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Flashcards in Week 7 Deck (93)
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1

What percentage of liver disease in Scotland is alcohol related?

80%

2

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.

3

What are some of the clinical signs of alcoholic liver disease?

Portal hypertension
Jaundice
Ascites
Encephalopathy
Cirrhosis
Hepatomegaly
Fever
Malaise
Sepsis
Deranged LFTs

4

What is 'Childs - Turcotte - Pugh'?

A scoring system/ model for end stage liver disease which indicates COMPENSATION or DECOMPENSATION

5

What is 'Maddney's Discriminant Function?'

A model which predicts PROGNOSIS in alcoholic hepatitis

6

What is the 'Glasgow Alcoholic Hepatitis Score'?

A model which predicts MORTALITY in alcoholic hepatitis patients

7

Which drug can be beneficial in for short-term prevention of mortality in alcoholic hepatitis but is not useful for medium/ long-term outcomes?

Prednisolone

8

What is the most common liver tumour in the absence of liver disease?

Haemangioma

9

List benign liver tumours

Haemangioma
Hepatic adenoma
Focal nodular hyperplasia
Liver cysts

10

List malignant liver tumours

Hepatocellular carcinoma
Cholangiocarcinoma
Hepatoblastoma
Fibro-lamellar carcinoma

11

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)

12

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

13

Which has a higher risk of malignant degeneration and bleeding ; Focal nodular hyperplasia tumours or hepatic adenomas?

Hepatic adenomas

14

What are some of the benign liver cysts?

Simple cysts
Hydatid cysts
Liver abscesses

15

How is polycystic liver disease managed?

Somatostatin analogues (for symptom relief)
Defenestration/ aspiration
Liver transplantation

16

How are liver abscesses managed?

Antibiotics
Aspiration/ drainage
Resection

17

What is the most common primary liver cancer?

Hepatocellular carcinoma (HCC)

18

What are the risk factors for hepatocellular carcinoma?

CIRRHOSIS
- Hep B
- Hep C
- Alcohol
- Aflatoxins

19

What are the clinical features of HCC?

Weight loss
RUQ pain
RUQ mass
Liver bruit

20

What sites can primary liver tumours metastasise to?

The rest of the liver
Portal vein
Lymph nodes
Lung
Bone
Brain

21

What tests are used for the diagnosis of HCC?

Elevated AFP
Ultrasound
CT
MRI
Biopsy

22

How is HCC managed/ treated?

Liver transplantation
Resection (small tumours with preserved liver function)
Local ablation
Chemoembolisation
Systemic therapies

23

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?

Normal AFP
CT shows stellate scar and persistent enhancement of the radial septa

24

What are the common site for secondary metastases TO the liver?

Colon
Breast
Lung
Stomach
Pancreas
Melanoma

25

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

26

What extra things should be asked about in a history of a patient who might have jaundice?

Travel history
Drugs
Sexual history
Blood transfusions
Tattoos
PMH of jaundice

27

What are the useful tests that can be done for a patient with suspected jaundice?

U&Es
FBC
LFTs
CRP
Virology
Ultrasound

28

Describe what is meant by prehepatic jaundice

Excess haemolytic - too much bilirubin is produced e.g haemolytic anaemia

29

Describe what is meant by intrahepatic jaundice

Hepatocytes are dead/ injured and therefore can't conjugate and excrete bilirubin/ bile

30

What are some of the causes of intrahepatic jaundice?

Hepatitis
Cirrhosis
Drugs
Pregnancy