Acutey Patootie
What is the definition of Acute Liver Failure?
When is Hepatitis considered chronic?
> 6 months = Chronic Hepatitis
Prolonged ALD can lead to what irreversible outcome?
Cirrhosis
What is the currently accepted medical term for "Fatty Liver"?
Metabolic dysfunction Associated Steatotic Liver Disease
(MASLD)
Despite advancements in diagnostic tools, what is still considered the 'gold standard' in diagnosing Cirrhosis?
Liver biopsy
What is the leading cause of Acute Liver Failure in the US?
Acetaminophen overdose
Which of the 5 Hepatitis viruses is a DNA virus?
Hepatitis B
What is the treatment for Alcoholic Liver Disease?
Cessation of alcohol + Supportive care
Why does Alpha1-Antitrypsin Deficiency (AATD) cause liver damage?
Deformed Alpha1-Antitrypsin accumulates in the liver
Why might Cirrhosis lead to pancytopenia?
Cirrhosis ––> Portal HTN ––> Hypersplenism ––> Sequestration of blood cells
What are the 2 most distinctive clinical features of Acute Liver Failure?
Which Hepatitis virus requires co-infection of a different strand of Hepatitis virus?
Hepatitis D virus
(requires Hepatitis B virus)
What is the typical LFT pattern for Alcoholic Hepatitis?
2:1 ratio of AST:ALT
(toAST to ALcohol)
What gene is commonly mutated in Hemochromatosis?
HFE gene
(leads to ↓ Hepcidin)
What are the 5 most common sites of varices secondary to portocaval shunting?
Esophagus, Gastric fundus, Anorectal veins, Periumbilical veins
What are 2 non-life threatening conditions that can present similarly to Acute Liver Failure?
Reye's Syndrome & Acute Fatty Liver of Pregnancy
Which Hepatitis B antigen is present in the 'window period'?
Hepatitis B C antigen (HBcAg)
What are the 2 metabolites of Ethanol that are directly hepatotoxic?
Acetaldehyde & NADP
What is the name of the ocular finding associated with Wilson's disease?
Kayser-Fleischer rings
Portal HTN is defined as an elevation in the Hepatic Venous Pressure Gradient (HVPG); what is the numerical threshold?
HVPG > 5mmHg
(tho clinically significant > 10mmHg)
What is the calculation model that best identifies Acute Liver Failure pts at highest risk for poor outcomes without transplantation?
King College Hospital's Criteria
(available in MD Calc)
No Anti-HBc present in vaccinated person
(only exposed to HBsAg)
What is the histological triad associated with Alcoholic Hepatitis liver biopsies?
Mallory bodies
PMNs
Interlobular fibrosis
An ATP7B mutation on chromosome 13 causes which chronic, genetic liver disease?
Wilson's disease
What imaging study used to evaluate R-to-L heart shunt can be used to evaluate for Hepatopulmonary Syndrome?
Bubble test