1. Cell Injury Flashcards
Alcoholic liver disease
a term that encompasses the liver manifestations of alcohol overconsumption, including fatty liver, alcoholic hepatitis, and chronic hepatitis with liver fibrosis or cirrhosis.
It is the major cause of liver disease in Western countries. Although steatosis (fatty liver) will develop in any individual who consumes a large quantity of alcoholic beverages over a long period of time, this process is transient and reversible
Hereditary haemochromatosis
is a hereditary (autosomal recessive) disease characterized by excessive intestinal absorption of dietary iron resulting in a pathological increase in total body iron stores.
Excess iron accumulates in tissues and organs disrupting their normal function. The most susceptible organs include the liver, adrenal glands, heart, skin, gonads, joints, and the pancreas
patients can present with cirrhosis, polyarthropathy, adrenal insufficiency, heart failure or diabetes.
Carbon monoxide poisoning
(Symptoms, treatment)
See metabolism for pathophysiology
Symptoms: Headache dizziness nausea and vomiting tiredness and confusion stomach pain shortness of breath and difficulty breathing
Treatment:
Oxygen therapy
Paracetamol overdose
In cases of paracetamol overdose, the phase II sulfate and glucuronide pathways become saturated, and more paracetamol is shunted to the Phase I cytochrome P450 system to produce NAPQI.
As a result, hepatocellular supplies of glutathione become depleted, as the demand for glutathione is higher than its regeneration.
NAPQI therefore remains in its toxic form in the liver and reacts with cellular membrane molecules, resulting in widespread hepatocyte damage and death, leading to acute hepatic necrosis.
Pancreatitis
inflammation of the pancreas.
two main types: acute pancreatitis and chronic pancreatitis.
Symptoms:
Pain in the upper abdomen, nausea and vomiting. The pain often goes into the back and is usually severe. In acute pancreatitis a fever may occur and symptoms typically resolve in a few days. In chronic pancreatitis weight loss, fatty stool, and diarrhea may occur. Complications may include infection, bleeding, diabetes, or problems with other organs.
The most common causes of acute pancreatitis are gallstones and heavy alcohol use. Other causes include direct trauma, certain medications, infections such as mumps, and tumors among others.
Chronic pancreatitis may develop as a result of acute pancreatitis. It is most commonly due to many years of heavy alcohol use. Other causes include high levels of blood fats, high blood calcium, some medications, and certain genetic disorders such as cystic fibrosis among others.
Smoking increases the risk of both acute and chronic pancreatitis.
Diagnosis of acute pancreatitis is based on a threefold increase in the blood of either amylase or lipase. In chronic pancreatitis these tests may be normal.
Testicular torsion
occurs when the spermatic cord (from which the testicle is suspended) twists, cutting off the testicle’s blood supply = ischemia.
The principal symptom is rapid onset of testicular pain.
The most common underlying cause is a congenital malformation known as a “bell-clapper deformity” wherein the testis is inadequately affixed to the scrotum allowing it to move freely on its axis and susceptible to induced twisting of the cord and its vessels.
The diagnosis should usually be made on the presenting signs and symptoms and an urgent ultrasound should only be done when the diagnosis is unclear.
Irreversible ischemia begins around six hours after onset and emergency diagnosis and treatment is required within this time to minimize the risk of testicle loss.
It is most common just after birth and during puberty.
Volvulus of the bowel
A volvulus is a subtype of malrotation, in which a loop of bowel is twisted about a focal point along the mesentery attached to the intestinal tract, that may result in a bowel obstruction.
Regardless of cause, volvulus causes symptoms by two mechanisms:
Bowel obstruction manifested as abdominal distension and bilious vomiting.
Ischemia (loss of blood flow) to the affected portion of intestine.
Midgut volvulus occurs in patients (usually in infants) that are predisposed because of congenital intestinal malrotation. Segmental volvulus occurs in patients of any age, usually with a predisposition because of abnormal intestinal contents (e.g. meconium ileus) or adhesions. Volvulus of the cecum, transverse colon, or sigmoid colon occurs, usually in adults, with only minor predisposing factors such as redundant (excess, inadequately supported) intestinal tissue and constipation.
Infective hepatitis
Hepatitis A
an acute infectious disease of the liver caused by the hepatitis A virus (HAV).
Many cases have little or no symptoms especially in the young. The time between infection and symptoms, in those who develop them, is between two and six weeks. When there are symptoms they typically last eight weeks and may include: nausea, vomiting, diarrhea, yellow skin, fever, and abdominal pain. Around 10–15% of people experience a recurrence of symptoms during the six months after the initial infection. Acute liver failure may rarely occur with this being more common in the elderly.
It is usually spread by eating or drinking food or water contaminated with infected feces. Shellfish which have not been sufficiently cooked is a relatively common source. It may also be spread through close contact with an infectious person. After a single infection a person is immune for the rest of their life.
Diagnosis requires blood testing as the symptoms are similar to those of a number of other diseases.
The hepatitis A vaccine is effective for prevention.
There is no specific treatment, with rest and medications for nausea or diarrhea recommended on an as needed basis.
Infections usually resolve completely and without ongoing liver disease.
Rhabdomyolysis
a condition in which damaged skeletal muscle tissue breaks down rapidly.
Breakdown products of damaged muscle cells are released into the bloodstream; some of these, such as the protein myoglobin, are harmful to the kidneys and may lead to kidney failure.
The severity of the symptoms, which may include muscle pains, vomiting, and confusion, depends on the extent of muscle damage and whether kidney failure develops.
The muscle damage may be caused by physical factors (e.g., crush injury, strenuous exercise, medications, drug abuse, and infections).
Some people have a hereditary muscle condition that increases the risk of rhabdomyolysis.
The diagnosis is usually made with blood tests and urinalysis.
The mainstay of treatment is generous quantities of intravenous fluids, but may include dialysis or hemofiltration in more severe cases.
Hepatic steatosis
Steatosis (fatty liver) is an accumulation of fat in the liver.
Steatohepatitis is when this progresses to become associated with inflammation.
Can progress to cirrhosis or hepatocellular carcinoma
Fatty liver disease is divided into:
Alcohol-related fatty liver disease.
Non-alcoholic fatty liver disease (NAFLD).
