19.3 Causes and consequences of liver disease

Question 1

What are the functions of the liver?

Answer 1

• Nutrition: stores glycogen, releases glucose, absorbs fats and fat-soluble vitamins, manufactures cholesterol
• Bile production
• Clotting factor production
• Immune function: Kupffer cells engulf antigens/bacteria
• Detoxification: alcohol breakdown, drug excretion
• Albumin and binding protein production

Question 2

Name some causes of abnormal liver function.

Answer 2

• Alcohol
• Non-alcoholic fatty liver disease (NAFLD)
• Infections (e.g. viral)
• Medications
• Malignancy

Question 3

Summarise the pathogenesis of liver disease.

Answer 3

Question 4

What causes jaundice?

Answer 4

Bilirubin levels greater than 40umol/L

Question 5

What are the causes of acute and chronic hepatitis?

Answer 5

• Virus
• Alcohol
• Drugs
• Autoimmune
• Non-alcoholic fatty liver disease/obesity
• Gallstones
• Cholecystitis

Question 6

What is ascites?

Answer 6

Abnormal build up of fluid in the abdominal cavity.

Question 7

What is the difference between acute and chronic hepatitis?

Answer 7

Acute viral hepatitis infection is considered chronic if it persits for longer than 6 months.

Question 8

What is meant by the term acute hepatitis?

Answer 8

Acute hepatitis describes a variety of conditions which cause inflammation of the liver.
Signs and symptoms:
- Fever
- Fatigue
- Nausea
- Jaundice
- Dark urine
- Joint pain

Question 9

What are the features of chronic liver disease?

Answer 9

• Clubbing of nails
• Palmar erythema – redness of palms of hands.
• Dupuytren’s contracture – fixed flexion of little (& ring) finger due to thickening of palmar
  fascia.
• Spider naevi – small arterial dilations common in skin of face & neck.
• Ascites – abnormal build-up of fluid in the abdomen.
• Oesophageal varices – extremely dilated sub-mucosal veins in lower 1/3 of oesophagus.