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Flashcards in GI Liver more Deck (24):
1

Cilastozol used in peripheral artery disease

oh ok

2

TZDs can help NASH

B/c reduces insulin resistance maybe

3

Spider telangectasia can happen in liver failure/cirrhosis from high estrogen

oh ok

4

What is budd chiari? Tx?

Thrombosis of hepatic vein or IVC. Presents with:

Ascites (BIG CLUE)
Hepatomegaly
Jaundice

RUQ pain, and the rest happening

Anticoag or shunting!

5

What is SAAG? What is cutoff?

Serum Albumin - Ascites Albumin

(Serum-Albumin Ascites Gradient)

1.1 is cutoff. If more than that it is low ascites in albumin. So FROM PORTAL HTN

If less than that, high albumin in ascites, or low albumin in serum. Cancer, Tb in peritoneum, pancreatitis, Nephrotic...

6

Ascites has high albumin and high LDH?

Means cancer caused it. Do workup for cancer

7

Spontaneous bacterial peritonitis tx?

Albumin and 3rd gen ceph

8

Portal HTN tx?

SPironolactone and furosemide
Beta blockers
Vasopressin
Hepatic shunting

9

Abd pain, testiculur atrophy, arhtralgia, polydipsea, has what kind of cardiomyopathy?

Hemochromatosis (test atrophy is from deposition in pituitary)

Dilated more common than restrictive

10

Screening test for hemochromatosis? Aut rec

tx

Ferritin.

Then biopsy is to see extent

Phlebotomy is tx once per week or so

avoid booze b/c always avoid it in liver disease

11

Complications of hemochromatosis?

Cirrhosis, hep carcionoma, CHF, diabetes, hypopituitarism (all makes sense)

12

Wilson caused by what

impaired copper secretion. You will find low ceruloplasm for screening (not the cause of it, but you find it)

Builds in liver, brain, cornea

Depression, personality change, loss of coordination, parkinsonian like symptom, tremor

Jaundice, hepatomegaly, cirrosis

Keyser flescher rings in cornia

13

Wilsons tx?

Trientine or penicillamine to chelate copper

zinc
restrict copper
Vit B6 supplements
Liver transplant

14

Alpha1 antitrypsin does what? Who you suspect?

inhibits elastase. So breaks down elastin in lungs

In liver, it Alpha 1 antitrypsin accumulate in liver, and that is toxic

Codominant, one bad gene, might get COPD in a smoke at a young age. If double bad genes bad early on (before 30)

15

Antibodies in autoimmune hepatitis? Tx?

Anti-smooth muscle (classic type 1)

Liver kidney microsomal LKM antibodies

Tx with azothiprine and steroids

16

Benign liver issues associated with what?

OCP use. Hep adenoma, focal nodular hyperplasia, hemangioma, hep cyst

17

What is associated with hepatic adenoma?

Benign tumor

OCP use
Steroids use (trend with hormones)
Glycogen storage disease

Can have mass effect and pain
Malignant transformation in 10%

18

Tx of hepatic adenoma?

AFP screening or serial imaging after stopping OCP

Resection if grows b/c 10% goes malignant

19

What do you do if hepatic cancer?

DO CT TO FIND WHERE METS CAME FROM

Consider colonoscopy

20

Aflatoxin ingestion is risk for what?

Infected grain products

21

Bruit over liver?

Consider cancer b/c lots of revascularization

SO TRY NOT TO BIOPSY B/c it will bleed

22

Tx liver carcinoma?

Surger, chemo, transplant, ready to block bleeding

23

Paraneoplastic stuff with hepatocarinoma?

Hypoglycemia
High Epo
Refractory watery diarrhea
Hypercalcemia
Skin lesions

24

Epo is high with what? mnemonic

Potentially Really High Hematocrit

Pheo
Renal cell
Hepatocellular
Hemangioblastoma (CNS)