Etiology
This is often reversible but it is the most common precursor of cirrhosis in the United States.
Alcoholic Hepatitis
A patient presents to the ER with ascites, confusion, abdominal pain, fever, and increased WBC. You perform a paracentesis, an absolute neutrophil count > 250 is noted in the fluid. Diagnosis is:
SBP
Secretion and production of this product by the liver is needed for the digestion of fats
Bile
These 2 lab tests can be defined as “liver function tests”
Albumin
INR
How far back does a Peth detect alcohol intake?
2-3 weeks
97-100% sensitivity, 66-96% specificity
A chronic liver disease characterized by autoimmune destruction of intrahepatic bile ducts and cholestasis, insidious in onset and often detected by a chance finding of elevated alk phos levels
PBC
This is a common abnormality in red blood cell morphology seen in patients with chronic liver disease.
Macrocytosis
The buildup of bilirubin is attributable to what being broken down by the liver
Red Blood Cells
In patients with suspected cirrhosis, this diagnostic test is required to confirm the diagnosis:
Liver Biopsy
Name 4 hepatic mass lesions.
Cysts, Hemangioma, Adenoma, Abscess, Focal Nodular Hyperplasia, HCC, Cholangiocarcinoma, metastasis
This is the most common causes of acute liver failure.
Acetaminophen Toxicity
45yoM presents to the ED with icterus and confusion. This medication will assist the body in excreting toxins potentially causing confusion via the GI tract.
Lactulose
Name 2 hormones the liver activates or regulates
Insulin, Estrogen, Cortisol
These three presentations must be present in order to diagnose acute liver failure:
Elevated AST/ALT, HE, elevated INR
Name 3 components of the MELD score.
Platelets, INR, Sodium, Age, Cr, Total Bili, Albumin
Name 3 causes of Cirrhosis:
Viral, Alcohol, Drug Tox, AI, Metabolic
This is the most important intervention in slowing progression of alcoholic fatty liver disease.
Abstinence from Alcohol
Name 2 Indications for Liver Biopsy:
Multiple parenchymal liver diseases, Abnormal liver tests of unknown etiology, Fever of unknown origin, Focal or diffuse abnormalities on imaging, Staging of known liver disease, Developing treatment plans based on histology
This hepatitis is most likely diagnosed on the following manifestations: exacerabtions known to occur postpartum with amenorrhea, depression, and positive ANA or smooth muscle antibodies.
Autoimmune hepatitis
What is the most common cause of death in cirrhotic patients?
Acute Variceal Bleeding
Name 2 medications linked to the development of Cirrhosis
Didanosine, Amiodarone, Methyldopa, PTU, Tamoxifen, Retinol, Isoniazid, Methotrexate
These are three reasons that malnutrition is a common complication in liver failure patients.
Poor dietary intake, Altered Gut absorption, Altered protein metabolism
The clinical features of cirrhosis result from these two pathological occurrences:
Name two acute liver diseases that manifest themselves with a prodrome of anorexia, nausea and vomiting, malaise, fever, enlarged and tender liver with jaundice.
Acute Viral Hepatitis A and B
A meld score > than ___ should prompt consideration of steroid treatment in alcoholic hepatitis.
MELD > 20