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Liver disease (signs of CLD (ascites (distension), melaena, leuconychia…

- - - - increased LFTs (increased ALT)
      - fatty liver on US
      - middle-aged obese female
  - - - too much copper in liver and CNS
- - - - Cirrhosis
        
        types
        
        primary biliary cirrhosis
        
        AI, chronic inflam leads to fibrosis, cirrhosis and portal hypertension
        
        asym, lethargy, pruritis, jaundice
        
        alcoholic cirrhosis
        
        primary biliary cholangitis
        
        A1AT deficiency
        
        primary sclerosing cholangitis
        
        clinical manifestations
        
        portal hypertension
        
        liver failure
        
        cholangiocarcinoma risk increased
        
        irreversible liver damage, liver architecture is diffusely abnormal and interferes with liver bf and function
        
        compensated vs decompensated
        
        compensated
        
        asym, although poss evidence of portal hypertension, such as esophageal or gastric varices
        
        progresses to decompensated
        
        decompensated
        
        symptomatic complications related to cirrhosis, incl those related to hepatic insufficiency (jaundice or hepatic encephalopathy), and those related to portal hypertension (ascites or variceal hemorrhage)
        
        treatment
        
        treat underlying cause
        
        lifestyle and dietary changes
        
        liver transplant
        
        causes
        
        Haemochromatosis (primary)
        Enzyme deficiency (alpha1-anti-trypsin)
        Post hepatic (infection + drug induced)
        Alcoholic
        Tyrosinosis
        Indigenous people in USA (galactosemia)
        Cardiac/cholestatic (biliary)/cancer/copper (Wilson's)