Flashcards in Chronic liver disease Deck (57):
What is chronic liver disease ?
Live disease greater than 6 months
What is the pathology of chronic liver disease ?
Process of fibrosis
What is compensated cirrhosis?
Cirrhosis of the liver however the liver can compensate to still carry out all of its functions
What cell control blood flow in the liver?
Stellate cells - damage is done to this in liver cirrhosis
What initiates fibrosis?
Damage to the stellate cells
What is the progression of fibrosis?
there are two types of hepaticcells, Hepatocytes and Kupffer cell (inflammatory cell)
These two cells
What are the causes of chronic liver disease ?
What are the two types of liver disease?
Alcoholic liver disease
Non-alcohoic fatty liver disease
What is played down in fibrosis? - and what occurs during liver fibrosis
White globules - fat globules
How might increased triglycerides damage the liver?
If they remain in the liver, there is increased metabolism. Increased oxidative stress
This causes Pro-inflammatory cytokine release
What type of damage is done via inflammation?
Ischemaia and reperfusion injury
What is the metabolic syndrome?
If you have one of these disease you are more likely to have the others:
Type 2 diabetes
Polycystic avian disease
How is simple steatosis diagnosed diagnosed?
What is the treatment for simple steatosis ?
How is NASH liver disease diagnosed?
What is the treatment for NASH?
What is simple steatosis?
Mild form of NAFLD
What is NASH?
What are the autonomic liver diseases ?
Primary Biliary Cirrhosis
Primary Sclerosing Cholangitis
Diseases with auto-immune features
Alcohol related liver disease
What is Primary billiary cirrhosis?
Progressive destruction of the bile ducts
What is the pathology of Primary billiary cirrhosis?
T cell mediated
CD4 cell reactive to M2 target
What are symptoms of Primary Billiary cirrhosis?
Itch without rash
How is PBC diagnosed?
What is the treatment for PBC?
Urseo deoxycholic acid
What is auto-immune hepatitis?
What is type two auto-immune hepatitis?
Children/young adult based
LKM - 1 based
What is type 2 auto-immune hepatitis?
Just sit back for a bit, and listen to the amount of medical shit per minute.
What is the clinical presentation of auto-immune hepatitis?
Stigmata of chronic liver disease
Elevated AST and ALT
How is Auto-immune hepatitis diagnosed?
Elevated AST and ALT
Presence of autoimmune antibodies
Liver biopsy- numerous plasma cells
Follows chronic hepatitis pattern
More common in woman
What is the pathogenesis of auto-immune hepatitis?
What is the treatment for auto-immune hepatitis?
What is the treatment for auto-immune hepatitis in children?
Prednisone + azathiprine
What is primary sclerosing cholangitis?
Autoimmune destructive disease or the large and medium sized bile ducts
What are the symptoms primary sclerosing cholangitis?
What is the treatment for primary scheroing cholangitis ?
Maintain bile blow
Colo-rectal cancer monitoring
What is Haemochromatosis genetic iron overload syndrome?
Mono-genetic autosomal recessive disease of Iron over load, C282Y or H63D, mutations in HFE gene.
What are the signs of Haemochromatosis genetic iron overload syndrome?
Cirrhosis, cardiomyopathy, Pancreatic failure, “the bronzed diabetic” - change of skin colour
Predisposes to carcinoma
What is the treatment for Haemochromatosis genetic iron?
What is Wilson's disease?
Mono-genetic autosomal recessive disease.
loss of function or loss of protein mutations in caeruloplasmin.
What are the clinical features of wilson's disease?
Neurological- chorea-atheitoid movements
Hepatic – cirrhosis or sub-fulminant liver failure
Kaiser Fleisher rings - down pigment around the edge of the iris
What is the treatment for wilson's disease?
Copper chelation drugs
What causes alpha 1 anti-trypsin deficiency?
Genetic, Mutations in the A1AT genes, multiple sites, causes variable phenotype
What are the clinical features of alpha 1 anti-trypsin deficiency?
What is Budd Chiari?
Thrombosis of the hepatic veins
What are the clinical features of Budd Chiari?
Acute - jaundice
How is Budd - chiari?
Visualisation of the veins
What is the treatment for Budd chiari?
How is Primary Biliary cirrhosis diagnosed/monitored?
Biopsy - may see grandmas and bile duct loss
Who is most likely to get primary biliary cirrhosis?
What are the storage diseases of the liver?
Who is more likely to get primary haemochromatosis?
What type of mutation is haemochromatosis?
How is iron retention confirm for primary hemochromatosis?
What type of mutation is alpha 1 antitrypsin deficiency?
Autosomal recessive disorder
What does alpha 1 antitrypsin deficiency cause?