Disorders of the Liver Flashcards
What does the liver do?
produces bile: emulsifies fat
metabolize and store nutrients
detoxify drugs and waste products
*the liver does a lot so if something happens to the liver a lot will be effected
What is a Fatty Liver?
accumulation of fat in liver tissue: liver enlargement (hepatomegaly)
asymptomatic: 20% or more people, reversible
What are the causes of a Fatty Liver?
alcohol, too little protein, infection, cancer, drugs, obesity, diabetes
What are the diet recommendations for a Fatty Liver?
depends on cause
What is hepatomegaly?
liver enlargement
What is Hepatitis ?
inflammation due to tissue damage
What are the causes of Hepatitis?
viral infection (Hepatitis A, B, and C), alcohol, drugs, supplements (chaparral, senna, mistletoe, valerian root, jin bu huan, bee pollen, germander, skullcap, ma huang)
What are the S/S of Hepatitis?
fatigue, muscle and joint pain, nausea, fever, pain in the liver area
jaundice
What is jaundice?
bilirubin leaking into the blood stream
What is the diet recommendation for hepatitis?
Depends of severity….
normal diet or high calorie diet, high protein
normally told to limit Fat intake b/c you don’t want a fatty liver on top of hepatitis
What is Cirrhosis?
hardening of the liver with scar tissue
final stage of chronic liver disease, irreversible
impairs liver function, lead to liver failure
40% are Asymptomatic b/c liver disease progresses very slowly
What are the causes of Cirrhosis?
alcohol, infection, bile duct disorders, congestive heart failure, drugs, supplements, genetic diseases
How long after a Hepatitis infection does Cirrhosis begin?
between 10-20 years after a Hepatitis infection
What are the complications of Cirrhosis?
Portal HTN Esophageal Varices Ascites Poor fat absorption: malnutrition Elevated blood ammonia levels Hepatic Encephalopathy Decreased production of clotting factors (bruising and bleeding)
What is Portal Hypertension?
high blood pressure in the portal vein
blood flow reduction to the liver: blood pressure increases
What is Esophageal Varices?
diversion of blood to smaller blood vessels surrounding the liver (collaterals along the GI tract)
pressure build up creates dilation of collaterals
bulging vessels in the esophagus: varices
vulnerable to rupture b/c collaterals aren’t made to handle all the blood the liver is diverting to them.
if rupture occurs so will massive bleeding (lack of clotting factors with damaged liver)
What are collaterals?
small blood vessels
What is Ascites?
Fluid accumulation in the abdominal cavity
very last stage of liver damage
usually w/in 10 years of disease onset
indication that liver damage has reached critical stage: death within 2 years
What are the 3 major factors that lead to fluid accumulation in the abdominal cavity (ascites)?
Portal HTN : causes fluid to leak from the blood vessels into the abdominal cavity
Reduced Albumin Synthesis : albumin retains water in the blood vessel, w/o it water will move out of the blood vessels into other tissue
Altered kidney function : Na and water retention
What is Hepatic Encephalopathy?
abnormal neurological functioning (due to high ammonia levels)
What is the diet therapy for liver problems/failure?
extra calories
high protein (depending on the severity b/c too much can give high ammonia levels with decreased liver functionality)
Vitamins and minerals
No alcohol and herbal supplements
What does Ammonia (NH3) in the body come from?
protein breakdown and bacterial action
How is urea made?
the liver binds CO2 with ammonia (from protein breakdown) to form urea…which is then excreted by the kidneys
How does cirrhosis affect ammonia in the body?
with cirrhosis the liver cannot metabolize all the ammonia so the ammonia builds up and stays in the blood stream.
PROBLEM: if NH3 stays in blood stream it depresses the nervous system. eventually will give you disturbances and coma (HEPATIC COMA)
Does all of the urea get excreted in normal conditions?
no, some of the urea may be reabsorbed in the kidney
