Ch.18 Flashcards
What are the serum measurements of hepatocyte integrity
AST
ALT
Lactate dehydrogenase (LDH)
What are the tests that look for biliary excretory fxn
Serum bilirubin
- Total: unconjugated and conjugated
- Direct: conjugated only
Urine bilirubin
Serum bile acids: plasma membrane enzymes from damage to bili canaliculus
Serum alkaline phosphatase
Serum y-glutamyl transpeptidase (GGT)
What are the tests that look for damage to the bile canaliculus
Serum alkaline phosphatase
Serum gamma-glutamyl transpeptidase (GGT)
What are the tests that look for hepatocyte synthetic function
Serum albumin
Coagulation factors: PT, PTT, Fibrinogen, prothrombin, factors V, VII, IX, X
Hepatocyte metabolism: serum ammonia, aminopyrine breath test
Cholestasis
Accumulation of bilirubin in liver
Cytokine released by kupffer cell
TGF-beta
Liver hilum is called
Porta hepatis
Characteristic sign of acute hepatic failure (2)
Asterixis (Encephalopathy)
Nonrhythmic, rapid extension-flexion of the head and extremities
Coagulopathy: impaired clotting due to lack of production of Vit K dep factors
- Easy bruising early sign
Acute hepatic failure is associiated with (3)
1) Disseminated intravascualr coagulation
- liver removes activated coagulation factors
2) Portal HTN (leads to ascites and encephalopathy)
3) Hepatorenal syndrome
- kidneys normal
- hyponuria, elevated BUN and creatine
Chronic liver failure is associated with
Hepatitis B and C
NAFLD
Alcoholic fatty liver disease
Signs of chronic liver failure (4)
- Palmar erythema
- Spider angiomata
- Hypogonadism
- Gyencomastia
Ultimate cause of death from liver failure
- Encephalopathy
- Bleeding from esophageal varices
- Bacterial infections
Cirrhosis leads to risk of developing
Hepatocellualr carcinoma
Hepatitis without chronic or carrier state
Hepatitis A virus
Hepatitis that is ds-DNA
Hepatitis B virus
Chronic liver failure w/ hepatitis seen inperson who is 20 or 30 years old
Hepatitis B virus
Chronic liver failure hepatitis
Hepatitis B virus
Hepatitis C virus
Hepatitis that is precursor for hepatocellular carcinoma
Hepatitis B virus
Liver biopsy shows finely granular “ground glass” hepatocytes
Chronic Hepatitis B virus
Associated with metabolic syndrome
HCV
HAV
- type
- family
- transmission
- chronic
- diagnosis
- Sudden hepatitis
ssRNA
Hepatovirus (picornavirus)
Fecal-oral (contaminated H2O)
Chronic= never
Diagnosis= serum IgM Ab
Acute hepatitis: Yes
HBV
- type
- family
- transmission
- chronic
- diagnosis
- Sudden hepatitis
dsDNA
hepaDNAvirus
parenteral, sexual contact, perinatal
Chronic: 5-10%
Diagnosis: HBsAg, antiHBcAg; PCR for DNA
Acute hepatitis: Yes
HCV
- type
- family
- transmission
- chronic
- diagnosis
- Sudden hepatitis
ssRNA
flaviviridae
Parenteral, intranasal cocaine
Chronic: >80%
PCR for DNA, Elisa for Ab
Acute hepatitis: NO
Hallmark for increased portal chronic inflammation
Portal tract expansion