Flashcards in Week 7 Deck (93)
What percentage of liver disease in Scotland is alcohol related?
What are the recommendations for weekly alcohol intake?
Men and women shouldn't have more than 14 units of alcohol per week and this should be spread over 3 or more days and drinkers should limit the amount they have on single occasions.
What are some of the clinical signs of alcoholic liver disease?
What is 'Childs - Turcotte - Pugh'?
A scoring system/ model for end stage liver disease which indicates COMPENSATION or DECOMPENSATION
What is 'Maddney's Discriminant Function?'
A model which predicts PROGNOSIS in alcoholic hepatitis
What is the 'Glasgow Alcoholic Hepatitis Score'?
A model which predicts MORTALITY in alcoholic hepatitis patients
Which drug can be beneficial in for short-term prevention of mortality in alcoholic hepatitis but is not useful for medium/ long-term outcomes?
What is the most common liver tumour in the absence of liver disease?
List benign liver tumours
Focal nodular hyperplasia
List malignant liver tumours
Focal nodular hyperplasia tumours are benign tumours of the liver. What are they composed of?
They are nodules of normal liver tissue and contain all the liver ultrastructure (sinusoids e.t.c)
Hepatic adenomas are benign liver tumours. What are they composed of?
They are nodules purely composed of hepatocyte - they do not contain all the liver ultrastructure
Which has a higher risk of malignant degeneration and bleeding ; Focal nodular hyperplasia tumours or hepatic adenomas?
What are some of the benign liver cysts?
How is polycystic liver disease managed?
Somatostatin analogues (for symptom relief)
How are liver abscesses managed?
What is the most common primary liver cancer?
Hepatocellular carcinoma (HCC)
What are the risk factors for hepatocellular carcinoma?
- Hep B
- Hep C
What are the clinical features of HCC?
What sites can primary liver tumours metastasise to?
The rest of the liver
What tests are used for the diagnosis of HCC?
How is HCC managed/ treated?
Resection (small tumours with preserved liver function)
Fibro- Lamellar carcinoma is a malignant liver tumour which is not associated with cirrhosis. How would this be diagnosed? What typical signs does it show on investigation?
CT shows stellate scar and persistent enhancement of the radial septa
What are the common site for secondary metastases TO the liver?
Describe the appearance of urine and stools in the 3 different forms of jaundice
Prehepatic - Normal urine and stools
(Intra)Hepatic - Dark Urine + normal/ pale stools
Posthepatic - Dark urine and pale stools
What extra things should be asked about in a history of a patient who might have jaundice?
PMH of jaundice
What are the useful tests that can be done for a patient with suspected jaundice?
Describe what is meant by prehepatic jaundice
Excess haemolytic - too much bilirubin is produced e.g haemolytic anaemia
Describe what is meant by intrahepatic jaundice
Hepatocytes are dead/ injured and therefore can't conjugate and excrete bilirubin/ bile