Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Case 2 > Disorders Of The Hepatic System > Flashcards

Disorders Of The Hepatic System Flashcards

1
Q

What are the function of the liver?

A

Bile production
Protein synthesis
Hormone production
Storage

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What are the normal levels of jaundice

A

Normal levels of serum bilirubin are 3-17 mmol/L

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What is the excessive RBC lysis

A

Bilirubin is produced at a faster rate than the rate of conjugation by the liver

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Why is there a low conjugation efficiency when there is liver damage?

A

The conjugated bilirubin is not efficiently secreted into bile

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Why is bilirubin conjugated?

A

To make it more water soluble

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Why is bile secreted in to the duodenum?

A

The aid digestion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What is bilirubin degraded to?

A

Bilirubin is degree to urobilinogen
80% oxidised and excrete in faeces
20% enters extrahepatic circulation and urine excreted

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What is bilirubin bound to?

A

Albumin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What happens to bilirubin when it enters the liver?

A

Bilirubin dissociates from albumin & enters hepatocytes
Conjugated with two glucuronic acids by UDP glucuronyl transferase —> which is water soluble
This is screed into the biliary canluculi and bile
Bile is iscrete into the duodenum to aid digestion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Why can neonates get jaundice?

A

Bilirubin accumulates as bilirubin glucuronyl transferase enzyme is low at birth

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is the treatment for neonatal jaundice?

A

Exposure of the newborn skin to blue fluorescent light which converts bilirubin to more polar & hence water soluble isomers. These can be excreted into bile without conjugation to glucuronic acid

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Why can hepatocellular jaundice cause jaundice?

A

There is low conjugation efficiency, conjugated bilirubin is not efficiently secreted into the bile

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

In liver damage what is the colour of urine?

A

Yellowish brown as bilirubin is present

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What happens during obstructive (post hepatic) jaundice

A

There is bile duct obstruction
Conjugated bilirubin is prevented from passing to the intestine
Which is passed to the blood increasing circulatory conjugated bilirubin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

In obstructive jaundice what is the colour of urine?

A

Yellowish brown colour, bilirubin is in the urine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What is hepatitis

A

Inflammation of the liver

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What is acute hepatitis?

A

Mild changes in hepatic function
Inflammation develops quickly and lasts short period of time
Patient normally recovers

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What damage can chronic hepatitis lead to?

A

Hepatic damage leads to fibrosis and potentially cirrhosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What can viral hepatitis cause?

A

Acute liver injury

Chronic liver injury.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Which virus does Hepatits A contain?

A

RNA virus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Can hepatitis A lead to chronic liver disease?

A

No

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What is HepE?

A

More severe liver damage than HepA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

How is HepB spread?

A

By blood, blood products, sexually, vertically (in utero)

24
Q

Which virus is HepB?

A

DNA virus

25
Q

How long is the incubation period for HepB?

A

1-6 months

26
Q

Why is there liver damage from HepB?

A

Caused by the antiviral immune response

27
Q

What is the treatment for HepB?

A

Interferon alpha = initial treatment for adults

Then nucleoside analogues

28
Q

What is the mechanism of action of interferon alpha?

A

Mimics interferons produced by virus infected cells
Binds cell surface receptor, stimulates proteins which inhibit viral mRNA translation
Inhibits viral replication and augments viral clearance from hepatocytes

29
Q

What is the mechanism of antiviral nucleosides

A

Nucleoside analogue undergoes initial rate limiting phosphorylation step by nucleoside kinase
Second phosphorylation step performed by nucleoside monophosphate kinase
Third phosphorylation step by nucleoside diphosphate kinase
Nucleoside triphosphates compete with deoxynucleotide triphosphates, causes chain terinnation

30
Q

How is HepC spread?

A

Blood, blood products and possibly sexually

31
Q

Which virus is HepC?

A

RNA

32
Q

Is hepatitis C symptomatic or asymptomatic?

A

Often asymptomatic

33
Q

What is treatment for HepC?

A

Sofosbuvir
In combination with
Peg-interferon Alfa
Ribavirin

34
Q

What are symptoms of Hep B?

A 
Fever 
Malaise 
Anorexia 
Nausea 
Arthralgia
Jaundice
35
Q

What are the presentations for autoimmune hepatitis?

A

Jaundice

Right upper quadrant pain

36
Q

How is autoimmune hepatitis investigated?

A

Type 1: anti smooth muscle antibodies (80%), anti nuclear antibodies (10%)
Type 2 (children): anti liver/kidney microsomal type 1 antibodies
Liver biopsy

37
Q

How is autoimmune hepatitis treated?

A

Immunosuppressants —> steroids, azathioprine
Transplant
Cyclosporin, Tacrolimus, Mycophenolate in corticosteroid resistant disease

38
Q

What is cirrhosis?

A

Hepatocytes replace and by non functional connective tissue

Portal vein hypertension and shunting of blood around liver

39
Q

What are the causes of cirrhosis?

A 
Alcohol 
Drugs 
Xenobiotics
Chronic viral hepatitis 
Autoimmune hepatitis 
Wilson’s disease 
Haemochromatosis
40
Q

What are the symptoms of cirrhosis?

A

Fluid retention, oedema in legs and abdomen
Gallstones
Coagulation defects
Peripheral neuropathy
Reduced mental function
Oesophageal and gastric varices and bleeding
Jaundice

41
Q

What is the pharmacological terament of cirrhosis p?

A

Alcohol cessation
Oedema = salt restriction and diuretics
Chronic hepatic encephalopathy = laxative, oral anti bacterials
Variceal haemorrhage

42
Q

What is alcohol induced hepatocellular steatosis?

A

Generation of excess NADH and acetaldehyde dehydrogenase
Increased lipid biosynthesis
Impaired secretion of lipoproteins
Increased peripheral catabolism of fat

43
Q

Which two types of lipid droplets accumulate in hepatocytes?

A

Microvesicular

Macrovesicular

44
Q

Why is there hepatocytes swelling in alcohol mediated hepatitis?

A

Accumulation of fat and water

Cell necrosis

45
Q

What does the liver look like with alcohol,mediated hepatic cirrhosis?

A

Brown, shrunken and non fatty

46
Q

What are the clinical features of alcohol liver disease?

A

Hepatic steatosis
Alcoholic hepatitis
Alcoholic cirrhosis

47
Q

WHat are the three types of liver damage that cause jaundice?

A

Excessive RBC lysis
Liver damage
Bile duct obstruction

48
Q

How is hepatitis A transmitted

A

Faecal contaminated water and food

49
Q

What does HepC cause?

A

Causes liver damage

50
Q

What does cirrhosis cause

A

Drug and alcohol isn’t metabolised which causes accumulation and can lead to toxicity

51
Q

What is a pro drug

A

Drugs that are active once they’re metabolised

52
Q

Why do pro drugs not work in cirrhosis

A

The liver cannot metabolise the pro drug p, hence the active metabolite isn’t formed

53
Q

Why is there high portal vein hypertension in liver cirrhosis?

A

There is higher drug concentration, which means there is higher drug clearance

54
Q

How does alcohol cause cirrhosis

A

There is an accumulation of alcohol over a short period of time, which cannot be metabolised by the liver, causing toxicity and killing hepatocytes, resulting in non functional cells

55
Q

Which medication can cause cirrhosis

A

Paracetamol, metabolic products can accumulate which toxic causing liver damage

Case 2 (11 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions