Cirrhosis Flashcards
why does the liver have dual blood supply
less susceptible to ischameia
hepatic artery - oxygenated blood
hepatic port vein - deoxygenated blood from the gut but has lots of nutrients from digestion
what are the functions of the liver
carb metabolism fat metabolism protein metabolism and synthesis bilirubin metabolism vitamin storage (A, D, B12 and iron) coagulation factors chemical detoxification and metabolism
what structures are normally present in the histology of the liver
portal tracts - hepatic artery, portal vein, bile duct
sinusoids - small channels to separate the hepatocytes
what are the two types of liver injury
acute - due to sudden overwhelming insult - significant amount of hepatocytes die at once
chronic - persistent ongoing damage, inflammatory response which leads to cirrhosis
what can cirrhosis be caused by
hepatitis, alcohol, obesity drugs
what are the two types of drugs that can cause liver damage
intrinsic hepatotoxins - cause liver damage to everyone in high doses such as paracetamol
idiosyncratic heptaotoxins - rare and unpredictable drugs
what is the toxic metabolite of paracetamol
NAPQI
what happens when you take high doses of paracetamol
glutathione is depleted and NAPQI skas with in the liver causing necrosis
what is the definition of acute liver failure
when more than 50% of hepatocyte loss
what is the main treatment of paracetamol overdoes
activated charcoal and N- acetyl cysteine (converted to glutathione)
why do we have liver biopsy
to asses degree of inflammation and degree of fibrosis
what is chronic liver disease
any disease that causes ongoing inflammation of the liver which results in necrosis and fibrosis
what is cirrhosis
end stage chronic liver disease, significant fibrosis with modularity of the parenchyma
what is the normal repair of the liver
can regenerate labile cells and stable cells
normal cells live for 6 months
quick regeneration if needed
what happens to regeneration as fibrosis of the liver increases
regeneration decreases
