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GI/Gen surg AM > Chronic liver disease > Flashcards

Chronic liver disease Flashcards

1
Q

What is chronic liver disease?

A

Liver disease persisting >6 months

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2
Q

What are the causes of chronic liver disease?

A

Chronic hepatitis
Chronic cholestasis
Fibrosis and cirrhosis
Liver tumours

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3
Q

How does compensated chronic liver disease present?

A

Asymptomatic, detected by abnormal LFTs

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4
Q

How does decompensated chronic liver disease present?

A 
Gynaecomastia, spider navei, clubbing, palmar erythema
Jaundice
Ascites
Varices
Encepahlopathy
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5
Q

What are the sequelae of chronic liver disease?

A

Ascites
VArices
Encephalopathy

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6
Q

What is ascites?

A

Accumulation of fluid in peritoneal cavity

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7
Q

What are the features of ascites?

A

Abdo distension

Shifting dullness

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8
Q

What investigations are done for ascites?

A

Serum ascites albumin gradient
Protein and albumin concentration
Cell count
Bloods- FBC, LFTs, U&Es

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9
Q

What can serum ascites albumin gradient suggest?

A

Elevated i.e.. >11 suggests cirrhosis

Low suggests cancer

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10
Q

What is the management of ascites?

A

Diuretics e.g. spironolactone

Large volume paracentesis with albumin cover

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11
Q

Why is albumin cover indicated in large volume paracentesis?

A

Prevent circulatory dysfunction

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12
Q

What does recurrent ascites indicate?

A

Need for liver transplant

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13
Q

What are varices?

A

Abnormally dilated vessels with tortuous course

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14
Q

What causes varices?

A

Portal hypertension

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15
Q

Where do varies occur?

A

Porto-systemic anastomoses- skin, oesophagus, stomach, rectum, posterior abdominal wall

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16
Q

What is the management of varices?

A

Endoscopic band ligation

Beta blockers

17
Q

What is the emergent management of bleeding varies?

A

Resus
Terlipressin
Emergency endoscopy

18
Q

What is hepatic encephalopathy and what causes it?

A

Failure of liver to break down ammonia, which crosses the blood brain barrier and causes confusion

19
Q

What triggers hepatic encephalopathy?

A 
GI bleeds
Infection
Constipation
Dehydration
Drugs
20
Q

What is the presentation of hepatic encephalopathy?

A

Confusion
Altered GCS
Apraxia
Flapping tremor

21
Q

What is the management of hepatic encephalopathy?

A

Lactulose

Treat underlying cause

22
Q

What does recurrent hepatic encephalopathy indicate?

A

Need for transplant

23
Q

What is cirrhosis?

A

End stage chronic liver disease

Advanced fibrosis replaces functional parenchyma, preventing function and blood flow into and out of liver

24
Q

What are the features of cirrhosis?

A 
Jaundice
haematemesis
Melaema
Ascites
Pruritis
Oedema
25
Q

What are the complications of cirrhosis?

A

Liver failure
Portal hypertension
Risk of hepatocellular carcinoma

GI/Gen surg AM (28 decks)

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