Jaundice and Chronic Liver Disease Flashcards

(36 cards)

1
Q

synthetic products of the liver

A

clotting factors

bile acids

carbohydrate
proteins
lipid

hormons

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2
Q

elaborate on how the liver functions to detoxify blood

A

ammonia –> urea

detoxification of drugs

bilirubin metabolism

breakdown of insulin and hormones

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3
Q

elaborate on the immune functions of the liver

A

combats infections

clears the blood of particles and infections
(including bacteria)

neutralising and destroying all drugs and toxins

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4
Q

what does the liver store

A

glycogen

vitamin A, D, B12 and K

copper

iron

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5
Q

what is bilirubin

A

byproduct of haeme metabolism generated by dying red blood cells in the spleen

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6
Q

what does the liver do to bilirubin

A

helps solubilise it

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7
Q

what can cause bilirubin to be raise

A

haemolysis

parenchymal damage

obstruction post-hepatic

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8
Q

what are aminotransferases and where are they located

A

enzymes

hepatocytes

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9
Q

which aminotransferases are more/ less specific and why

A

ALT more specific than AST because AST can be elevated due to other conditions outwith the liver, where as ALT will only be elevated with a liver problem

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10
Q

what are alkaline phosphatase and where are they present

A

enzymes

bile ducts (GI)
also present in bone, placenta and intestines
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11
Q

what can cause alkaline phosphatase to be raised

A

obstruction or liver infiltration

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12
Q

what is gamma GT

A

non specific liver enzyme

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13
Q

what can cause raised Gamma GT

A
  • alcohol use

- NSAIDs

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14
Q

what do low levels of albumin suggest

A

chronic liver disease

kidney disorders

malnutrition

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15
Q

what does prothrombin time indicate

A

degree of liver dysfunction

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16
Q

what can prothrombin time be used to calculate

A

scores to decide stage of liver disease, who needs a liver transplant and who gets a transplant

17
Q

Indicators from creatine LFT

A

determines survival from liver disease

18
Q

why/how can platelet count be influenced by the liver

A

liver is source thrombopoietin

cirrhosis results in splenomegaly

platelets low in cirrhotic subjects mainly as a result of hypersplenism

indirect marker of portal hypertension

19
Q

symptoms of liver problems

A

jaundice

ascites

variceal bleeding

hepatic encephalopathy

20
Q

definition of jaundice

A

yellowing of the skin and other tissues caused by excess circulating bilirubin

21
Q

possible differential diagnosis’s for yellowing of the skin

A

jaundice

carotenemia

22
Q

3 classifications of jaundice

A

pre-hepatic

hepatic

post hepatic

23
Q

effect of pre-hepatic jaundice

A
  • increased quantity of bilirubin

- impaired transport

24
Q

effects of hepatic jaundice

A

defective uptake of bilirubin

defective conjugation

defective excretion

25
effects of post-hepatic excretion
defective transport of bilirubin by the biliary ducts
26
asterixis
liver flap
27
ultrasound of the abdomen - what can it show?
where cause changes spread
28
benefits of ultrasound over CT/MRI
cheaper no radiation portable good for gallstones
29
benefits of CT/MRI over ultrasound
high sensitivity | better for pancreas
30
MRCP benefits over ERCP
no radiation no complications no sedation required can image outwith the ducts
31
ERCP > MRCP benefits
therapeutic options no claustrophobia
32
uses of therapeutic ERCP
- biopsies of tumours - can remove stones - stenting of biliary tract obstruction
33
downsides of therapeutic ERCP
- acute pancreatitis - post operative biliary complications bleeding perforation cholangitis sedation issues
34
when would a percutaneous transhepatic cholangiogram be used instead of ERCP
duodenal obstruction or previous surgery for hilar stenting
35
functions of endoscopic ultrasound
- characterising pancreatic masses staging tumours fine needle aspiration of tumours and cysts excluding biliary microcalculi
36
chronic liver disease
liver disease that persists beyond 6 months