Liver 2

Question 1

name 5 causes of hepatitis

Answer 1

1) Viral hepatitis
2) alcoholic hepatitis
3) Autoimmune hepatitis
4) Drug induced hepatitis e.g. paracetamol
5) Non alcoholic fatty liver disease

Question 2

most common Viral hepatitis worldwide?

Answer 2

Hepatitis A

Question 3

How is Hep A transmitted

Answer 3

oral-faecal route

Question 4

how is Hep B transmitted

Answer 4

direct contact with blood/bodily fluids
&
vertical transmission

Question 5

antibody for Hep A that appears soon after symptoms develop

Answer 5

IgM

Question 6

antibody for Hep A that becomes positive 5-10 days after symptoms develop & remains lifelong

Answer 6

IgG

Question 7

what does

surface antigen for Hep B

HBsAg indicate?

Answer 7

active infection

Question 8

what does E antigen for Hep B indicate?

Answer 8

marker of viral replication - implying high infectivity

Question 9

what does core antibody - HBcAb indicate?

Answer 9

past or current infection

Question 10

what does surface antibody - HBsAb indicate?

Answer 10

implies vaccination or past/current infection

Question 11

what is given in the Hep B vaccine?

Answer 11

HBsAg - surface antigen for Hep B

Question 12

vaccination routine for Hep B?

Answer 12

requires 3 doses

Question 13

how does Hep D survive?

Answer 13

Hepatitis D can only survive in patients who also have a Hep B infection (as attaches to the HBsAg)

Question 14

define cirrhosis

Answer 14

irreversible liver damage. Histologically there is loss of hepatic architecture with bridging fibrosis & nodular regeneration

Question 15

most common cause of cirrhosis

Answer 15

alcohol

Question 16

what are capat medusae?

Answer 16

engorged superficial epigastric veins

Question 17

name 3 types of varices?

Answer 17

• capat medusae
• rectal varices
• oesophageal varices

Question 18

location of oesophageal varices

Answer 18

located at gastro-oesophageal junction: superfical and are liable to rupture causing massive GI haemorrhage

Question 19

how to diagnose causes of ascites?

Answer 19

ascitic tap

Question 20

how is underlying cause of ascites found out?

Answer 20

taking a sample of fluid and measuring the SAAG (serum ascites albumin gradient)

SAAG > 11/g = transudate

SAAG < 11/g = exudate

Question 21

what does SAAG > 11 g/L indicate?

Answer 21

transudative ascites

Question 22

causes of transudative asictes?

Answer 22

• Heart failure
• Hypoalbuminaemia
• constrictive pericarditis

Question 23

causes of hypoalbuminaemia

Answer 23

• liver failure
• nephrotic syndrome
• malnutrition

Question 24

what does SAAG < 11 g/L indicate?

Answer 24

exudative ascites

Question 25

causes fo exudative ascities

Answer 25

inflammatory & infective causes - malignancy - TB/bacteria infection - pancreatitis - bowel obstruction

Question 26

1st line prevention of bleeding for patients with cirrhosis with mid to large oesophageal varices

Answer 26

endoscopic variceal band ligation

Question 27

management of refractory ascites

Answer 27

transjugular intrahepatic portosystemic shunt

Question 28

what are the 2 main types of liver cancer?

Answer 28

hepatocellular carcinoma & cholangiocarcinoma

Question 29

tumour marker for hepatocellular carcinoma

Answer 29

Alpha-fetoprotein

Question 30

tumour marker for cholangiocarcinoma

Answer 30

CA19-9

Question 31

investigations for staging cancer

Answer 31

CT/MRI

Question 32

investigation to diagnose cholangiocarcinoma

Answer 32

ERCP

Question 33

common benign tumours of the liver

Answer 33

Haemangioma

Question 34

benign liver tumour made up of fibrotic tissue

Answer 34

focal nodular hyperplasia

Question 35

mechanism of desferoxamine and what is it used to treat

Answer 35

treats high Fe levels in hereditaty haemochoromatosis binds to Fe which makes it easier to be rid of via urine