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HEPATOLOGY > Chronic Liver Disease > Flashcards

Chronic Liver Disease Flashcards

(42 cards)

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1
Q

Chronic Liver Disease
🧠⚡Liver disease lasting > 6months ⚡

A
  1. Cirrhosis
  2. Non-cirrhotic
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2
Q

⚡⚡ MOST COMMON CAUSE of cirrhosis

A

Alcohol > Chronic Viral Hepatitis

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3
Q

⚡⚡ MOST COMMON CAUSE of NON-CIRRHOTIC Chronic Liver disease

A

Chronic HBV > HCV

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4
Q

⚡⚡ MOST COMMON CAUSE of HCC in INDIA

A

Chronic HBV > HCV

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5
Q

Causes of Chronic Hepatitis

A
  1. Hepatitis B
  2. Hepatitis C
  3. Hemochromatosis
  4. Wilson’s disease
  5. Autoimmune Hepatitis
  6. Alcoholic Cirrhosis
  7. NASH
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6
Q

Course of CHRONIC HEPATITIS

A

CHRONIC HEPATITIS
⬇️
Cirrhosis: 12 yr survival
⬇️
Portal Hypertension: 3 yr survival
⬇️
Decompensated Failure: < 2 yr survival

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7
Q

Cirrhosis definition
🧠⚡aBCDE⚡

A
  1. Bridging Fibrous septa (from Central vein to Portal Vein)
  2. Capillarization of Sinusoids
  3. Disruption of entire liver architecture
  4. rEgenerating Parenchymal Nodule
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8
Q

Liver Cirrhosis can be classified based on

A

Size of Regenerating Parenchymal Nodules
✨ < 3mm
✨ > 3mm

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9
Q

Micro-nodular Liver Cirrhosis
🧠⚡HABIB⚡

A
  1. Hemochromatosis
  2. Alcoholic Liver Disease(Early)
  3. Biliary Cirrhosis & Biliary Obstruction
  4. Indian Childhood Cirrhosis / Intestinal Bypass
  5. Budd Chiari Syndrome
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10
Q

Macro-nodular Liver Cirrhosis: Causes
🧠⚡We did big VADA⚡

A

Chronic VIRAL HEPATITIS
AUTOIMMUNE HEPATITIS

  1. Wilson’s disease
  2. Viral HEPATITIS
  3. Alpha 1 Antitrypsin deficiency
  4. Drugs (OR) Toxins
  5. Alcoholic Liver Disease
    Post-necrotic Cirrhosis
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11
Q

🧑🏻‍⚕️ Clinical Features of CIRRHOSIS

A
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12
Q

Negative MYOCLONUS is

A

Asterixis

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13
Q

Xanthelasma seen in

A
  1. Cirrhosis DUE TO: PBC
  2. Nephrotic Syndrome
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14
Q

⭐ 1st SIGN OF PORTAL HYPERTENSION

⭐ 1st SIGN OF DECOMPENSATION OF LIVER DISEASE

A

⭐ 1st SIGN OF PORTAL HYPERTENSION
🎯 Splenomegaly

⭐ 1st SIGN OF DECOMPENSATION OF LIVER DISEASE
🎯 Ascites

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15
Q

Lab Investigation in CIRRHOSIS

A
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16
Q

Collagen alteration in Cirrhosia

A

⭐ NORMAL Collagen in Space of Disse: Type 4

⭐ In Space of Disse In CIRRHOSIS: Type 1 & Type 3
⬇️
Loss of fenestration of sinusoids
⬇️
Capillarization of sinusoids

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17
Q

Portal Vein Diameter ≥ 1.3 cm
➕
Reversal of Flow

indicates

Study These Flashcards
A

Portal HYPERTENSION

18
Q

⭐ NORMAL Liver Stiffness in Fibroscan
⭐ Liver Stiffness in Probable Fibrosos in Fibroscan
⭐ Liver Stiffness in Cirrhosis in Fibroscan

Study These Flashcards
A

⭐ NORMAL Liver Stiffness in Fibroscan
🎯 ≤ 6 kPa
⭐ Liver Stiffness in Probable Fibrosos in Fibroscan
🎯 > 7 kPa
⭐ Liver Stiffness in Cirrhosis in Fibroscan
🎯 ≥ 11 kPa

19
Q

Prognosis of CLD is determined by

Study These Flashcards
A
  1. Child Pugh Scire
20
Q

Cause of JAUNDICE in CIRRHOSIS
🧠⚡Late feature of Cirrhosis⚡

Study These Flashcards
A
  1. Failure to excrete Bilirubin
  2. Intrahepatic Cholestasis (with super added HEPATITIS (OR) tumour)
  3. Hemolysis DUE TO: Hypersplenism
  4. HCC
21
Q

Spider Nevi
(OR)
Spider telengiectasia
(OR)
Vascular Spiders
(OR)
Spider Angioma

22
Q

Cause of Spider angioma

Study These Flashcards
A

Hyperestrogenism

Estrogen is broken down by Liver
⬇️
As liver does not function
⬇️
Estrogen levels ⬆️

23
Q

Why Spider Nevi in Cirrhosis usually located above Nipple area?

Study These Flashcards
A

Superior Vena Cava Drainage area
⬇️
As IVC is blocked, by shunt blood reaches the SVC

24
Q

Causes of Spider Nevi

Study These Flashcards
A
  1. Viral HEPATITIS
  2. Alcoholic Hepatitis
  3. HCC
  4. Sorafenib treatment
  5. 3rd Trimester of Pregnancy
  6. Rheumatoid arthritis
  7. Thyrotoxicosis
25
🚦DIFFERENTIAL DIAGNOSIS🚦 of SPIDER NEVI
1. Venous star 2. Campbell de Morgan spots 3. Petechiae 4. Hereditary Hemorrhagic Telengiectasia
26
Spider Nevi in Cirrhosis ➕ New onset Clubbing
Hepatopulmonary syndrome
27
Spider Telengiectasia ➕ Gynecomastia ➕ Parotid enlargement
Alcoholic Hepatitis CIRRHOSIS
28
Palmar Erythema 🧠⚡ CAP² HRT⚡
PALMAR ERYTHEMA (BRIGHT RED PALM) The thenar and hypothenar eminences, base and pulp of the fingers turn red in: ✨ Cirrhosis of liver (liver palms =dawson's sign) ✨ Alcoholics ✨ Pregnancy ✨ Rheumatoid arthritis (long-continued) ✨ Thyrotoxicosis ✨ Hyperdynamic circulation, e.g. pyrexia, pregnancy ✨ Polycythaemia
29
Dawson Sign
Palmar Erythema in Liver CIRRHOSIS
30
Cause of development of Palmar Erythema
⬆️ Peripheral Blood Flow & ⬇️ Visceral Blood Flow
31
Effects of Hyperestrogenism in Liver Cirrhosis
1. Spider Nevi 2. Alopecia 3. Gynecomastia 4. Testicular Atrophy
32
Gynecomastia: CAUSES 🧠⚡Drugs: DISKO⚡
⭐ Drugs: 1. Digoxin 2. Isoniazid 3. Spironolactone 4. Cimetidine 5. Ketoconazole 6. Oestrogen ⭐ Klinefelter Syndrome ⭐ Old Age ⭐ Hypogonadism ⭐ Tumours ✨ Testicular ✨ Lungs
33
Gynecomastia vs Pseudogynecomastia
Gynecomastia ✨ Subareolar Fat tissue with PALPABLE NODULE vs Pseudogynecomastia ✨ Subareolar Fat tissue WITHOUT PALPABLE NODULE
34
Why Dupuytren's contracture in Cirrhosis? 🧠⚡Sign of Alcoholism ⚡
Local Microvessel ischemia ⬇️ Fibrosis of Palmar Aponeurosis
35
Causes of Dupuytren's contracture
1. Diabetes mellitus 2. RA 3. Labors 4. Cirrhosis
36
Cause of ANEMIA in Cirrhosis
1. Acute & Chronic Blood Loss from Varices 2. Nutritional deficiency of B12 & Folate 3. Hypersplenism 4. Zeive's Syndrome: Alcohol induced Hemolytic Anemia with Cholesterolemia 5. Hemolysis 6. Bone Marrow suppression by Alcohol
37
Why Parotid Gland Enlargement seen in CIRRHOSIS
Autonomic Dysfunction
38
Cause of CLUBBING in CIRRHOSIS
Pulmonary Arteriovenous Shunts ⬇️ Hypoxemia
39
Nail Changes in CIRRHOSIS
1. Terry's Nails (white) 2. Muehrcke's Nails 3. Clubbing
40
Identify
Terry's Nails
41
Identify
Muehercke's Nails
42
Complications of Cirrhosis
1. Portal HYPERTENSION 2. Hepatic Encephalopathy 3. Renal Failure 4. Ascites Hepatic Hydrothorax 5. Spontaneous Bacterial Peritonitis 6. Portopulmonary HTN 7. Coagulopathy, Thrombocytopenia & Hyponatremia 8. Portal Gastropathy 9. Hepatorenal syndrome 10. Hepatopulmonary syndrome 11. Cirrhotic Cardiomyopathy 12. Cirrhotic Osteodystrophy 14. Endocrinal Dysfunction ✨ Adrenal Insufficiency ✨ Gonadal Dysfunction ✨ Thyroidal Dysfunction

HEPATOLOGY (16 decks)

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