6.1 Liver Function + Pathology

Question 1

What molecules are stored in the liver?

Answer 1

Glycogen
Vitamins ( A, D, E, K B12)
Iron
Copper

Question 2

What are the 2 main proteins produced by the liver?

Answer 2

Clotting factors

Albumin

Question 3

What does the liver synthesise?

Answer 3

Glucose
Lipids
Cholesterol
Bile 
Proteins

Question 4

What are the important metabolic functions of the liver?

Answer 4

Metabolising:
Bilirubin
Ammonia 
Drugs
Alcohol
Carbohydrates
Lipids

Question 5

Why can decreased levels of albumin be detrimental?

Answer 5

Albumin is the main circulating protein. It helps maintain on otic pressure in intravascular space. Decrease in albumin can lead to oedema as fluid moves into cells due to decrease in on otic pressure in vessels.

Question 6

What is decompensated liver disease?

Answer 6

Sudden onset of liver disease that happens acutely without previous history of liver pathology. Acute liver failure.

Question 7

What are the more specific symptoms of liver disease?

Answer 7

Jaundice
Oedema/ascites
Bleeding
Confusion

Question 8

What are the non-specific symptoms of liver disease?

Answer 8

Nausea
Vomiting
Abdominal pain
Loss of appetite 
Fatigue

Question 9

What causes jaundice?

Answer 9

A rise in circulating bilirubin due to impaired metabolism or abnormal accumulation (haemolytic anaemias)

Question 10

Why are patients with reduced liver function likely to bruise easily?

Answer 10

Cant produce enough clotting factors and therefore bleed easily

Question 11

What are common cause of acute liver disease?

Answer 11

Excessive alcohol intake
Paracetamol overdose
Viral ( EBV, CMV, Hepatitis)
Medications (aspirin in children)

Question 12

What is cirrhosis?

Answer 12

Permanent irreversible liver damage due to inflammation, fibrosis and distortion of liver architecture. Results in impairment of function of liver

Question 13

Why does cirrhosis lead to reduced function of the liver?

Answer 13

Fibrotic tissue form strict bands around the liver, forming nodules. This causes necrosis of hepatocytes and therefore decreased function of the liver.

Question 14

How does a liver with cirrhosis appear?

Answer 14

Covered in nodules.

Question 15

What are the 5 main causes for liver inflammation?

Answer 15

Drugs
Infection
Deposition
Autoimmune
Other

Question 16

Excluding alcoholic liver disease, how else might liver disease be caused by drugs?

Answer 16

Iatrogenic

Question 17

How does excessive alcohol intake cause Cirrhosis?

Answer 17

• initially cause fatty damage as alcohol stored in deposits on liver as TAGS
• results in Hepatomegaly
• chronic intake causes alcoholic hepatitis
• inflammation of the liver leads to irreversible scarring and cirrhosis.

Question 18

How does alcoholic hepatitis present?

Answer 18

RUQ pain
Jaundice
Hepatomegaly
Ascites
Oedema

Question 19

What infections can result in cirrhosis?

Answer 19

Hep B

Hep C

Question 20

What are the main differences between Hep B and Hep C?

Answer 20

Hep B has a vaccine, Hep C doesn’t
Hep C can be cured, Hep B cant
Hep B is symptomatic, Hep C is asympatomatic

Question 21

What is the main cause of Hep C in the UK?

Answer 21

Intravenous drug use

Question 22

What are potential secondary complications due to infection by hepatitis B or C?

Answer 22

Hepatocellular carcinoma

Both can cause chronic infection and chronic inflammation. This can cause cirrhosis and malignancy.