IDHD case
Hypouricaemia
Hypercholesterolaemia
Low HDL cholsterol
Hypocalcaemia
Raised triglycerides
Raised ESR
Increased CVS mortality
Renal failure
Increased risk of gallstones
Increased risk of pancreatic cancer
Increased risk of osteoporosis
Positive AMA - autoimmune chronic active hepatitis
Low caeruloplasmin - Haemochromatosis
Raised transferrin saturation - Wilson's disease
Positive ANCA antibodies - primary sclerosing cholangitis
Raised IgM - primary biliary cirrhosis
Ask a close contact
Routine LFTs
U+Es
Arrange a liver biopsy looking for specific alcohol features
Measure the MCV
Abnormal focal lesions suggestive of liver cancer
Bile duct dilation
A bright liver
An enlarged spleen
Abnormal flow in the portal vein
Simple steatosis
Cirrhosis
Liver cancer
Advanced fibrosis
Bile duct obstruction
Advise to restrict fluid intake
Advise to completely abstain from alcohol
Advise to reduce dietary fat
Advise to take as much rest as possible
Advise to increase exercise levels
If they were to develop increasing fatigue
If they were to develop resistant ascites
If they were to develop an 8cm liver cell cancer
If they were to develop frequent episodes of encephalopathy
If they were to have a variceal bleed
AMA and PBC
AMA and PSC
ASMA and AIH
AMA and AIH
IgA and Alcohol
IgG and AIH
IgM and PBC
IgM and Alcohol
IgM and AIH
IgG and Alcohol
IgG and PBC
IgA and PBC
IgA and AIH
Alpha Fetoprotein in AIH
Alpha Feto-protein in HCC
ANCA and PSC
ANCA and PBC
AIH can be caused by ANA, ASMA, Anti LKM1 antibodies, and Soluble Liver Antigen
Elevated caeruloplasmin indicates Wilson's
Elevated ferritin indicates Wilson's
Elevated ferritin indicates Haemochromatosis
Elevated caeruloplasmin indicates Haemochromatosis
IgG means the infection has been cleared, or vaccinated against, in the past
IgM indicates an acute infection
Hep A and E have similar presentations
Hep A and E never progress to chronic disease
Anti Hepatitis B Surface antibody indicates immunity to Hep B
Anti Heptatitis B e antibody indicates decreased infectivity
Anti Hepatitis B c antibody indicates immunity to Hep B
Anti Hepatitis B surface antibody indicates reduced infectivity
Hep B can lead to chronic hepatitis, but not HCC
Hep B is a risk factor for HCC
Hep B can be vaccinated against
Hep C can be vaccinated against
In Heb B, sexual transmission is most important route
In Hep C, sexual transmission is most important route
In hep B, IV transmission is most important route
In hep C, IV transmission is most important route
Hep D is clinically irrelevant
>60% of hep C patients develop chronic disease
>80% of Hep C patients develop chronic disease