Clinical Aspects of Liver Disease Flashcards Preview

Gastoenterology > Clinical Aspects of Liver Disease > Flashcards

Flashcards in Clinical Aspects of Liver Disease Deck (13):
1

What are the features of alcoholic steatosis/stratosis?

- Macrovesicular steatosis with lipid vacuole filling the hepatocute cytoplasm

2

What are the features of alcoholic hepatitis/NASH?

- Neutrophils and lymphocytes surrounding hepatocytes with Mallory hyaline

3

What are the features of alcoholic cirrhosis/AFLD?

- Pericellular fibrosis as well as bands of fibrois tracts between portal tracts

4

What are the features of NAFLD?

- Increasing severity of NAFLD in patients with T2DM and HTN

5

What are the differences between ALD and NAFLD?

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6

What are the features are usually seen on investigation of alcoholic hepatitis?

- Recent excess alcohol

- Bilirubin >80µmol/l

- Exclusion of other liver disease

- AST <500 (AST:ALT ratio >1.5)

- May show hepatomegaly +/- fever +/- leucocytosis +/- hepatic bruit

7

What are the elements of the Glasgow Alcoholic Hepatitis Score?

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8

What are the signs of chronic liver disease?

- Stigmata

- Spiders

- Fetor

- Encephalopathy

- 'Synthetic dysfunction' (prolonged PT, hypoalbuminaemia)

- Portal hypertension (caput medusa, hypersplenism, thrombocytopenia)

9

What are the stages of chronic liver disease?

- 0) No fibrosis

- 1) Portal fibrosis

- 2) Portal fibrosis with septa

- 3) Bridging fibrosis (focal, diffuse or marked)

- 4) Cirrhosis

10

How is the severity of chronic liver disease assessed? (Evil Ascites Beats All Physicians)

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11

How is ascited assessed?

- Cell count >500WBC/cm3 and >250 neutrophils/cm3 suggest spontaneous bacterial peritonitis

- Albumin involves the serum ascites albumin gradient (SAAG) which is serum albumin minus ascetic albumin g/l – SAAG >11g/l = portal hypertension

- Treatment involves low salt diet, diuretics (spironolactone, furosemide) and paracentesis

12

What scoring system is used to grade mental state in hepatic encephalopathy?

- Conn score (West Haven Classification)

- 0) No abnormality

- 1) Lack of awareness

- 2) Disorientation

- 3) Confusion/stupor

- 4) Coma

13

How is liver disease investigated?

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