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Y1 Gastrointestinal > Chronic Liver Disease > Flashcards

Chronic Liver Disease Flashcards

(64 cards)

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1
Q

what duration counts as chronic liver disease?

A

greater than 6 months

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2
Q

what is the end stage of chronic liver disease?

A

cirrhosis

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3
Q

what is the pathology behind chronic liver disease?

A

recurrent inflammation and repair with fibrosis in an attempt to preserve liver tissue results in fibrosis and then cirrhosis

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4
Q

name five common causes of chronic liver disease

A 
alcohol 
NAFLD 
primary biliary cholangitis 
autoimmune hepatitis 
hepatitis B
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5
Q

name five rare causes of chronic liver disease

A 
haemochromatosis 
primary sclerosing cholangitis 
wilson's disease 
alpha 1 anti trypsin deficiency 
budd chiari
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6
Q

what is the most potent drug that causes chronic liver disease?

A

methotrexate

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7
Q

what defines a chronic liver disease?

A

one that can lead to cirrhosis and has lasted over 6 months

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8
Q

what is the most common disease in the world?

A

non alcoholic fatty liver disease

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9
Q

what is the most common indication for a liver transplant?

A

NAFLD

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10
Q

what is NAFLD strongly associated with?

A

metabolic syndrome

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11
Q

how does NAFLD progress?

A

steatosis
steatohepatitis
fibrosis
cirrhosis

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12
Q

what does hepatocyte degeneration in steatohepatitis cause?

A

ballooning

mallory bodies

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13
Q

how is simple steatosis diagnosed?

A

ultrasound

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14
Q

how is simple steatosis treated?

A

weight loss and exercise

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15
Q

how is NASH diagnosed?

A

liver biopsy

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16
Q

is there a risk of cirrhosis in steatosis?

A

no

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17
Q

is there a risk of cirrhosis in NASH?

A

yes

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18
Q

what does NASH stand for?

A

non alcoholic steatohepatitis

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19
Q

how is NASH treated?

A

weight loss

exercise

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20
Q

what are the three main types of autoimmune liver disease?

A

primary biliary cirrhosis
autoimmune hepatitis
primary sclerosing cholangitis

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21
Q

what two liver diseases have autoimmune features?

A

alcohol related liver disease

drug reactions

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22
Q

what cell mediates primary biliary cirrhosis?

A

CD4+ cells reacting to an M2 receptor target

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23
Q

what group most commonly gets primary biliary cirrhosis?

A

middle aged women

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24
Q

how does primary biliary cirrhosis usually present?

A

usually an asymptomatic, incidental finding

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25
what three symptoms might primary biliary cirrhosis present with?
fatigue itch xanthelasma/xanthomas
26
how is primary biliary cirrhosis diagnosed?
if patients have two of: - positive AMA - cholestatic LFTs - positive biopsy
27
what is AMA?
antimitochondrial antibody
28
what condition is positive for AMA?
primary biliary cirrhosis
29
what is the first line treatment for primary biliary cirrhosis?
ursodeoxycholic acid
30
which gender is more commonly affected by autoimmune hepatitis?
women
31
what are the two types of autoimmune hepatitis?
type 1 and type 2
32
who is most commonly affected by type 1 autoimmune hepatitis?
young women
33
what three antibodies/antigens are present in type 1 autoimmune hepatitis?
ANA ASMA SLA
34
what is ANA?
anti nuclear antibody
35
what is ASMA?
anti smooth muscle antibody
36
what is SLA?
soluble liver antigen
37
what does the presence of SLA in autoimmune hepatitis suggest?
higher severity
38
who is affected by type 2 autoimmune hepatitis?
children and young adults
39
what antibody is exclusive to type 2 autoimmune hepatitis.
LKM-1
40
what is LKM-1?
liver kidney microsomal antibody
41
what blood results are elevated in autoimmune hepatitis?
AST ALT IgG
42
what is the best test to diagnose autoimmune hepatitis?
liver biopsy
43
what two things can be seen upon histology of cells with autoimmune hepatitis?
piecemeal necrosis | interface hepatitis
44
what is the first line treatment for autoimmune hepatitis?
corticosteroids
45
what corticosteroid is given to adults with autoimmune hepatitis?
azathioprine
46
what corticosteroids can be given to children with autoimmune hepatitis?
azathioprine or 6MP
47
what combination therapy of corticosteroids is given to patients with autoimmune hepatitis?
azathioprine and prednisolone
48
what is primary sclerosing cholangitis?
the autoimmune destruction of large and medium sized bile ducts
49
who is more commonly affected by primary sclerosing cholangitis?
males
50
what disease is associated with primary sclerosing cholangitis?
ulcerative colitis
51
how is primary sclerosing cholangitis diagnosed?
MRCP or ERCP
52
what is haemochromatosis?
genetic syndrome of iron overload
53
mutation of which gene causes haemochromatosis?
HFE
54
how is haemochromatosis treated?
venesection (removing excess iron by removing haemoglobin) done whenever needed
55
what is another name for wilson's disease?
lenticulo-hepatic degeneration
56
what type of disease is wilson's disease?
autosomal recessive
57
what does wilson's disease cause?
mutated ceruloplasmin results in tissue deposition of copper causes neurological or hepatic degeneration
58
how is wilson's disease treated?
with copper chelation drugs
59
what causes alpha 1 antitrypsin deficiency?
mutations in the A1AT genes
60
what does A1AT deficiency cause?
emphysema liver damage
61
what is budd-chiari syndrome?
thrombosis of hepatic veins
62
how is budd-chiari syndrome diagnosed?
ultrasound of hepatic veins
63
what drug is a dose dependent liver toxin?
methotrexate
64
what is methotrexate used for?
rheumatoid arthritis psoriasis

Y1 Gastrointestinal (48 decks)

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