Cirrhosis

Question 1

cirrhosis (aka hepatic fibrosis)

Answer 1

appearance of fibers that replace hepatocytes; end stage liver disease

Question 2

fibrosis

Answer 2

appearance and deposition of non-functional fibers

Question 3

diffuse fibrosis

Answer 3

widespread fibrosis throughout the liver, dec in functional cells

Question 4

primary problems w/ cirrhosis

Answer 4

dec liver fx

portal HTN

Question 5

etiology

Answer 5

• alcohol abuse (toxic)
• viral hep
• biliary disease (bile duct issues)
• metabolic disorders (ex. hemochromatosis)
• cryptogenic (idiopathic)
• other hepatotoxic drugs

Question 6

how are cells affected

Answer 6

large quantities of cell damage cause scar tissue to form; hepatocytes that regenerate will be surrounded by dysfunctional tissue

Question 7

how are vessels affected

Answer 7

• impeded perf d/t fibers constricting blood vessels causing portal HTN
• inc CHP pushes fluid from vessels into interstitial space of liver and into abd cavity –> ascites

Question 8

how are ducts affected

Answer 8

• bile flow impeded d/t duct constriction –> bile stasis –> bile stones –> further obst of flow
• if sphincter closed, bile backs up into cystic duct and fills the gall bladder
• bile ducts blocked –> fats cannot be emulsified

Question 9

how is detoxification fx of liver impaired

Answer 9

dec liver fx to metabolize toxic compounds into the excretable form causes less metabolic waste clearance

Question 10

mnfts

Answer 10

• anorexia
• weakness
• weight loss
• hepatomegaly
• jaundice

Question 11

cmplx

Answer 11

• portal HTN –> ascites (fluid shift)
• varices can rupture
• splenomegaly

Question 12

tx

Answer 12

dec workload on liver by:

• no alcohol or hepatoxic drugs
• inc proten + dec fat in diet
• sodium restriction for portal HTN