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GI Revision Concise Cards > Revision Week 6 Liver > Flashcards

Revision Week 6 Liver Flashcards

(63 cards)

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1
Q

What is Glisson’s capsule?

A

fibrous protective lining on the liver

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2
Q

What divides the left and larger right lobe?

A

falciform

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3
Q

What does each segment have?

A

Own portal vein, artery and bile duct

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4
Q

What does fenestrated endothelium mean?

A

Liquid has access but blood does not

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5
Q

What are the stages in Phase I of drug metabolism in the liver?

A
  • Oxidation
  • reduction
  • hydrolysis
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6
Q

What is Phase II of drug metabolism?

A

Conjugation

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7
Q

How are drugs excreted from body?

A
  • Kidneys
  • faeces (bile from liver)
  • lungs (water vapour)
  • sweat/tears
  • milk, saliva
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8
Q

What does Phase 1 do in drug metabolism?

A

Increases drug polarity

-creates a new chemically reactive group permitting conjugation

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9
Q

What happens in phase 2

A

further increases polarity

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10
Q

What do LFTs distinguish in liver?

A

Hepatocellular injury or cholestasis

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11
Q

What are LFTs?

A
  • ALT
  • AST
  • ALP
  • GGT
  • Bilirubin
  • Albumin
  • PT
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12
Q

Why are bilirubin, albumin and pt called true LFTs?

A

Measures of protein synthesis in liver

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13
Q

ALT

A

marker for hepatocellular injury

-mainly exists in liver

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14
Q

AST

A
  • also in heart, skeletal muscle,brain, RBC

- may be elevated because of diseases associated with other areas its in

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15
Q

Where can ALP be found?

A

-present in liver, bile duct, bone and placenta

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16
Q

altered levels raising ALPs?

A
  • biliary obstruction
  • liver disease
  • bone problems
  • hyperthyroidism, hyperparathyroidism
  • renal osteodystrophy
  • pregnancy
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17
Q

When does ALP synthesis increase?

A

During cholestasis

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18
Q

In what cells in bone can ALP be found?

A

osteoblasts

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19
Q

GGT present where?

A
  • liver/bile duct
  • kidneys
  • pancreas
  • gallbladder
  • etc. etc.
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20
Q

hepatocellular injury?

A

ALT increased

AST increased

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21
Q

cholestasis

A

ALP increased

GGT increased

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22
Q

What is cholestasis?

A

Blockage of bile duct

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23
Q

If ALP and GGT both increased what does that suggest?

A
  • suggests biliary epithelial damage and bile flow obstruction
  • GGT increase confirms that ALP increase is from liver
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24
Q

GGT and alcohol

A

GGT raised with lots of alcohol

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25
albumin function
maintains intravascular osmotic pressure
26
bilirubin
breakdown product of haemoglobin, gets conjugated in liver and excreted
27
What causes darker urine
conjugated bilirubin passes to liver causing darker urine
28
pre-hepatic jaundice
excessive red blood cell breakdown
29
hepatocellular jaundice
jfpsf
30
post-hepatic
liver fine, obstruction biliary drainage but bilirubin still conjugated
31
pre-hepatic jaundice causes
- Gilbert's syndrome | - Haemolytic anaemia
32
hepatocelullar jaundice acute causes
- poisoning e.g. paracetamol - infection - liver ischaemia
33
hepatocellular jaundice chronic causes
- cirrhosis | - etc
34
obstructive jaundice causes
- gallstones - strictures - tumours - congenital biliary atresia
35
When is chronic liver disease chronic
longer than 6 months
36
compensated cirrhosis
asymptomatic stage | LFTs show damage
37
decompensated cirrhosis
symptomatic: - ascites - jaundice - variceal haemorrhage - hepatic encephalopahty
38
what cells are activated in liver when damaged and produce fibrosis
heapptonfn
39
what is steatosis
fatty acid build up in cells in liver
40
NASH
steatosis + inflammation and scarring
41
When is it not reversible
fibrosis
42
What is mainly responsible for liver disease in alcohol?
acetaldehyde
43
What are scores for grading cirrhosis
CHild-Pugh | -...
44
UKELD score for transplant
49
45
ascites diagnosis
- shifting dullness | - USS
46
What is treatment for ascites?
- treat underlying disease - look for infection - decrease salt intake - no NSAIDs - spironolactone first line - loop diuretics - paracentesis - TIPSS or transplant
47
What is first line medication for ascites?
Spironolactone -mineralocorticoid receptor antagonist
48
What is hepatorenal syndrome?
Kidney failure seen in those with severe liver damage
49
What activates RAAS system in kidneys?
decreased perfusion of glomeruli
50
Treatment for hepatorenal syndrome?
- Transplantation | - TIPSS
51
Spontaneous bacterial peritonitis?
bacterial infection in the peritoneum, despite the absence of an obvious source of infection
52
What antibiotics for SBP? (Mild and severe?)
Mild - co-trimaxazole PO | Severe -
53
What is hepatic encephalopathy?
build up of ammonia -> hyperammonaemia
54
What is hyperammonaemia toxic to?
CNS - disturbs astroytes
55
treatment for hepatic encephalopathy?
- lactulose | - antibiotics
56
What is definition of acute liver failure?
causing encephalopathy and impaired protein synthesis
57
hep A
igM
58
hepA and igG
means theyve had vaccination
59
How is Hepatitis B transmitted? (3 Bs)
- Bone (sex) - Baby - Blood
60
What are children with Hep B more likely to get?
Chronic Hep B
61
Surface antigens Hep B HBsAg
present in all infectious individuals
62
HBeAg
marker for how infectious individual is - usually related to acute
63
Hep B virus DNA
measure response to antiviral therapy | -used for prognosis

GI Revision Concise Cards (4 decks)

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