gi biomarkers and treatments basics

Question 1

triple therapy for GI

Answer 1

metronidazole
gentamicin
amoxicillin

Question 2

functional LFT

Answer 2

bilirubin
prothrombin time
albumin

Question 3

cholestatic lft’s

Answer 3

ggt

alk phos

Question 4

liver damage lft

Answer 4

ast

alt

Question 5

name for classfication scoring system for cirrhosis

Answer 5

child-pugh

Question 6

most common cause of acute liver failure in the UK and worldwide

Answer 6

uk=paracetamol overdose

worlwide= viral hepaitits

Question 7

haemolysis disease

Answer 7

unconjugated bilirubin

normal ALT, ALKP, GGT and albumin

Question 8

gilbert’s disease

Answer 8

UDP gluconryltransferase enzyme proble
unconjugated hyperbilirubinaemia
normal LFTS

Question 9

cirrhosis

Answer 9

normal bilirubin
high alt, alkp, ggt and pt
low albumin
thrombocyptopaenia (low platelets)
anaemia
hyponatraemia
hyperbilirubinaemia
imaging shows varices

Question 10

alcoholism

Answer 10

normal bilirubin
high alt and ast 
ast>alt
high ggt especially
high alkp
normal albumin unless cirrhosis

Question 11

metastases to the liver

Answer 11

normal bilirubin, alt,
high ggt, alkp, pt
low alb

Question 12

hcc

Answer 12

high afp

Question 13

hepatitis

Answer 13

mixed bilirubin
high alt especially
high alkp and ggt
normal albumin

Question 14

CCF

Answer 14

high bilirubin
normal ALT
high alkp, ggt and pt
low albumin

Question 15

acute liver failure

Answer 15

high mixed bilirubin
v. high ALT
high alkp, ggt and pt
low albumin

Question 16

chronic liver failure

Answer 16

high mixed bilirubin
high alt, alkp, ggt, pt
very low albumin

Question 17

pancreatic cancer or gallstone

Answer 17

high conjugated bilirubin
high alkp and GGT especially
high alt and pt 
low albumin 
urine bilirubinaemia

Question 18

haemochromatosis

Answer 18

HFE gene

high iron and ferritin

Question 19

pbc

Answer 19

AMA-mitochondria
ANA-nuclear
anti-centromere
ALKP
GGT

Question 20

PSC

Answer 20

ALKP
GGT
IgM
ANCA

Question 21

wilsons

Answer 21

high copper

low caeruloplasmin

Question 22

nafld

Answer 22

high alt
1/3 high alkp or ggt
1/2 high ferrritin

Question 23

alpha 1 antitrypsin

Answer 23

ALT
pizz positive
alpha 1 antitrypsin level

Question 24

budd chiari

Answer 24

JAK2 mutation

Question 25

hep B

Answer 25

HBsAg HBeAg HBeAb HBV DNA >20,000 for treatment

Question 26

hep c

Answer 26

hcv antibody | hcv rna

Question 27

cholangiocarcinoma

Answer 27

CA19-9

Question 28

coeliac antibodies

Answer 28

``` anti-tissue transgluaminase (IgA/ IgG) anti-endomysial (IgA) anti-deaminated gliadin (dgp IgA IgG) anti-gliadin (IgG), (IgA) anti caesin antibody ```

Question 29

UC

Answer 29

HLA DR103

Question 30

CD

Answer 30

NOD2 ATG16L1 IRGM genes

Question 31

autoimmune hepatitis

Answer 31

``` ast alt ASMA- anti smooth muscle ANF LKM ANA ```

Question 32

hepatitis B treatment

Answer 32

tenofovir interferon lamivudine

Question 33

hepatitis C treatment

Answer 33

interferon ribavirin DAA's

Question 34

PBC treatment

Answer 34

ursodeoxycholic acid

Question 35

AICAH auto-immune chronic active hepatitis treatment

Answer 35

steroids | azathioprine

Question 36

wilsons disease treatment

Answer 36

pencillamine | triantine

Question 37

budd chiari syndrome treatment

Answer 37

anti-coagulation | decompression of venous system

Question 38

haemochromatosis treatment

Answer 38

venesection

Question 39

child-pugh score factors

Answer 39

``` prothrombin time albumin bilirubin encephalopathy ascites ```

Question 40

tumour marker for colorectal cancer

Answer 40

cea | carcinoembryonic antigen

Question 41

gene pj sydrome

Answer 41

stk11

Question 42

fap gene

Answer 42

apc at 5q21

Question 43

hnpcc gene/lynch

Answer 43

mismatch repair genes

Question 44

which one is the marker of acute liver disease prothrombin time or albumin

Answer 44

prothrombin time as it has a shorter half life to albumin so used to measure paracetamol overdose -albumin is an acute inflammatory marker so decrease with acute inflammation