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Flashcards in ALD Deck (21)
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1
Q

What is jaundice?

A

Yellowing of the skin and sclera due to high bilirubin levels being deposited in these places

2
Q

What 3 main areas of pathology can cause jaundice?

A

1) pre-hepatic
2) hepatic
3) post-hepatic (blockage)

3
Q

Name a pre-hepatic cause of jaundice?

A

Haemolytic anaemia

4
Q

What is the main age group at risk of ALD?

A

45-64

Males > females

5
Q

What is normal bilirubin?

A

30-35micromol/L

6
Q

What is normal alkaline phosphatase?

A

100-150 U/L

7
Q

What is normal ALT?

A

40-45 U/L

8
Q

What is normal albumin?

A

35-55 g/L

9
Q

What are the main causes of post-hepatic jaundice?

A

Blockage issues = malignancy or bending tumour

10
Q

Can alcohol cause post-hepatic jaundice?

A

No, alcohol Hx does not always mean it is the cause

11
Q

What is the most common type of pancreatic cancer?

A

Pancreatic adenocarcinoma

12
Q

What is the treatment for post-hepatic blockage causing jaundice?

A

ERCP

Stenting of ducts

Treatment of underlying blockage cause (tumour/mass)

13
Q

What signs may you see on a patient with chronic alcoholic liver disease?

A
  • Spider naevi/angioma = Liver can not metabolise oestrogen, which is the cause of this due to its effect of dilating the sphincters of cutaneous arterioles
  • Dupuytren’s contracture
  • Ascites
  • Caput Medusa
  • Pruritic scratch marks (bilirubin from jaundice causes pruritis)
14
Q

Ascites can be transudates or exudates.

Explain the difference and how each occurs in Ascites.

A

Transudates = low protein content = caused by increased hepatic portal vein pressure = cirrhosis causes

Exudates = active secretion due to inflammation = protein content high (>30g/L) = malignancy causes

15
Q

What is pabrinex?

What does it treat?

A

Injection

Contains Vits B and C (thiamine, riboflavin, pyridoxine, nicotinamide and ascorbic acid)

Treats poor diet (alcoholics, psychiatric, post-surgery)

16
Q

What is the treatment for alcoholic hepatitis?

A

Steroid (prednisolone)

17
Q

What type of bleed is melena associated with?

A

Upper GI (e.g. oesophageal varices)

18
Q

What is the treatment for bleeding oesophageal varices?

A

Oesophageal banding

19
Q

What is the name of the scoring system used to stage CLD/cirrhosis?

A

Child-Pugh score

20
Q

Why do CLD patients get oedema in their lower extremities?

A

Less albumin produced by cirrhosed liver = serum albumin low = water loss from vasculature into tissues

21
Q

What type of anaemia is seen in CLD?

A

Macrocytic