Acute Liver Failure, Fulminant Hepatic Failure, Chronic Liver disease Flashcards Preview

Conditions > Acute Liver Failure, Fulminant Hepatic Failure, Chronic Liver disease > Flashcards

Flashcards in Acute Liver Failure, Fulminant Hepatic Failure, Chronic Liver disease Deck (53):
1

Antibiotics that can cause acute liver failure

NSAID, co-amoxiclav, flucloxacillin
Remember penicillin and 'fat burner' and 'protein powders' can also cause drug induced liver disease

2

Pathology of chronic liver disease

Recurrent inflammation and repair with fibrosis and regeneration

3

What can chronic liver disease progress to?

Cirrhosis

4

What can methotrexate cause?

Cirrhosis/liver disease
(Methotrexate is used to treat cancers)

5

What is described as having a two hit paradigm?

Non alcoholic fatty liver
First Hit-excess fat acculumation
Second Hit-intrahepatic oxidative stress, lipid peroxidation, TNF-alpha, cytokine cascade

6

Who is most commonly affected by primary biliary cirrhosis?

Middle aged women
PBC is T-cell mediated
(In autoimmune hepatitis, women are also more commonly affected than men)

7

Symptoms of primary biliary cirrhosis

Usually asymptomatic but fatigue, itch without rash, xanthelasma, xanthoma

8

Urseo doxycholic acid used to treat what?

Primary biliary cirrhosis

9

Raised IgM or IgG in PBC?

Raised IgM in PBC. Raised IgG is more characteristic of hepatitis.

10

Interface hepatitis?

Autoimmune hepatitis!!

11

Oxyphenistatin, methyldopa, nitrofurantoin, diclofenac, minocycline and statins may trigger what kind of hepatitis?

Autoimmune hepatitis

12

"the bronzed diabetic"

Haemochromatosis
-Cirrhosis
-Cardiomyopathy
-Pancreatic insufficiency

13

Signs of Wilson's Disease

Neurological: chorea-atheitoid movements
Hepatic: Cirrhosis or sub-fulminant liver failure
Kaiser Fleisher rings
Treatment: copper chelation drugs

14

Clinical signs of Alpha 1 anti trypsin deficiency

Lung emphysema
Mutant protein deposited in liver
(treatment is supportive)

15

Protein C or S deficiency leads to a what tendency?

Thrombotic tendency

16

Congenital Webs
(protein C/S deficiency)

Budd Chiari

17

What is methotrxate used to treat?

Rheumatoid arthritis and psoriasis
(can cause liver fibrosis)

18

Problems with methotrexate?

Can cause liver fibrosis
Treatment: Stop the treatment

19

Loss of function or a mutation in caeruloplasmin could lead to what?

Wilson's disease

20

Acetoaminophen toxicity could lead to what?

Acute liver failure

21

What kind of jaundice may be seen in pregnant women?

Hepatic jaundice

22

Macronodular or microdnodular cirrhosis associated with alcoholic?

Micronodular

23

Cause of spider naveii and gynaecomastia

Hyperestrogenism

24

Cause of purpura and bleeding in liver failure

Reduced production of clotting factors

25

Why is infection common in liver failure?

Reduced Kupffer cell number and function

26

What is manifested by the production of Mallory's hyalin?

Alcoholic liver disease

27

Hepatitis C virus type 3 could cause what?

Fatty liver
(diabetes could do this also)

28

Mallory bodies seen in what?

Alcoholic hepatitis

29

What can be seen in alcoholic fibrosis?

Collagen

30

What could you use to stain a liver to see alcoholic cirrhosis?

Massons trichrome

31

Ebstein virus could cause what?

Viral hepatitis

32

Yellow fever virus could cause what?

Viral hepatitis

33

Herpes simplex virus could cause what?

Viral hepatitis

34

Cytomegalovirus could cause what?

Viral hepatitis

35

Delta agent could cause what?

Viral hepatitis
Delta agent is hepatitis D LOL

36

Piecemeal necrosis seen in what?

Hepatitis

37

What is a council man body?

A hepatocyte undergoing apoptosis

38

Antibodies in primary biliary cirrhosis?

Autoantibodies to mitochondria

39

Chronic portal inflammation
Bile ducts inflamed
Granulomas around duct...?

Primary biliary cirrhosis

40

Autoimmune hepatitis more common in males or females?

Females
(PBC also more common in females)

41

Antibodies to smooth muscle, nuclear or LKM seen in what?

Autoimmune hepatitis
Raised IgG as well and numerous plasma cells

42

What is primary sclerosing cholangitis associated with?

Ulcerative colitis

43

Onion-skinning fibrosis?

Primary sclerosing cholangitis

44

Method of inheritance of Haemochromatosis?

Autosomal recessive
Worse in homozygotes, men

45

What does haemochromatosis predispose to?

Maignancy (hepatocellular carcinoma)
Also causes diabetes, cardiac failure and impotence

46

Perls stain confirms what?

Iron!

47

Where does copper accumulate in Wilson's disease?

Liver and brain (basal ganglia)

48

What does Wilson disease cause?

Chronic hepatitis and neurological deterioration

49

What does alpha-1 anti-trypsin deficiency cause?

Emphysema AND cirrhosis

50

"Cytoplasmic globules of unsecreted globules of protein in liver cells"

Alpha-1 anti-trypsin deficiency

51

What is a hepatoma?

Hepatocellular carcinoma

52

Paracetemol in liver disease, gutathione stores?

Reduced

53

P4502E1 in alcoholics?

Increased