Edu Day: Chronic Liver Disease

Question 1

Icterus (jaundice) is clinically visible when serum bilirubin is more than ______ umol/L

Answer 1

50

Question 2

Important investigations in CLD (7)

Answer 2

FBC
LFT
Coagulation profile
RP
Virologies
Thyroid function
Autoimmune markers for PBC and AIH

Question 3

Limitation of US for scanning Liver

Answer 3

Distal biliary obstruction cannot be seen because of overlying bowel gas

Question 4

Imaging from first line and onwards to assess liver

Answer 4

US Liver
CT
MRI (contrast: Primovist)
MRCP
Endoscopic US
Fibroscan
Liver biopsy

Question 5

Common causes of cirrhosis (4)

Answer 5

Alcohol
Hepatitis B +- D
Hepatitis C
NAFLD

Question 6

Triggers of decompensation of ACLD (8)

Answer 6

Infection
Bleeding
Hepatotoxic drugs
È imbalance
Malignancy
Constipation
Portal vein thrombosis
Surgery

Question 7

What makes a chronic insult?

Answer 7

Something that is always there like Hep B, NASH, cirrhosis

Question 8

Modified Child Pugh used for?

Parameters?

Answer 8

1, 5, and 10 year survival rate for liver cirrhosis

Ascites
Encephalopathy
Bilirubin
Albumin
Prothrombin time (secs over normal)

Question 9

Factors (others) associated with poor survival. (6)

Answer 9

MAP <= 82 mmHg
Adrenal insufficiency –> HyopNa+
Hepatorenal syndrome
Hepatopulmonary syndrome
ICU requiring inotropes
Jaundice

Question 10

Liver decompensation signs (4)

Answer 10

Hepatic Encephalopathy
Ascites
Variceal bleed
Jaundice