liver Flashcards
what is non alcoholic fatty liver disease
fatty deposits in the liver (thought to be lead by insulin resistance) cause reduced function leading to hepatitis, fibrosis and cirrhosis if severe
what are the investigations to diagnose NAFLD
usually found accidentally on USS
will have elevated ALT and AST
if pt symptomatic and no cause is found usually they will do a non-invasive liver screen
on the USS usually fatty deposits will show
then first line test is an enhanced liver fibrosis test to see the degree / level of fibrosis
NAFLD fibrosis scoring is done second line if no ELF tests available
3rd line is a fibroscan which can also be used to monitor degree of fibrosis
what is the management of non alcoholic fatty liver disease
- conservative with emphasis on weight loss, exercise,
- control diabetes, BP and cholesterol
- all patients with evidence of fibrosis refer to hepatologist who may treat with vitamin E / pioglitazone
name 5 causes of hepatitis
- viral
- drug induced eg paracetomol overdose
- non alcoholic fatty liver
- autoimmune
- alcoholic hepatitis
what type of virus is hep A
RNA
what type of virus is hep B
DNA
what type of virus is hep c
RNA
what type of virus is hep E
RNA
what type of virus is hep D
RNA
which viral hepatitis are chronic
B, C and D
presentation of hep A and E
acute onset
flu like prodome, jaundice, tender hepatomegaly, RUQ pain, joint ache, N+V
derranged LFT’s (can cause cholestasis so can either be hepatic picture or cholestatic picture or mixed)
management of hep A and E
conservative bc self limiting
how are Hep A and E spread
poo
complications of hep C and B
hepatocellular carcinoma
cirrhosis
liver failure
management of hepatitis C
screen for other blood borne viruses
fibroscan and screening for HCC
direct antivirals for 8-12 weeks (all end in ivir)
notify PHE
