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Patho II > Cirrhosis > Flashcards

Cirrhosis Flashcards

1
Q

Chronic, inflammatory, irreversible disease of the liver resulting in reduced liver function. Is also a fibrotic condition and characterized by the formation of scar tissue

A

Cirrhosis

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2
Q

Approximately ________ people per year are hospitlized

A

400,000

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3
Q

Slightly more common in (men or women)

A

Men

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4
Q

Word that means “yellow-orange” which is the color that a cirrhotic liver looks like

A

Kirrhos

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5
Q

25% of cirrhosis cases are due to

A

Hepatitis C

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6
Q

20% of cirrhosis cases are due to

A

Alcoholism

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7
Q

Another cause of cirrhosis includes which disease?

A

Non-alcoholic fatty liver disease (NAFLD)

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8
Q

Liver is supplied from which two vessels?

A

Hepatic artery (oxygenated blood) and portal vein (deoxygenated blood)

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9
Q

Where do the hepatic artery and portal vein drain into?

A

Hepatic sinusoid

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10
Q

Sinusoids are lined by ______ and _______ cells

A

Endothelial and Kupffer cells

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11
Q

Which cells are similar to macrophages and act as a resident immune cell that can stimulate inflammation for the liver?

A

Kupffer cells

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12
Q

Filtered blood drains into which vessels?

A

Central veins

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13
Q

Central veins then drain into which vessel?

A

Hepatic vein

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14
Q

What is the normal pressure of the liver system?

A

5-10mmHg

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15
Q

What are the cells that synthesize fibrin in the liver and stimulate fibrosis?

A

Stellate cells

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16
Q

What is the main cause of cirrhosis?

A

Imbalance between ECM production and degradation, which increases fibrosis

17
Q

How does the imbalance between ECM production and degradation occur?

A
  1. Inflammatory response causes the release of chemical mediators released from hepatocytes and Kupffer cells
  2. These mediators activate stellate cells to produce excess collagen and fibrin that deposits into extracellular space
  3. Causes the hepatocytes to regenerate into nodules
  4. Causes sinusoids to become constricted, which increases portal pressure above 10mmHg, causing portal hypertension
  5. Collateral vessels form and shunts blood around the liver, which results in poor metabolism of toxins, bilirubin, drugs, hormones, etc.
18
Q

What is the main chemical mediator release from Kupffer cells?

A

TGF-beta

19
Q

No manifestations of cirrhosis until how much of the liver has lost function?

A

> 80%

20
Q

Most common, initial symptoms (7)

A
  1. Nausea
  2. Loss of appetite
  3. Weight loss
  4. Weakness
  5. Fatigue
  6. Hepatomegaly
  7. Jaundice
21
Q

Other, not as common symptoms (4)

A
  1. Confusion
  2. Fever
  3. Edema
  4. Easily bruise or bleed
22
Q

100% certain diagnostic measure of cirrhosis

A

Liver biopsy

23
Q

What would a CBC test show in individuals with cirrhosis?

A

Decreased production of all blood cell types

24
Q

What happens to PT and INR?

A

Both are increased (takes longer to clot)

25
Q

How are the liver enzyme levels affected of AST and ALT?

A

Massive increase of these in blood stream (over 1000x)

26
Q

What will happen to bilirubin and serum albumin levels?

A

Increased bilirubin, decreased albumin

27
Q

A nonspecific marker, alkaline phosphate, will be increased or decreased?

A

Increased

28
Q

Complications of portal hypertension (4)

A
  1. Esophageal varices - distended veins in lower esophagus
  2. Ascites - accumulation fluid in peritoneal cavity
  3. Hepatic encephalopathy - accumulation of ammonia causing neurologic deficits
  4. Hepatocellular carcinoma; hepatorenal failure
29
Q

A higher grade of hepatic encephalopathy means condition is (better or worse)

A

Worse

30
Q

What is the only cure for cirrhosis?

A

Liver transplant

31
Q

Two staging/severity tools used to monitor cirrhosis?

A
  1. Child-Turchotte-Pugh (CTP) classification
    * More common
  2. Model for End-Stage Liver Disease (MELD)

Patho II (13 decks)

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