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Diet Therapy 2380 > Ch. 25 Liver Diseases > Flashcards

Ch. 25 Liver Diseases Flashcards

1
Q

The portal vein carries blood from ____ to ____.

A

Digestive tract; liver

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2
Q

About how much blood is estimated to pass through the liver?

A

70-80%

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3
Q

What are important functions of the liver?

A

Produce bile (emulsifier of fats; stored in gallbladder)
Detox
Heme metabolism
Storage (glycogen, fat, fatty acids, fat-soluble vitamins)
Synthesis of fat and proteins

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4
Q

What is a fatty liver?

A

An accumulation of fat in the liver tissue

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5
Q

What can contribute to a fatty liver?

A 
Alcoholic liver disease
Exposure to drugs and toxic metals
Obesity, diabetes mellitus, kwashiorkor and marasmus
After GI bypass surgery
Long-term TPN
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6
Q

Can fatty liver be seen in kids?

A

Yes

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7
Q

Are there different progressions to a fatty liver?

A

Yes

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8
Q

2013: Of liver disease deaths (aged ≥ 12 years), what percentage involved ETOH?

A

46.4%

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9
Q

What is cirrhosis?

A

Advanced stage of liver disease

Scar tissue replaces healthy liver tissue –> liver cells lose their function

Scarring becomes extensive as disease progresses

Leads to liver failure –> death

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10
Q

Can you get Cirrhosis from other factors besides ETOH?

A

Yes

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11
Q

Does the liver have the capacity to regenerate cells?

A

Yes

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12
Q

What color does a liver with Cirrhosis appear?

A

Orange

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13
Q

What are causes of Cirrhosis?

A

Chronic ETOH use
Chronic Hepatitis C infection
Fatty liver disease
Chronic Hepatitis B infection

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14
Q

Is Cirrhosis a systemic infection/disease?

A

Yes; infects whole body

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15
Q

Cirrhosis: Consequences

A
  1. Portal Hypertension
  2. Collaterals and Gastroesophageal Varices
  3. Ascites
  4. Jaundice
  5. Hepatic Encephalopathy
  6. Malnutrition and Wasting
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16
Q

Portal Hypertension

A

consequence of cirrhosis

Elevated blood pressure in the portal vein caused by obstructed blood flow through the liver
–scar tissue is what actually obstructs the blood flow

17
Q

Collaterals and Gastroesophageal Varices

A

consequence of cirrhosis

Develop through gastrointestinal tract - become enlarged and engorged - may rupture - sometimes fatal

18
Q

Ascites

A

consequence of cirrhosis

Abnormal accumulation of fluid in the abdominal cavity (“beer gut”)

Caused by portal hypertension

Water retention due to altered kidney function

Reduced albumin synthesis by the diseased liver
–albumin helps to hold fluid in the blood

Abdominal discomfort and early satiety –> leads to malnutrition

19
Q

About how many patients with ascites die within a couple of years?

A

About half

20
Q

Jaundice

A

consequence of cirrhosis

Yellow discoloration of tissues (sclera)

“yellowing of eyes”

Due to increase of bilirubin

21
Q

Hepatic Encephalopathy

A

consequence of cirrhosis

Condition in advanced liver disease characterized by abnormal neurological functioning.

May result in:

  • -changes in personality, reduced mental abilities
  • -amnesia
  • -seizures
  • -hepatic coma
  • -elevated ammonia levels
22
Q

What’s the problem with increased ammonia levels and Hepatic Encephalopathy?

A

AA breakdown –> get ammonia –> liver extracts ammonia from the portal blood and converts it to urea

Much of the urea gets excreted by the kidneys

Advanced liver disease: ammonia can reach the brain –> get altered neurological symptoms

23
Q

What macronutrient do we associate with ammonia?

A

Protein

24
Q

Malnutrition and Wasting

A

consequence of cirrhosis

Risk of developing protein-energy malnutrition (PEM)
–they’re sick. They don’t feel like eating

Consume less food due to reduced appetite, fatigue, or gastrointestinal symptoms (ascites - early satiety)

Diet has lack of taste - limited sodium

Fat malabsorption - steatorrhea

25
Q

Figure 25-1: Functions of the liver?

A

Receives nutrients from the digestive tract and processes them for distribution throughout the body

26
Q

Figure 25-1: Functions of the Biliary System?

A

Includes the gallbladder, which stores and secretes bile, and the bile ducts, which conduct bile from the liver to the gallbladder and from the gallbladder to the intestine.

27
Q

Figure 25-1: Function of the Hepatic Vein?

A

Returns blood from the liver to the heart

28
Q

Figure 25-1: Function of the Hepatic Artery?

A

Supplies oxygen-rich blood from the heart to the liver

29
Q

Figure 25-1: Function of the Portal Vein?

A

Carries nutrient-rich blood from the digestive tract to the liver

30
Q

Figure 25-1: Function of the GI Tract Veins?

A

Transport absorbed nutrients to the portal vein

31
Q

Cirrhosis Dietary Intervention if Malnourished

A

Increase kcal
Protein 0.8-1.2g/kg/d (dry weight)
–we don’t restrict protein as much as we used to
–reasonable balancing act when it comes to protein
Frequent small meals

32
Q

Cirrhosis Dietary Intervention if Ascites

A 
Sodium restriction (ex: less than 2,000 mg/d [2 g/d])
Fluid restriction (ex: 1,200-1,500 cc/d)
Potassium
33
Q

Cirrhosis Dietary Intervention if Esophageal Varices

A

Small, frequent meals, avoid irritants such as spicy foods

34
Q

Cirrhosis Dietary Intervention if Fat Malabsorption

A

Restrict total calories from fat

35
Q

Should you give alcohol to someone with cirrhosis?

A

NO

36
Q

Can vitamin and mineral supplementation be a part of dietary intervention for those with cirrhosis?

A

Yes

Diet Therapy 2380 (28 decks)

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