Liver 2

Question 1

What are the different types of jaundice

Answer 1

1. ) PREHEPATIC JAUNDICE
2. )HEPATIC JAUNDICE
3. )POST HEPATIC JAUNDICE

Question 2

What is the cause of pre-hepatic jaundice

Answer 2

-Anything that increases the rate of hemolysis

Question 3

Where does unconjugated bilirubin come from?

Answer 3

The breakdown of the heme pigment found in the RBCs haemoglobin

Question 4

What are the causes of hepatic jaundice

Answer 4

• cirrhosis
• viral hepatitis
• tumors
• drugs

Question 5

What are the causes of post hepatic jaundice?

Answer 5

gallstones
Cancer of bile ducts:
-carcinoma of head of the pancreas
-Carcinoma of ampulla of vater

Question 6

What is the ampulla of vater

Answer 6

formed by the union of the pancreatic duct and the common bile duct

Question 7

How can we classify the problems that arise with the plumbing of the liver

Answer 7

• The plumbing of the liver consists of bile ducts

- Problems can be classified as benign or malignant

Question 8

What may alcoholic liver disease (ALD) be known as

Answer 8

-Disease of the young

Question 9

What are the normal bilirubin levels?

Answer 9

17.1-20.5micromol/L

Question 10

What are the normal alkaline phophate levels?

Answer 10

44-147U/L

Question 11

What are the normal ALT levels?

Answer 11

40/45U/L

Question 12

What are the normal albumin levels

Answer 12

35-55g/L

Question 13

What does a low albumin level indicate

Answer 13

less protein is being synthesised than normal

Question 14

What is ERCP

Answer 14

• Endoscopic retrograde cholangiopancreatography
• Enables examination of the pancreatic and bile ducts
• Looks like a CT scan;contrast is injected
• You put a plastic metal stent inside,allowing for expansion.It is covered with plastic so that it doesn’t get stuck in their forever. This allows the bile to drain away

Question 15

What is non-hodgkin lymphoma

Answer 15

• A form of malignant lymphoma distinguished from Hodgkin’s disease only by the absence of binucleate giant cells
• Develops when the body makes abnormal B cells called lymphoma cells
• The lymphoma cells usually build up in lymph nodes, but they can affect other parts of the body
• Different types eg diffuse large B-cell type which is an aggressive lymphoma
• classified by the type of lymphocyte involved

Question 16

What are the signs of chronic liver disease?

Answer 16

• spider naevi

- Dupytren’s contractures

Question 17

What may abdominal swelling be caused by

Answer 17

• Fetus
• Fat
• Fluid
• Faeces
• Flatus

Question 18

What is caput medusae

Answer 18

• The appearance of distended or engorged superficial epigastric veins
• May be a sign of portal hypertension. Caused by dilation of the paraumbilical veins, which carry oxygenated blood from mother to fetus in utero and normally close within one week of birth, becoming re-canalised due to portal hypertension caused by liver failure

Question 19

What is acutely decompensated cirrhosis

Answer 19

The development of jaundice, ascites, variceal haemorrhage or hepatic encephalopathy
-Survival is poor and pts should be considered for liver transplantation

Question 20

Outline the Child-Pugh classification of cirrhosis

Answer 20

5 Factors include:

• serum biliribun
• serum albumin
• Prothrombin time
• Ascites
• Hepatic encephalopathy
• each factor is awarded a score of 1-3 with 3 being the worst according to certain values
• The max score is 15 (the worst)

Question 21

Outline a liver screen consists of

Answer 21

• Aim to exclude other causes as well
• For chronic liver disease

includes. ..
- abdominal ultrasounds
- autoimmune screen (IgM/IgG/IgA, ANA, anti-LKM antibodies, anti-mitochondrial abs, anti-smooth muscle abs
- Caeruloplasmin (<40yrs)
- Alpha-1 antitrypsin
- Transferrin saturation
- Hepatitis (Hep A IgG, Hep B sAg, Hep C IgG)

Question 22

How can we summarise alcoholic hepatitis

Answer 22

-Toxic inflammation

Question 23

What is prednisolone used for

Answer 23

-A steroid used to treat certain types of allergies, inflammatory conditions, autoimmune disorders and cancers

Question 24

What is banding of varices?

Answer 24

Endoscopic therapy is a way of preventing and treating variceal bleeding without the requirement for surgery.
-Most common procedure= endoscopic variceal banding (or ligation), rubber bands are placed around varices in the esophagus through a flexible endoscope which is used to visualize the vessels.

Question 25

What is hepatic hydrothorax?

Answer 25

'white out' | -Basically ascites in the pleural space

Question 26

What is a tonic-clonic seizure?

Answer 26

disturbance in the functioning of both sides of your brain | -Combo of a tonic seizure and a clonic seizure

Question 27

What is a clonic seizure?

Answer 27

Rhythmic twitching or jerking of one or several muscles

Question 28

What is a tonic seizure

Answer 28

- Sudden stiffening and contraction of the muscles | - Loss of muscle tone

Question 29

What is acute-on-chronic liver failure?

Answer 29

A syndrome where acute decompensation of chronic liver disease and high organ failure