Liver Disease Flashcards
(32 cards)
Diagnostic Tests
ANA or SMA, elevated IgG levels, and compatible histology
Autoimmune hepatitis
Diagnostic Tests
Mitochondrial antibody, elevated IgM levels, and compatible histology
Primary biliary cirrhosis
Diagnostic Tests
P-ANCA, cholangiography
Primary sclerosing cholangitis
Diagnostic Tests
Reduced 1 antitrypsin levels, phenotypes PiZZ or PiSZ
1 Antitrypsin disease
Diagnostic Tests
Decreased serum ceruloplasmin and increased urinary copper; increased hepatic copper level
Wilson’s disease
Diagnostic Tests
a-fetoprotein level >500
US or CT image of mass
HCC
Biopsy size adequate
1.5-2 cm
most common causes of chronic liver disease in general order of frequency
chronic hepatitis C, alcoholic liver disease, nonalcoholic steatohepatitis, chronic hepatitis B, autoimmune hepatitis, sclerosing cholangitis, primary biliary cirrhosis, hemochromatosis, and Wilson’s disease
CPC score
A 5-6
B 7-9
C 10-15
Purpose of CPC
> predictor of survival
predicts the likelihood of major complications of cirrhosis such as bleeding from varices and spontaneous bacterial peritonitis
Child pugh
Bilirubin Albumin Prothrombin time Hepatic encephalopathy Ascites
cirrhotics screen/surveillance HCC
6-12 mo ultrasound liver
Markers autoimmune hepatitis
ANA
anti LKM
MArker sclerosing cholangitis
p-ANCA
PBC marker
AMA
Dupuytren contracture
parotid enlargement-
o chronic alcoholism
o alcoholic liver disease
Kayser-Fleischer rings
Wilson’s disease; olden-brown copper pigment deposited in Descemet’s membrane at the periphery of the cornea
Mucocutaneous vasculitis with palpable purpura
o cryoglobulinemia of chronic hepatitis C
slate gray pigmentation of skin
hemochromatosis
o xanthelasma and tendon xanthomata
o retention and high serum levels of lipids and cholesterol
o Hyperpigmentation of skin
primary biliary cirrhosis and sclerosing cholangitis
Triad of hepatopulmonary syndrome
- liver disease
- hypoxemia
- pulmonary AV shunting
where seen:
platypnea and orthodeoxia- shortness of breath and oxygen desaturation that occur paradoxically upon assuming an upright position
• hepatopulmonary syndrome
acute liver failure + hepatic encephalopathy
fulminant hepatitis