JB-Gastro and UGI Flashcards
AUDIT score which may indicate harmful use?
Greater than 8
FBC changes in alcoholic liver disease
Raised MCV
HB could also be low if bleeding
Treatment for alcoholic hepatitis
Steroid improve short term outcomes (caution of infection and GI bleed)
Thiamine, high protein diet
Treatment for alcoholic hepatitis
Steroid improve short term outcomes (caution of infection and GI bleed)
Thiamine, high protein diet
Difference between Wernicke and Korsakoff
W: confusion, oculomotor disturbances and ataxia
K: memory impairment, behaviour changes
4 most common causes of liver cirrhosis
Alcoholic LD
Non alcoholic fatty LD
Hepatitis B
Hepatitis C
What may hyponatraemia indicate in severe liver disease
Fluid retention
Cause of hyponateraemia in LD
Cirrhosis -> portal hypertension -> hepatic splenic vessel dilatation.
Reduced effective CO -> RAS/ ADH activated.
ADH -> solute free water retention
RAS -> hypo perfused kidneys as angiotensin 2 causes vasoconstriction
First line investigation in assessing fibrosis in non-alcoholic fatty LD
Enhanced liver fibrosis blood test (HA, PIIINP, TIMP-1) <7.7 normal, >9.8 severe
USS changes in liver fibrosis
Nodularity on surface
Corkscrew appearance to hepatic arteries
Enlarged portal vein
Ascites and splenomegaly
What scan should patients with cirrhosis have regularly?
USS every 6 months to look for HCC
Fibroscan every 2 years for elasticity
Score that indicates severity of cirrhosis
Child Pugh
HUS presentation
Bloody diarrhoea after a short gastroenteritis.
HTN, AKI, haemolytic anaemia, thrombocytopenia.
HUS management
Antihypertensives, blood transfusion, plasma exchange and dialysis.
What is an melanosis coli
Darkened discolouration of bowel associated with excessive laxative use (bulimia)
