205 Alcoholism and Hepatitis Flashcards
What divides the left and right lobes of the liver?
Hepatic vein
Which lobe contains the caudate and the quadrate lobes?
Right
How many segments are in the liver?
8
Where does blood from the sinusoids drain into?
Hepatic vein
Which lobe of the liver drains directly into the IVC?
Caudate
Where in the liver is lymph formed?
Perisinusoidal space
What is an acinus?
Functional unit of the liver
Where are Kupffer cells found and what is their function?
Surrounding the sinusoids - phagocytic cells
Where are stellate cells found? What do they contain?
In the space of Diss - contain desmin
What is the role of hepatic stellate cells?
Relatively quiescent until there is insult then involved in fibrosis
What is the role of lecithin-cholesterol acyltransferase?
Catalyses cholesterol to cholesterol ester
What is the role of hepatic lipase?
Removes TG from intermediate density lipoproteins –> LDLs
What are bile acids synthesised from?
Cholesterol
Which amino acids do cholic acid and chenodeoxycholic acid conjugate with to increase their solubility?
Taurine/glycine
Which cells of the liver breakdown RBCs?
Kupffer cells
What are the products when haem from a RBC is broken down?
Bilirubin and Iron
Which protein does bilirubin conjugate with in the spleen to be transported via blood to liver?
Albumin
What does bilirubin conjugate with in the liver?
glucuronic acid
Where are varices likely to form in chronic liver disease?
Oesophageal veins
What is the mechanism of fatty liver disease?
Fatty deposits start to occupy the space of Diss.
NAD+ is used in the metabolism of alcohol but it is also needed in the gluconeogenesis.
It promotes steatosis by stimulating the synthesis of fatty acids and opposing their oxidation
What toxin causes alcoholic hepatitis?
Acetaldehyde
Which cells infiltrate hepatocytes in chronic alcoholic hepatitis?
Eosinophils
Name 5 clinical features of alcoholic liver disease
7 listed
Palmar erythema Dupuytrens Caput Medusae Spider naevi Ascites Gynaecomastia Umbilical hernia
Name 3 complications of alcoholic liver disease
Portal HTN Spontaneous bacterial peritonitis Acute decompensation Hepato-renal syndrome Hepatocellular carcinoma
What is hepato-renal syndrome?
Rapid deterioration of kidney function in liver cirrhosis
What is Wernicke’s encephalopathy?
Neuro symptoms (ophthalmoplegia, ataxia, confusion) caused by thymine deficiency (essential for the carboxylation off pyruvate). Causing damage to the mamillary bodies, medial thalamus, posterior hypothalamus as well as generalised cerebral atrophy.
What can Werincke’s encephalopathy develop into?
Korsakoff’s syndrome
What is Korsakoff’s syndrome?
Dementia with confabulation