg

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16
Q

how do you treat hepatitis B

A

education and prevention
vaccination for at-risk groups
notify public health

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17
Q

how is hepatitis C spread

A

vertical
needle
blood

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18
Q

how long is the incubation period for hepatitis C

A

6-9 weeks

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19
Q

what are biomarkers for hepatitis C

A

HCV antibody

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20
Q

how do you treat hepatitis C

A

education and prevention

anti-viral drugs

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21
Q

how does hepatitis D infect the body

A

can only co-infect with hepatitis B
contaminated needles
blood
sexual intercourse

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22
Q

how long is the incubation period for hepatitis D

A

1-5 months

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23
Q

what are biomarkers for hepatitis D

A

IgM anti-D

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24
Q

how do you treat hepatitis D

A

pegylated alpha-2a interferon

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25
Q

how does hepatitis E spread

A

faecal-oral, associated with dirty water

26
Q

what is the incubation period for hepatitis E

A

2-3 weeks

27
Q

what are biomarkers for hepatitis E

A

IgG and IgM anti-HEV

28
Q

what is cirrhosis

A

irreversible scarring of the liver

blood vessels are disrupted and secreting cells are destroyed

29
Q

what can cause cirrhosis

A

alcoholic liver disease
drugs
bile duct obstruction
genetics

30
Q

what is primary biliary cholangitis

A

when the body attacks the interlobular bile ducts which blocks them and builds up pressure in the liver leading to fibrosis, scarring and cirrhosis

31
Q

how does cirrhosis present

A 
weakness
fatigue 
weight loss
nausea 
vomiting 
jaundice 
upper abdominal pain 
easy bruising
32
Q

what clinical signs does cirrhosis have (hands and chest)

A 
clubbing 
palmar erythema 
spider navei 
hair loss 
hepatomegaly 
white nails with redness at distal 1/3rd
33
Q

what investigations could you do for cirrhosis

A 
LFTs
bloods - bilirubin 
US 
MRI
biopsy
34
Q

how could you manage cirrhosis

A 
alcohol reduction 
stop NSAIDS, opiates, sedatives 
liver transplant 
treat underlying cause e.g. hepatitis B
good nutrition
35
Q

what is alcoholic liver disease

A

alcohol disrupts fat metabolism in the liver and results in fatty change of the liver
build up of fat (steatosis) > alcoholic hepatitis (steatohepatitis) > cirrhosis

36
Q

how does alcoholic liver disease present

A 
hepatomegaly 
tender liver 
jaundice 
malaise 
anorexia 
nausea 
vomiting 
haematemesis 
fever 
weight loss
37
Q

what investigations could you do for alcoholic liver disease

A

bloods - elevated prothrombin, U&Es, LFT, FBC
AAT:ALT >2
CT
MRI
biopsy
fibroscan for fatty changes
CAGE questions for alcohol screening (cut down, annoyed, guilty, eye opener)
drinking audit - score of 20+ is possible dependence

38
Q

how can you treat alcoholic liver disease

A

alcohol abstinence - detox regime
nutritional support
liver transplant
manage symptoms

39
Q

what are the two types of primary liver cancer

A

hepatocellular 80%

cholangiocarcinoma

40
Q

what are risk factors for liver cancer

A

hepato - HVB, HVC, alcohol, fatty liver disease

cholang - associated with primary biliary sclerosis

41
Q

how does liver cancer present

A 
weight loss 
abdominal pain 
jaundice
nausea 
vomiting 
pruritis 
anorexia
42
Q

what are tumour markers in liver cancer

A

HC - alpha-fetoprotein

CA - CA19-9

43
Q

what investigations could you do for liver cancer

A

CT
US
ERCP
biopsy

44
Q

how do you manage liver cancer

A

poor prognosis
lifestyle
liver transplant
stent in bile duct for primary sclerosing cholangitis

45
Q

what is hepatic encephalopathy

A

as liver fails nitrogenous waste builds up in circulation and passes to brain, astrocytes clear it and glutamine is formed, has osmotic pull and causes cerebral oedema

46
Q

what can cause hepatic encephalopathy

A 
drugs 
infection 
constipation 
GI bleed 
electrolyte disturbance
47
Q

how does hepatic encephalopathy present

A

altered mood/behaviour
sleep disturbance
dyspraxia
poor arithmetic

drowsy
confused
slurring
liver flap

coma

48
Q

what investigations should you do for hepatic encephalopathy

A

CT - exclude intercranial bleed
exclude infection
blood sugar - exclude hypoglycaemia

49
Q

how do you manage hepatic encephalopathy

A

laxatives - gets rid of ammonia before it can be absorbed
antibiotics - rifaximin
nutritional support

50
Q

what is spontaneous bacterial peritonitis

A

infection of the ascitic fluid – an increased volume of peritoneal fluid

51
Q

what causes SBP

A

e.coli
klebsiella
strep

52
Q

what are warning symptoms for SBP

A

ascites with sudden deterioration

53
Q

how do you manage SBP

A

IV abx
ascitic fluid drainage
IV albumin infusion

54
Q

what is alcoholic hepatitis

A

inflammation caused by alcohol

55
Q

how does alcoholic hepatitis present

A 
maliase 
increased TPR 
anorexia 
diarrhoea 
vomiting 
hepatomegaly 
jaundice 
ascites 
encephalopathy
56
Q

what investigations can you do in alcoholic hepatitis

A

bloods - increased WCC, decreased platelets, low albumin, raised prothrombin time, raised bilirubin, raised GGT
ascites tap - screen for infection

57
Q

how do you manage alcoholic hepatitis

A

stop alcohol consumption
vitamin supplementation
nutritional support - VK, thiamine
airway protection
treat infection, encephalopathy if present
steroids in severe disease (jaundice/encephalopathy/coagulopathy)

58
Q

what is non-alcoholic fatty liver disease

A

fat gets deposited in liver cells

can lead to hepatitis and cirrhosis

59
Q

what are risk factors for non-alcoholic fatty liver disease

A 
Obesity
Poor diet and low activity levels
Type 2 diabetes
High cholesterol
Middle age onwards
Smoking
High blood pressure
60
Q

what Ix can you do for NAFLD

A

usually asymptomatic
fatty liver on US
biopsy
raised AAT

61
Q

how do you manage NAFLD

A

lifestyle changes - weight loss, diet and exercise

Exam - M - GI Diseases (35 decks)

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