chronic liver disease symposium Flashcards
what is cirrhosis
final common pathway of many liver diseases
inflammation to fibrosis to cirrhosis
roles of the normal liver
regulation of metabolism (protein synthesis, carb metabolism, lipid metabolism)
portal venous drainage (hormone and drug inactivation and protein degradation)
formation off bile
immune function (reticuloendothelial system)
effects of cirrhotic liver
reduced metabolic capacity (coagulopathy, reduced albumin, hypoglycaemia)
portal hypertension (ascites, hypersplenism, varices, hepatic encephalopathy)
jaundice
impaired immune response
causes of cirrhosis
non alcoholic fatty liver disease alcohol viral hepatitis (B, C) AI liver disease (AI hepatitis, primary biliary cholangitis, primary sclerosing cholangitis) wilson disease haemochromatosis
what does compensated cirrhosis look like
well patient
some signs and symptoms
abnormal/normal LFTs
abnormal imaging anf biopsy
what does decompensated cirrhosis look like
unwell jaundice ascites coagulopathy low albumin encephalopathy abnormal LFTs and imaging
what are the two aspects of decompensated cirrhosis
liver cell failure (jaundice, coagulopathy, encephalopathy) portal hypertension (splenomegaly, ascites, varices, encephalopathy)
where does the liver receive blood from
portal vein from
superior and inferior mesenteric, splenic (and coronary vein - away to oesophagus)
where does blood leave the liver
posteriorly and superiorly
R, Middle, L hepatic veins to IVC
What is the basic structure of liver lobules
hexagonal
central vein and portal triad at each corner
likely test results from cirrhosis
high bilirubin and INR
low Hb, Platelets, albumin
what results from splenomegaly
hypersplenism so low platelets
what is seen on a US of cirrhosis
nodular liver, no focal lesions
reversed portal vein flow
large spleen
large volume ascites
How to remember the aspects of portal hypertension
SAVE(R) Splenolmegaly ascites varices encephalopathy (renal failure)
