Makindo Medical Notes"One small step for man, one large step for Makindo" |
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Related Subjects: |Chronic liver disease |Cirrhosis |Alkaline phosphatase (ALP) |Liver Function Tests |Ascites Assessment and Management |Budd-Chiari syndrome |Autoimmune Hepatitis |Primary Biliary Cirrhosis |Primary Sclerosing Cholangitis |Wilson disease |Hereditary Haemochromatosis |Alpha-1 Antitrypsin (AAT) deficiency |Non alcoholic steatohepatitis (NASH) |Spontaneous Bacterial Peritonitis |Alcoholism and Alcoholic Liver Disease |Hepatitis C
First-line Blood Tests |
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Cause | Typical Presentation | Investigations | Treatment |
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Hepatitis B | Fatigue, jaundice, arthralgia → cirrhosis/HCC | HBsAg, HBeAg, HBV DNA, LFTs, Fibroscan | Antivirals (tenofovir, entecavir); transplant if end-stage |
Hepatitis C | Often asymptomatic; later cirrhosis/HCC | Anti-HCV, HCV RNA PCR, genotype, LFTs, Fibroscan | Direct-acting antivirals (DAAs) tailored to genotype |
Autoimmune Hepatitis | Fatigue, jaundice, arthralgia, hepatomegaly | ANA, SMA, LKM1, IgG, biopsy | Prednisolone ± Azathioprine |
Alcoholic Hepatitis | Jaundice, hepatomegaly, ascites | AST:ALT > 2, bilirubin ↑, biopsy if unclear | Abstinence, nutrition, steroids if severe |
NAFLD / NASH | Often asymptomatic; hepatomegaly, cirrhosis | Ultrasound, Fibroscan, biopsy if uncertain | Weight loss, exercise, control DM/dyslipidaemia |
Drug-Induced | Fatigue, jaundice, variable course | Drug history, LFTs, biopsy if unclear | Stop drug, supportive care |
Wilson’s Disease | Hepatic + neuro/psychiatric symptoms | Low ceruloplasmin, urinary copper, biopsy, genetics | Penicillamine, zinc; transplant if failure |
Haemochromatosis | Fatigue, bronze skin, diabetes, cirrhosis | Ferritin, transferrin saturation, HFE genotype | Venesection; chelation if not tolerated |
💡 Exam tip: In OSCEs, mention that all CLD patients need HCC surveillance and variceal screening once cirrhosis develops.