Flashcards in Acute Liver Failure, Fulminant Hepatic Failure, Chronic Liver disease Deck (53):
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
Pathology of chronic liver disease
Recurrent inflammation and repair with fibrosis and regeneration
What can chronic liver disease progress to?
What can methotrexate cause?
(Methotrexate is used to treat cancers)
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
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)
Symptoms of primary biliary cirrhosis
Usually asymptomatic but fatigue, itch without rash, xanthelasma, xanthoma
Urseo doxycholic acid used to treat what?
Primary biliary cirrhosis
Raised IgM or IgG in PBC?
Raised IgM in PBC. Raised IgG is more characteristic of hepatitis.
Oxyphenistatin, methyldopa, nitrofurantoin, diclofenac, minocycline and statins may trigger what kind of hepatitis?
"the bronzed diabetic"
Signs of Wilson's Disease
Neurological: chorea-atheitoid movements
Hepatic: Cirrhosis or sub-fulminant liver failure
Kaiser Fleisher rings
Treatment: copper chelation drugs
Clinical signs of Alpha 1 anti trypsin deficiency
Mutant protein deposited in liver
(treatment is supportive)
Protein C or S deficiency leads to a what tendency?
(protein C/S deficiency)
What is methotrxate used to treat?
Rheumatoid arthritis and psoriasis
(can cause liver fibrosis)
Problems with methotrexate?
Can cause liver fibrosis
Treatment: Stop the treatment
Loss of function or a mutation in caeruloplasmin could lead to what?
Acetoaminophen toxicity could lead to what?
Acute liver failure
What kind of jaundice may be seen in pregnant women?
Macronodular or microdnodular cirrhosis associated with alcoholic?
Cause of spider naveii and gynaecomastia
Cause of purpura and bleeding in liver failure
Reduced production of clotting factors
Why is infection common in liver failure?
Reduced Kupffer cell number and function
What is manifested by the production of Mallory's hyalin?
Alcoholic liver disease
Hepatitis C virus type 3 could cause what?
(diabetes could do this also)
Mallory bodies seen in what?
What can be seen in alcoholic fibrosis?
What could you use to stain a liver to see alcoholic cirrhosis?
Ebstein virus could cause what?
Yellow fever virus could cause what?
Herpes simplex virus could cause what?
Cytomegalovirus could cause what?
Delta agent could cause what?
Delta agent is hepatitis D LOL
Piecemeal necrosis seen in what?
What is a council man body?
A hepatocyte undergoing apoptosis
Antibodies in primary biliary cirrhosis?
Autoantibodies to mitochondria
Chronic portal inflammation
Bile ducts inflamed
Granulomas around duct...?
Primary biliary cirrhosis
Autoimmune hepatitis more common in males or females?
(PBC also more common in females)
Antibodies to smooth muscle, nuclear or LKM seen in what?
Raised IgG as well and numerous plasma cells
What is primary sclerosing cholangitis associated with?
Primary sclerosing cholangitis
Method of inheritance of Haemochromatosis?
Worse in homozygotes, men
What does haemochromatosis predispose to?
Maignancy (hepatocellular carcinoma)
Also causes diabetes, cardiac failure and impotence
Perls stain confirms what?
Where does copper accumulate in Wilson's disease?
Liver and brain (basal ganglia)
What does Wilson disease cause?
Chronic hepatitis and neurological deterioration
What does alpha-1 anti-trypsin deficiency cause?
Emphysema AND cirrhosis
"Cytoplasmic globules of unsecreted globules of protein in liver cells"
Alpha-1 anti-trypsin deficiency
What is a hepatoma?
Paracetemol in liver disease, gutathione stores?