Block 1: Liver Disorders Flashcards
What are the two sources of blood supply to the liver?
i) Oxygenated blood- Hepatic Artery
ii) Venous blood - Hepatic Portal vein
What are Sinusoids?
Channels in the liver that provide exchange of blood between hepatocytes.
How does blood leave the liver?
Hepatic vein
Where is bile produced?
Hepatocytes
Name 3 functions of the liver?
- Bilirubin elimination
- Bile salt production
- Drug & Alcohol metabolism
- Steriod hormone metabolism
- Carborhydrate, lipid and protein metabolism
- Vitamin & mineral storage
- Glycogen storage
- Synthesis of plasma proteins and clotting factors
What is bilirubin a waste product of?
Breakdown of haemoglobin
Jaundice results from an excessive accumulation of?
Bilirubin
Haemolysis due to a blood incompatibility reaction would lead to elevated serum levels of?
Unconjugated bilirubin
Name the 3 types of Jaundice?
1) Pre-hepatic
2) Intra-hepatic
3) Post-hepatic
What is kernicterus?
High bilirubin in neonates that can cause brain damage
Why is a neonate a higher risk of kernicterus?
Immaturity of both liver function to form conjugated bilirubin and blood brain barrier.
How is conjugated bilirubin transported in the body?
Attached to protein carrier albumin
What is Prehepatic jaundice?
Increased rate of RBC breakdown, from haemolytic anaemias, incompatible Rh factors or blood transfusion reactions.
What is Intrahepatic jaundice?
The inability of the liver to process conjugated bilirubin or secrete it.
What is Posthepatic jaundice?
Due the obstruction of bile flow between the liver and the intestine.
Where are bile salts and acids stored?
Gall bladder
What are bile salts important for?
Act as emulsifiers in digestion of lipids (fats)
What is steatorrhoea?
Increased excretion of fat in faecal matter.
Two enzymes involved in drug & alcohol metabolism?
i) Microsomal
ii) Cytochrome P450
What vitamins and minerals are stored the liver?
Vitamins: A, B12, D, E, K
Minerals: Iron, copper
Increased levels of iron storage in the liver can be a sign of?
Haemochromatosis
Low albumin production by the liver leads to?
Oedemas and ascites (fluid build up in abdominal cavity)
Two factors that lead to a Hepatic coma?
i) Hypoglycaemia
ii) Ammonia build-up
What is Cholestasis?
Disorders of the liver, bile duct, or pancreas causing a reduction or stoppage of bile flow.
What are some symptoms of Cholestasis?
The skin and whites of the eyes look yellow, the skin itches, urine is dark, and stools may become light-colored and smell foul.
Name 3 clinical markers that may be elevated from cholestasis?
i) Alkaline phosphatase (Alk phos)
ii) gamma glutamyl transferase (GGT)
iii) Bilirubin
Name two enzymes that if elevated may suggest hepatocyte damage?
i) Alanine aminotransferase (ALT)
ii) Aspartate aminotransferase (AST)
Name the common liver function tests?
i) Hepatitis virus series
ii) Ultra-sound
iii) Liver biopsy
iv) CT, MRI scans
Why is albumin important in healthy liver function?
It is important in maintaining normal fluid distribution between interstitial and intravascular compartments - “Oncotic pressure”.
What is cirrhosis?
Cirrhosis of the liver describes a condition where scar tissue (fibrosis) gradually replaces healthy liver cells.
Name 3 symtoms can arise from cirrhosis?
Portal hypertension, ascites and varices
What is hepatitis?
Hepatitis refers to an inflammatory condition of the liver. It’s commonly caused by a viral infection.
Name 2 clotting factors produced in the liver?
i) Fibrinogen
ii) Prothrombin
