Chapter 38 bookies Flashcards
Functionof liver
-Produces bile ( bile breaks down fats so it can be easily absorbed in digestive tract
-Process nutrients
-regulates blood glucose levels
-Detoxification
-storage energy in form of glycogen
-Protein synthesis
-recycling blood cells
How much blood supply goes to the liver?
about a quart 1/4 of blood supply goes to the GI system which includes the liver
**Liver blood flow
what is hepatic portal vein ?
Digestive tract and major abdominal organs
-direct blood to liver and receive nutrient rich blood
Ask about liver blood flow
What are things the liver can serve as?
-Blood reservoir- serves as storage and filter
-Metabolism- carbohydrate, fat, protein, fat soluble drugs
-Secretory- bile, bile acids, salts and pigments
-Excretory- Bilirubin, drugs, toxins
-Synthesis -vitamins, carbohydrates, etc
-Storage-Vitamins, carbohydrates, etc
-detoxification-Toxins, ammonia
How much bile is produced daily
500-600 ml daily
What is cholestasis?
When bile does not flow and has not flowed through the liver to the gall bladder into the small intestine
What is bilirubin elimination
Travels to small intestine where it is absorbed into the portal circulation or excreted in feces
-it should not hang out because it is a waste product and should be 100% eliminated
what is jaudince?
Build up of bilirubin in blood stream causing yellowing of skin
What causes jaudince ?
-Destruction of rbc
-Impaired uptake of bilirubin by liver cells
-Decreases conjugation of bilirubin
-Obstruction of bile flow in the canaliculi of hepatic lobules or in the intrahepatic or extrahepatic bile ducts
What are categories of jaundice?
Prehepatic
Intrahepatic
posthepatic
**Categories of jaundice
What is prehepatic of jaundice?
Destruction of RBC, body is breaking down rbc quickly
-Bilirubin starts to appear in the blood stream and yellowing of skin, eyes occur
**Categories of jaundice
What is intrahepatic of jaundice?
Disorders that directly affect how the liver is able to remove bilirubin from the blood so it can be eliminated
**Categories of jaundice
What is Post hepatic jaundice?
Bile flow is obstructed so bile can’t drain as it should between liver and intestine
What is hepatitis?
Inflammation of the liver
What can cause hepatitis?
-Autoimmune disorders
-Reactions to drugs or toxins
-Infectious disorders like malaria, amebiasis
-Hepatotropic (Liver-specific ) v
What are patterns for hepatitis
-could be asymptomatic
-Acute hepatitis has specific symptoms
-Carrier state, is when it remains the liver and will be in carrier state
-Chronic hepatitis
-Fulminating disease which is when it starts affecting other organs and not only the liver
what is hepatitis A caused by?
-Transmitted through the fecal- oral route
-Hepatitis A virus
Describe hepatitis A
-could be asymptomatic
-Could last for about 2 months and resolve on its own
-Transmitted through fecal oral route
-Immunizations prevent diseasese
What are signs and symptoms of hepatitis A?
-Dark urine and jaundice!
-Fever
-Malaise,
-nausea
-anorexia
-Abdominal discomfort
What causes hepatitis b?
Hepatitis B virus
How is hepatitis B transmitted?
-Infected blood
-Other body fluid like sexual or orally
Describe hepatitis B
Incubation is about 14-28 days
-It could last a couple of weeks to 6 months
-If it gets serious it can cause liver failure
-Has immunization
What are signs and symptoms of Hepatitis B?
-Clay colored stool and joint pain
-Loss of appetite
-Nausea
-Vomiting
-Joint pain
-Abdominal pain
How is hepatitis C be trasmitted?
-Blood to blood
-Injection drug use
-high risk sexual behavior
Describe hepatitis C?
signs and symptoms are very similar to hepatitis B
- incubation is about 2-26 days and duration is 2-12 weeks
-Immunization does not exist
What is fulminant hepatitis?
Fatalform of Acute form of hep usually b
- associated with sever hep B infection
-The liver is severely damages and there in no cure
-rare but has a few cases
What is intrahepatic biliary disease?
Disease that disrupt flow of bile through the liver which could result in cholestasis and biliary cirrhosis
What causes intrahepatic biliary disease?
-Primary biliary cirrhosis
-Primary sclerosing cholangitis
-Secondary biliary cirrhosis
What are early symptoms of Intraheptic bilary disease
Unexplained pruritus (itching)
Weight loss
Fatigue
What are later symptoms of Intrahepatic biliary disease?
-Dark urine and pale stools
-Jaundice
What are 3 types of alcohol induced liver disease?
-Fatty liver disease
-Alcoholic hepatitis
-Cirrhosis
Describe the Alcoholic liver disease
-Liver will start to have more fatty tissue in it
-it will have acute inflammation and that will cause scaring so fibrin will build up and make liver stiff
-Scaring will lead to Cirrhosis will make the liver stiff and unable to fix
-Cirrhosis will eventually lead to liver failure which is not reversible
What is non alcoholic fatty liver disease?
Excess fat deposited into the liver
-The fatty deposit disease does not increase unless you make it worse with drinking
What are risk factors of non alcoholic fatty liver disease?
-Co-existing obesity
-Type 2 diabetes
-Metabolic syndrome
-Dyslipidemia
-nutritional abnormalities
-Surgery,drugs, exposure to toxins
What are signs and symptoms of non alcoholic fatty liver disease?
Usually asymptomatic
-Fatigue
and upper quadrant paint will be present
What is cirrhosis?
-End stage chronic liver disease
-Dense fibrous tissue replaces hepatic tissue
-The fibrous tissue leads to scarring and due to the stiff scaring the liver can no longer function
What are signs and symptoms of cirrhosis?
-Melena which is dark tarry stools
-Fector hepaticus which would be bad breathe
-Esophageal varices is varicose veins in the esophagus
-Asterixis which is hand shaking
-Diarrhea or constipation
-Hepatomegaly
-Jaundice
-Abdominal pain
-Anorexia, weakness, weight loss
What are signs and symptoms of liver failure?
-Hematologic disorders
-Endocrine disorders
-Skin disorders
-Hepatorenal syndrome
-Hepatic encephalopathy
What is portal hypertension
increased pressure within the portal venous system
What is primary liver cancer?
Starts in the liver
What is secondary liver cancer/ Metastatic liver cancer?
Cancer that started somewhere else and is affecting the liver
What is hepatocellular carcinoma ?
Most common liver cancer
-arise from the liver cells
What can cause hepatocellular carcinoma?
-Viral hepatitis
-Cirrhosis
-Drug exposure
-Water contaminated with arsenic
What are signs and symptoms of Liver cancer?
-Fullness or pain
-Abdominal swelling
-Weakness
-anorexia
-Weightloss
-Fatigue
What is cholangiocarcinoma?
Primary cancer of bile ducts but rare
What is cholangitis?
Inflammation of common bile duct
What is function of gall bladder
Store and concentrate bile
What is pancreatitis
Inflammation of the pancreas
What are the two types of pancreatitis?
Acute and chronic
What is acute pancreatitis?
Pancreatic ducts becomes obstructed and enzymes back up which causes autodigestion and inflammation of the pancreas
What are signs and symptoms of acute pancreatitis?
epigastric or periumbilical pain radiating to back, chest, or flank; fever; tachycardia; hypotension; severe abdominal tenderness; abdominal distention. Can be mild, severe, or life-threatening
pain will be in upper right quadrant with fever
What is chronic pancreatitis?
Progressive inflammatory disorder that destroys the pancreas.
Cells are replaced by fibrous obstructing the pancreatic and common bile ducts
What are signs and symptoms of chronic pancreatitis?
recurring epigastric or upper left quadrant pain; precipitated by alcohol or overeating; anorexia, nausea, vomiting, constipation, flatulence
What are common causes for acute pancreatitis?
-GALLSTONE (stones in the common duct)
-Alcohol abuse
-HYPERLIDEMIA
Hyperparathyroidism
Infections (particularly viral)
Abdominal and surgical trauma
Drugs such as steroids and thiazide diuretics
What is the cause of pancreatic cancer?
UNKNOWN
What are risk factors of pancreatic cancer?
SMoking and diet
-High intake of fat, meat, salt
-Dehydrated foods, fried foods, refined sugars, soybeans, and nitrosamines
What are signs and symptoms of pancreatic cancer?
dull epigastric pain radiating to dull back pain; worsening pain in supine position relieved by sitting; jaundice; weight loss
