Liver Diseases - Overview
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Questions and Answers

What disease is defined by acute viral liver inflammation, transmitted via the faeco-oral route, and typically resolves with supportive treatment?

  • Hepatitis D
  • Hepatitis A (correct)
  • Hepatitis B
  • Hepatitis C

What disease involves a DNA virus that integrates into the host genome, potentially leading to chronic hepatitis, cirrhosis, and hepatocellular carcinoma?

  • Hepatitis E
  • Hepatitis A
  • Hepatitis B (correct)
  • Hepatitis C

Which disease is characterized by an RNA virus causing liver inflammation with a high risk of progressing to chronic liver disease and cirrhosis?

  • Hepatitis A
  • Hepatitis E
  • Hepatitis D
  • Hepatitis C (correct)

What liver disease is caused by a defective virus that requires Hepatitis B for replication and exacerbates liver damage when both infections are present?

<p>Hepatitis D (A)</p> Signup and view all the answers

What acute viral hepatitis, transmitted faeco-orally, is typically self-limiting but poses a greater risk of severe outcomes during pregnancy?

<p>Hepatitis E (C)</p> Signup and view all the answers

What condition results from irreversible scarring of the liver caused by long-term damage from factors such as alcohol abuse or viral hepatitis?

<p>Cirrhosis (B)</p> Signup and view all the answers

What liver condition involves excessive fat accumulation in the liver unrelated to alcohol consumption, often associated with obesity or high cholesterol?

<p>Non-Alcoholic Fatty Liver Disease (NAFLD) (C)</p> Signup and view all the answers

What inherited disorder disrupts copper metabolism, leading to the accumulation of copper in the liver, brain, and eyes?

<p>Wilson Disease (A)</p> Signup and view all the answers

What disease of the liver is caused by an excessive intake of paracetamol?

<p>Drug-induced Hepatitis (B)</p> Signup and view all the answers

What condition results in the yellowing of the skin and sclera due to elevated bilirubin levels, often linked to liver dysfunction or hemolysis?

<p>Jaundice (Icterus) (B)</p> Signup and view all the answers

What disease is characterized by irreversible scarring of the liver due to long-term damage from factors such as chronic hepatitis or alcohol abuse?

<p>Cirrhosis (A)</p> Signup and view all the answers

Which liver disease is caused by a DNA virus and can lead to chronic infection, cirrhosis, or hepatocellular carcinoma?

<p>Hepatitis B (D)</p> Signup and view all the answers

What liver condition is specifically associated with excessive and prolonged alcohol consumption?

<p>Alcohol-Related Liver Disease (ARLD) (A)</p> Signup and view all the answers

Which form of viral hepatitis requires co-infection with Hepatitis B to cause liver damage?

<p>Hepatitis D (B)</p> Signup and view all the answers

What is the primary route of transmission for Hepatitis E?

<p>Fecal-oral route (A)</p> Signup and view all the answers

What condition involves ongoing liver injury for more than six months, characterized by progressive fibrosis and an increased risk of cirrhosis?

<p>Chronic Liver Disease (A)</p> Signup and view all the answers

What disease is caused by an RNA virus that is mainly transmitted through blood and can cause chronic hepatitis, cirrhosis and liver cancer?

<p>Hepatitis C (C)</p> Signup and view all the answers

A patient presents with jaundice, ascites, and hepatic encephalopathy due to long-standing alcohol abuse. Liver biopsy shows extensive fibrosis and nodule formation. What is the most likely diagnosis?

<p>Alcoholic cirrhosis (C)</p> Signup and view all the answers

A 30-year-old pregnant woman from a developing country presents in her third trimester with acute jaundice, nausea, vomiting, and right upper quadrant pain. Serological tests are negative for Hepatitis A, B, and C. What is the most likely form of hepatitis?

<p>Hepatitis E (A)</p> Signup and view all the answers

A 55-year-old male with a history of intravenous drug use is diagnosed with chronic hepatitis. Serological tests reveal the presence of anti-HCV antibodies and a high viral load. Liver biopsy shows significant fibrosis and inflammation. What is the most critical next step in managing this patient's condition?

<p>Starting antiviral therapy with direct-acting antivirals (DAAs). (B)</p> Signup and view all the answers

What liver condition is defined by irreversible scarring resulting from prolonged damage, irrespective of the initial cause?

<p>Cirrhosis (B)</p> Signup and view all the answers

Which viral hepatitis is caused by a DNA virus and has a vaccine available for prevention?

<p>Hepatitis B (B)</p> Signup and view all the answers

What liver disease is uniquely associated with requiring Hepatitis B virus for its replication and to cause infection?

<p>Hepatitis D (D)</p> Signup and view all the answers

Which type of viral hepatitis is primarily transmitted through the faeco-oral route and is particularly dangerous for pregnant women?

<p>Hepatitis E (C)</p> Signup and view all the answers

What condition is characterized by ongoing liver damage lasting more than six months, increasing the risk of developing cirrhosis?

<p>Chronic Liver Disease (C)</p> Signup and view all the answers

Which medication, commonly used as an analgesic and antipyretic, is a well-known cause of acute liver failure in cases of overdose?

<p>Paracetamol (D)</p> Signup and view all the answers

In the context of liver serology, what does the detection of HBsAg in a patient's blood indicate?

<p>Acute or chronic Hepatitis B infection (A)</p> Signup and view all the answers

What class of medication is often used in patients with cirrhosis and ascites to manage fluid accumulation by promoting increased fluid excretion?

<p>Diuretics (D)</p> Signup and view all the answers

Which of the following statements best describes the mechanism of action of Vitamin K in managing liver disease-related coagulopathy?

<p>Acts as a cofactor in the synthesis of certain clotting factors. (A)</p> Signup and view all the answers

Considering drug metabolism in severe liver disease, which of the following antibiotic classes is generally advised to be avoided due to increased risk of adverse effects?

<p>Macrolides (e.g., Erythromycin) (D)</p> Signup and view all the answers

What liver disease is defined by irreversible scarring resulting from prolonged damage, often due to alcohol or viral hepatitis?

<p>Cirrhosis (A)</p> Signup and view all the answers

Which condition involves liver damage that results from long-term alcohol misuse, potentially leading to fatty liver, hepatitis, and cirrhosis?

<p>Alcohol-Related Liver Disease (ARLD) (A)</p> Signup and view all the answers

What liver condition is characterized by excessive fat accumulation unrelated to alcohol intake, frequently associated with obesity and high cholesterol?

<p>Non-Alcoholic Fatty Liver Disease (NAFLD) (B)</p> Signup and view all the answers

Which inherited disorder leads to the accumulation of copper in the liver, brain, and eyes due to a defect in copper metabolism?

<p>Wilson Disease (D)</p> Signup and view all the answers

What autoimmune disease progressively destroys the small bile ducts in the liver?

<p>Primary Biliary Cirrhosis (A)</p> Signup and view all the answers

Which condition is a genetic disorder that causes the body to store too much iron, potentially damaging the liver and other organs?

<p>Haemochromatosis (C)</p> Signup and view all the answers

What condition results in the yellowing of the skin and eyes due to elevated bilirubin levels?

<p>Jaundice (Icterus) (D)</p> Signup and view all the answers

What is the term for liver disease that persists for more than six months, potentially progressing to cirrhosis and other complications?

<p>Chronic Liver Disease (B)</p> Signup and view all the answers

A defective virus requires coinfection with Hepatitis B for its replication and causes increased liver damage. What is this virus?

<p>Hepatitis D (A)</p> Signup and view all the answers

What is the most common route of transmission for Hepatitis A?

<p>Faeco-oral (D)</p> Signup and view all the answers

What disease is characterized by irreversible scarring of the liver resulting from prolonged damage, such as from alcohol abuse or viral hepatitis?

<p>Cirrhosis (B)</p> Signup and view all the answers

What disease involves a DNA virus that can integrate into the host genome, potentially leading to chronic hepatitis, cirrhosis, and even hepatocellular carcinoma?

<p>Hepatitis B (A)</p> Signup and view all the answers

What disease is specifically associated with excessive fat accumulation in the liver in individuals who do not consume excessive amounts of alcohol?

<p>Non-Alcoholic Fatty Liver Disease (NAFLD) (C)</p> Signup and view all the answers

What disease involves abnormal copper metabolism, leading to copper accumulation in the liver, brain, and eyes?

<p>Wilson Disease (C)</p> Signup and view all the answers

What disease is characterized by yellowing of the skin and sclera due to elevated bilirubin levels in the blood?

<p>Jaundice (Icterus) (A)</p> Signup and view all the answers

What disease is defined as liver damage resulting from long-term alcohol misuse, which can manifest as fatty liver, alcoholic hepatitis, and cirrhosis?

<p>Alcohol-Related Liver Disease (ARLD) (B)</p> Signup and view all the answers

What disease is characterized by an RNA virus and has a high risk of progressing to chronic liver disease and cirrhosis?

<p>Hepatitis C (D)</p> Signup and view all the answers

What disease is caused by a defective virus that requires Hepatitis B for replication and exacerbates liver damage when both infections are present?

<p>Hepatitis D (C)</p> Signup and view all the answers

What disease is defined as an autoimmune condition leading to the progressive destruction of small bile ducts within the liver?

<p>Primary Biliary Cirrhosis (A)</p> Signup and view all the answers

What disease is characterized by acute viral liver inflammation, is typically transmitted via the faeco-oral route, and usually resolves without leading to chronic liver damage?

<p>Hepatitis A (A)</p> Signup and view all the answers

What disease is characterized by irreversible scarring of the liver due to long-term damage from various causes, such as viral hepatitis or alcohol abuse?

<p>Cirrhosis (A)</p> Signup and view all the answers

What condition results from chronic, excessive consumption of alcohol, leading to a spectrum of liver damage from fatty liver to cirrhosis?

<p>Alcohol-Related Liver Disease (ARLD) (B)</p> Signup and view all the answers

What disease involves a defective virus that can only replicate in the presence of Hepatitis B, exacerbating liver damage?

<p>Hepatitis D (C)</p> Signup and view all the answers

What acute liver disease is typically transmitted via the fecal-oral route and poses a higher risk of severe illness in pregnant women?

<p>Hepatitis E (B)</p> Signup and view all the answers

What condition is classified by ongoing liver damage lasting more than six months, potentially leading to cirrhosis?

<p>Chronic Liver Disease (D)</p> Signup and view all the answers

What acute condition can develop as a result of acetaminophen overdose, potentially leading to rapid liver failure?

<p>Paracetamol-induced liver injury (D)</p> Signup and view all the answers

What infection is caused by an RNA virus, primarily transmitted through blood, which often leads to chronic hepatitis and increases the risk of liver cancer?

<p>Hepatitis C (B)</p> Signup and view all the answers

What prophylactic medication is administered to alcohol misusers to prevent variceal bleeding by reducing portal hypertension?

<p>Prophylactic Beta-Blockers (A)</p> Signup and view all the answers

What condition in patients with liver disease is treated with medications like spironolactone, which increase fluid excretion to counteract fluid accumulation caused by portal hypertension?

<p>Ascites (B)</p> Signup and view all the answers

A patient presents with jaundice, dark urine, and a history of recent travel to an area with poor sanitation. Serological tests reveal the presence of anti-HAV IgM antibodies. What is the most likely diagnosis?

<p>Hepatitis A (D)</p> Signup and view all the answers

Flashcards

Hepatitis B

DNA virus infecting the liver; can be acute or chronic, leading to cirrhosis or liver cancer.

Hepatitis C

RNA virus often progressing to chronic hepatitis, cirrhosis, or liver cancer, mainly blood-borne.

Hepatitis D

Defective virus needing Hepatitis B co-infection; worsens liver damage.

Hepatitis E

Acute viral hepatitis spread via the faeco-oral route; severe in pregnant women.

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Cirrhosis

Irreversible scarring (fibrosis) of the liver after long-term damage.

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Chronic Liver Disease

Ongoing liver injury over >6 months with progressive fibrosis and risk of cirrhosis.

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Alcohol-Related Liver Disease (ARLD)

Liver damage from chronic excessive alcohol use, presenting as fatty liver, hepatitis, or cirrhosis.

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Interferon

Antiviral/immunomodulatory for chronic Hepatitis B or C; enhances immune response.

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Ribavirin

Used with Interferon for Hepatitis C; antiviral nucleoside analogue interfering with viral RNA synthesis.

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Hepatitis Serology

Identifies hepatitis viruses and markers to diagnose infection, immunity, or carrier states.

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NAFLD

Excess fat accumulation in the liver unrelated to alcohol, often linked to obesity or high cholesterol.

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Haemochromatosis

Genetic condition causing excessive iron storage, damaging the liver and other organs.

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Primary Biliary Cirrhosis

Autoimmune disease causing progressive destruction of small bile ducts in the liver.

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Jaundice (Icterus)

Yellow discoloration of skin/sclera from high bilirubin levels, often due to liver dysfunction or hemolysis.

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ARLD Stages

Liver damage due to chronic alcohol use, ranging from fatty liver to cirrhosis.

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Acute Liver Failure

An acute liver condition often caused by paracetamol overdose.

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Prophylactic Beta-Blockers

Blocks beta-adrenergic receptors, lowering portal venous pressure.

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Fresh Frozen Plasma (FFP)

Used to correct coagulopathy in liver disease or bleeds.

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Miconazole Mechanism

Inhibits fungal cell membranes by blocking ergosterol synthesis.

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Beta-Blockers (in ARLD)

Non-selective β‐adrenergic blockade lowers portal venous pressure.

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Diuretics (liver disease)

Increase fluid excretion, lowering fluid from portal hypertension.

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Interferon Mechanism

Enhances immune response to viruses, reducing viral replication.

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Chronic Liver Disease Tx

Treat the cause, manage complications, avoid harmful factors, screen high-risk groups.

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CMV / EBV / Herpes Simplex

Viral infections that can cause hepatic inflammation.

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Paracetamol Overdose

Acute liver damage caused by excessive intake of paracetamol (acetaminophen).

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Hepatitis A Cause

An acute viral inflammation of the liver, transmitted via the faeco-oral route.

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Hepatitis A Treatment

Rest and fluids. Rarely requires hospitalization.

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Hepatitis A Prevention

Vaccination, improved hygiene, avoid contaminated food/water.

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Wilson Disease

An inherited disorder of copper metabolism, leading to copper accumulation in the liver, brain, and eyes.

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Non-Alcoholic Fatty Liver Disease (NAFLD)

Excess liver fat, unrelated to alcohol, linked to obesity/cholesterol.

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ARLD Cause

Liver damage from prolonged, high alcohol intake

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Paracetamol Use and Risk

Analgesic, antipyretic: reduces prostaglandin synthesis centrally. Toxic in overdose.

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NSAIDs Mechanism

Inhibit cyclooxygenase enzymes, reducing prostaglandin synthesis.

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Fluconazole

Antifungal inhibiting ergosterol synthesis. Dose adjust needed in liver disease.

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Vitamin K role

Corrects coagulopathy by replenishing clotting factors.

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Avoid Antibiotics (Liver Disease)

Erythromycin, Metronidazole, Tetracycline: Avoid due to liver impact.

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Interferon Use/Mechanism

Antiviral/immunomodulatory enhances immune response. Used for Hepatitis B or C.

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Study Notes

Hepatitis A

  • Acute viral inflammation of the liver, transmitted via the faeco-oral route.
  • Caused by Hepatitis A virus (HAV), often from contaminated water/food or poor hygiene.
  • Acute, self-limiting inflammation of the liver transmitted faeco-orally, with no chronic carrier state.
  • Treatment is usually supportive (rest, fluids).
  • Hospitalization is rarely needed
  • Prevented by vaccination; improve hygiene, avoid contaminated food/water.

Hepatitis B

  • DNA virus that can be acute or chronic (>6 months) and lead to cirrhosis or hepatocellular carcinoma
  • Parenteral exposure (blood/bodily fluids), sexual transmission, IV drug use, vertical (mother to baby) can cause it.
  • A viral infection (DNA virus) that integrates into the genome; can be acute or progress to chronic hepatitis and increase the risk of cirrhosis and hepatocellular cancer.
  • Chronic cases might need Interferon or antiviral therapy; in end-stage disease, transplant considered
  • Vaccination is key; safe sex, avoid shared needles, screen blood products help prevent it.

Hepatitis C

  • RNA virus that commonly progresses to chronic hepatitis, cirrhosis, or liver cancer
  • Mainly blood-borne, e.g., IV drug use, transfusions (rare nowadays), needlestick accidents can cause it.
  • An RNA virus causing acute or chronic liver inflammation; high risk of chronic disease and cirrhosis.
  • Interferon ± Ribavirin, though modern direct-acting antivirals can achieve high clearance rates can assist treatment
  • No vaccine; avoid contaminated needles, reduce transmission risks assists prevention

Hepatitis D

  • Same parenteral routes as HBV but only in the presence of active Hepatitis B can cause it
  • A defective virus that needs Hepatitis B for replication; worsens liver damage when co-infected.
  • Treatment & prevention includes controlling/preventing Hepatitis B (HBV vaccination), also limit needle/blood exposure
  • A defective virus that requires Hepatitis B co-infection; can worsen the liver damage.

Hepatitis E

  • Caused by contaminated food/water.
  • Supportive care; only rarely needs transplant can assist treatment
  • Good hygiene, properly cooked/clean water and no widely used vaccine assists prevention
  • An acute viral hepatitis spread via faeco-oral route (often water-borne)
  • Can be severe in pregnant women

CMV / EBV / Herpes Simplex

  • Viral infections (Cytomegalovirus, Epstein-Barr Virus, Herpes Simplex) that can cause hepatic inflammation.

Cirrhosis

  • Chronic hepatitis (B or C), alcoholic liver disease, NAFLD, or autoimmune conditions can cause it
  • Address underlying cause (e.g., suppress alcohol, treat hepatitis), manage complications (varices, ascites).
  • Advanced cases might need transplant can assist treatment
  • Limit or treat triggers (alcohol, viruses), early intervention if the disease is found assists prevention
  • Irreversible scarring of the liver from long-term damage (e.g., alcohol, viral hepatitis), leading to liver failure.
  • Irreversible scarring (fibrosis) of the liver after long-term damage (viral, alcohol etc.)

Chronic Liver Disease

  • Chronic viral hepatitis (C/B), alcohol, autoimmune, toxins, or NAFLD can cause it
  • Focus of treatment includes treating the cause (antiviral therapy, stop alcohol, etc.) and managing complications.
  • Prevention involves avoiding harmful factors and screening high-risk individuals.
  • Ongoing liver injury over >6 months with progressive fibrosis and risk of cirrhosis.
  • Liver damage from chronic excessive alcohol use, typically presenting as fatty liver, alcoholic hepatitis, or cirrhosis.
  • Abstinence from alcohol, nutritional support, management of complications (ascites, varices, encephalopathy).
  • Liver damage comes from chronic alcohol misuse, encompassing fatty liver and cirrhosis also
  • Keep alcohol low (4 g/day, with >10–15 g potentially causing acute liver failure).

Paracetamol Overdose (Drug-induced Hepatitis)

  • Follow dosage guidelines strictly and patient education for prevention
  • Acute liver damage comes from excessive paracetamol (acetaminophen) intake.
  • Use activated charcoal if early; N‐acetylcysteine can be used as antidote, and supportive measures.

Non-Alcoholic Fatty Liver Disease (NAFLD)

  • Excess fat accumulation in the liver unrelated to alcohol, often linked to obesity or high cholesterol.

Haemochromatosis

  • A genetic condition causing excessive iron storage, which can damage the liver and other organs.

Primary Biliary Cirrhosis

  • An autoimmune disease causing progressive destruction of the small bile ducts in the liver.

Wilson Disease

  • An inherited disorder of copper metabolism, leading to copper accumulation in liver, brain, and eyes.

Jaundice (Icterus)

  • A condition of yellow discoloration of skin/sclera from high bilirubin levels, often due to liver dysfunction or hemolysis.

Medication List

  • Use of Interferon: Antiviral/immunomodulatory for chronic Hepatitis B or C.
  • Mechanism of Interferon: Enhances immune response to viruses, reducing viral replication.
  • Use of Ribavirin: Combined with Interferon for Hepatitis C.
  • Mechanism of Ribavirin: Antiviral nucleoside analogue interfering with viral RNA synthesis.
  • Use of Paracetamol: Analgesic, antipyretic.
  • Mechanism of Paracetamol: Reduces prostaglandin synthesis (centrally). Toxic in overdose → liver failure.
  • Use of Prophylactic Beta‐Blockers (e.g., Propranolol): In alcohol‐abusing patients to reduce portal hypertension and variceal bleeding risk.
  • Mechanism of Prophylactic Beta‐Blockers (e.g., Propranolol): Non‐selective β‐adrenergic blockade lowers portal venous pressure.
  • Use of Miconazole: Antifungal for candidiasis.
  • Mechanism of Miconazole: Inhibits ergosterol synthesis in fungal cell membranes.
  • Use of Fluconazole: Systemic antifungal for candidiasis, etc.
  • Mechanism of Fluconazole: Also inhibits fungal cytochrome P450 needed for ergosterol production.
  • Erythromycin: Macrolide antibiotic inhibiting bacterial protein synthesis (50S).
  • Metronidazole: Disrupts anaerobic bacterial DNA.
  • Tetracycline: Inhibits protein synthesis by binding the 30S ribosomal subunit.
  • Mechanism of NSAIDs: Inhibit COX enzymes → reduce prostaglandin synthesis. Often avoided if GI bleed risk is high.
  • Vitamin K use: Replenish or boost coagulation factors (II, VII, IX, X) in liver disease.
  • Vitamin K Mechanism: Cofactor for gamma‐carboxylation of clotting factors. IV Vit K may help correct coagulopathy if cause is deficiency.
  • Diuretics use: In cirrhosis patients for ascites (e.g., spironolactone or loop diuretic).
  • Diuretics Mechanism: Increase fluid excretion, lowering portal hypertension–related fluid accumulation.
  • Use of Antibiotics (general): If infection is suspected (e.g., spontaneous bacterial peritonitis).
  • Mechanism of Antibiotics (general): Depends on chosen antibiotic, but aim is to kill or inhibit bacterial growth.
  • Sedation (Benzodiazepines) use: Anxiolytic/sedative.
  • Sedation (Benzodiazepines) Mechanism: Enhance GABA activity. In cirrhosis, can precipitate coma due to poor metabolism → must avoid or use with great caution.

Medication List Additional Information

  • Miconazole is contraindicated in severe liver impairment.
  • Fluconazole's dose needs adjusting in liver disease.
  • Erythromycin, Metronidazole, and Tetracycline should be avoided in severe liver disease.

Procedures List

  • Hepatitis Serology use: Identifies specific hepatitis viruses (A, B, C, E) and markers (e.g., HBsAg, anti-HBc, anti-HBs) for infection status.
  • Hepatitis Serology mechanism: Blood tests detect viral antigens/antibodies indicating active or past infection, carrier states, or immunity.
  • Fresh Frozen Plasma (FFP) use: Correcting coagulopathy in severe liver disease or acute bleeds (contains clotting factor).
  • Fresh Frozen Plasma (FFP) mechanism: Replaces missing/deficient clotting factors to reduce bleeding risk.
  • Ultrasound, MRI, CT for the Liver use: Imaging to evaluate liver architecture, detect cirrhosis, masses, or vascular abnormalities.
  • Ultrasound, MRI, CT for the Liver mechanism: The non-invasive scanning techniques provide structural information (ultrasound is first-line, MRI more detailed for soft tissue, CT more general).
  • Endoscopy (re: Varices) use: Detecting or treating esophageal varices in portal hypertension.
  • Endoscopy (re: Varices) mechanism: Flexible endoscope visualizes the esophagus, allowing, potential for banding varices to prevent bleeding.
  • Vaccination (Hepatitis A/B) use: Preventing infection by hepatitis A or B virus.
  • Vaccination (Hepatitis A/B) mechanism: Induces protective antibodies that neutralize or prevent the viral infection.

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Study notes defining Hepatitis A, B, and C. Hepatitis A is a self-limiting liver inflammation, while Hepatitis B can be acute or chronic. Hepatitis C is an RNA virus with a high risk of chronic disease.

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