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11 Cards in this Set
- Front
- Back
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Ultrasound abnormalities of liver disease |
Enlargement - extends beyond costal arch Increased echogenicity (same as spleen) Rounded margins Loses homogeneity of hepatic parenchyma |
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Ultrasound location right side for liver? |
9-14th ICS -mid height |
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Ultrasound location left side for liver? |
4th-7th ICS- compare to spleen (spleen whiter) |
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Front (Term) |
Cholestasis- bile ducts GGT would be elevated May have bacterial cholangitis/hepatitis |
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What is the anatomical location for a liver biopsy? |
12-14th ICS on right Surgical prep, lignocaine, Stan incision, Trucut Histopath, MC&S |
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What are complications related to liver biopsy? |
Haemorrhage Haemabdomen Pneumothorax Peritonitis Bile leakage Colon puncture Abscess |
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Which sedative is contraindicated for hepatopathy? |
Diazepam- gaba agonist- aids formation of HE |
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What are the 7 principles of treating liver disease? |
Treat primary liver specific agent (doxycycline) Supportive care (fluid w dextrose) Decrease GIT ammonia production (reduce bacteria: lactulise, neomycin, metronidazole) Vitamins (B1, B12 and K weekly) Reduce hepatic fibrosis (pentoxifylline, colchicine) Anti inflammatory (NSAIDs, DMSO, corticosteroids) Nutritional support |
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What are the nutritional support recommendations for liver disease? |
Supplement BCAA (min aromatic) beet pulp, sorghum, bran Limit protein (reduce ammonia)- avoid lucerne hay and legumes Readily digestible CHO (cracked corn) sparing gluconeogenesis) Multiple small feeds (impaired gluconeogenesis) Graze out of sunlight (photosensitisation) |
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What are good prognostic indicators for liver disease? |
Trend of decreasing bile acids and GGT |
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What are poor prognostic indicators for liver disease? |
Severe HE bridging fibrosis IV haemolysis or coagulopathy Profound acidosis Greatly inc serum bile acid conc Decreased serum albumin |
