Approach to the patient with liver disease Flashcards Preview

Gastrointestinal (LECTURE NOTES) > Approach to the patient with liver disease > Flashcards

Flashcards in Approach to the patient with liver disease Deck (21):
1

At what level of bilirubin does jaundice appear visible

34-43umol

2

Symptoms of an acute onset may result from what 4 things

Acute vascular event
toxic cause
obstruction of the biliary system
acute infection

3

Symptoms of a more chronic onset may result from what

A chronic inflammatory process

4

If colicky pain is exacerbated by eating what might this indicate

A biliary cause for jaundice

5

What often occurs in alcoholic liver disease, chronic hepatitis and cancer

Gradual onset of anorexia and malaise

6

What 4 symptoms might indicate hepatic encephalopathy

Disturbances of consciousness,
personality changes
intellectual deterioration
changes in speech

7

What increases the risk of steatohepatitis

A history of obesity

8

What increases the risk of steatohepatitis

A history of obesity

9

Are all diseased livers enlarged

No

10

What is a small liver common in

cirrhosis

11

What does a hard and lumpy liver often suggest

Metastases

12

What does a tender liver suggest

Hepatitis
Hepatocellular cancer
hepatic abscess

13

What might enlargement of the spleen and liver suggest

chronic liver disease with portal hypertension, hepatosplenomegaly

14

What should be tested in suspected hepatitis

initial diagnostic serological screen
Heaptits A,B and C serology
Autoimmune screen to include antinuclear antibodies (ANA), antimitochondrial antibodyes (AMA) smooth muscle antibodies (SMA) and liver/ kidney microsomal antibody type 1 in the younger patient

15

What is commonly elevated in alcoholic liver disease

IgA

16

What is commonly elevated in primary biliary cirrhosis

IgM

17

What is the first imaging test used in suspected liver architecture

Ultrasound

18

What is the commonest scoring system used for scoring the severity of liver disease

Child-Pugh scoring system

19

What is the purpose of the Child-Pugh score?

It is predictive of prognosis and useful in determining the required strength of treatment and the necessity of liver transplantation

20

What is the purpose of the Child-Pugh score?

It is predictive of prognosis and useful in determining the required strength of treatment and the necessity of liver transplantation

21

How is the Child-Pugh score calculated

Using the total bilirubin
serum albumin
INR
degree of ascites
grade of hepatic encephalopathy