Jaundice / LFTs
Dark urine in jaundice specifically implies this type of bilirubin is present in urine.
What is conjugated bilirubin?
The two commonest predisposing factors for acute pancreatitis are these.
What are gallstones and alcohol?
What are 5 causes of upper haematemesis?
Peptic ulcer
Esophagitis
Gastritis
Gastro-oesophageal varices
Mallory-Weiss tear
Upper gastrointestinal tumour
Angiodysplasia
Portal hypertensive gastropathy
Boerhaave syndrome
What term means fatty change in the liver?
Steatosis
Which hepatitis has a double-stranded DNA virus?
Hepatitis B
Marked elevation of ALP and GGT with relatively smaller ALT/AST rise is the classic biochemical pattern of this.
What is cholestatic/obstructive jaundice?
The two enzymes classically elevated in acute pancreatitis are these.
What are amylase and lipase?
What are some clinical signs of chronic liver disease?
Spider naevi
Palmar erythema
Jaundice
Encephalopathy
Hepatomegaly
Splenomegaly
Ascites
Peripheral oedema (hypoalbuminaemia)
List 4 substances or groups stored by the liver.
Name the scoring system used to prognosticate liver disease.
Child - Pugh
Pale stools and dark urine in a jaundiced patient most strongly suggest this broad category of jaundice.
What is post-hepatic jaundice? (eg gallstones, malignancy, biliary stricture etc)
A carcinoma in the head of this organ classically presents with what major clinical syndrome?
Obstructive jaundice
List 3 causes of acute hepatitis
List 2 abnormal storage diseases/products mentioned that affect hepatocytes.
Gastrinoma causes what syndrome?
Zollinger–Ellison syndrome.
List 3 causes of obstructive jaundice
What endocrine complication can arise from chronic destruction of this organ?
Secondary diabetes mellitus
due to generalized pancreatic disease such as chronic pancreatitis.
List 4 causes of RUQ pain
-Biliary colic
-Acute cholecystitis
-Acute cholangitis
-Emphyesematous cholecystitis
-Acute hepatitis
-Pyogenic liver abcess
-Liver rupture
-Duodenal ulcer
-Portal vein thrombosis
Which primary liver tumour is associated with PSC and chronic inflammatory disease of bile ducts?
Cholangiocarcinoma
What are causes of portal hypertension (give 1 example for each):
1-Prehepatic
2-Hepatic
3-Posthepatic
Prehepatic -> obstructive thrombosis
Hepatic -> cirrhosis, massive fatty changes, malignancy
Posthepatic -> severe right sided HF, constrictive pericarditis, hepatic vein outflow obstruction
A patient with jaundice has a high INR.
Give two mechanisms that could explain this abnormality.
1. Impaired hepatic synthesis of clotting factors
2. Vitamin K malabsorption in obstructive jaundice
List the 3 patterns of necrosis described in acute disease of this organ.
Which major chronic inflammatory biliary diseases predispose to biliary cirrhosis?
List 5 liver functions
What are 5 causes of hepatocellular injury?
ABCDEFGHI
Autoimmune disease
Hep B
Hep C
Drugs/toxins
Ethanol
Fatty liver
Growths (tumours)
Haemodynamic disorder -> congestive heart failure
Iron (haemochromatosis), copper (Wilson’s)