GI - 5 Liver Disease pt 4 Flashcards
AST>ALT usually by 2x or more. AST rarely >300, not nearly as high as viral hepatitis in:
Alcoholic liver disease
1 treatment for alcoholic liver disease is
abstinence
3 causes of cirrhosis. which is most common?
Chronic Heb B and C, alcohol (most common)
What causes cirrhosis in Autoimmune Hep?
High AMA - irritatoin and swelling blocking bile flow - primary biliary cirrhosis
Big symptom of cirrhosis is:
loss of libido
First check which 2 places for jaundice?
Conjunctiva and sclera of eyes
Treatment of cirrhosis
Treat the underlying disorder
Healthy diet, no alcohol
Check sonogram and AFP q 6 mos***
What makes encephalopathy worse? (2)
Ace inhibitors & narcotics
Azotemia without shock or significant proteinuria
Failure of renal function to improve after fluids
Oliguria (not urinating b/c of low blood flow to kidneys), hyponatremia, low urinary sodium
Increased renal vasoconstriction, kidneys nl
Often terminal
Kidneys are normal though
Hepatorenal syndrome
__ is most measurable toxin but not solely responsible for Hepatic encephalopathy
Ammonia
Ammonia is the most measurable toxin, but NOT solely responsible for:
Hepatic encephalopathy
Flapping of the hands is a sign of
Hepatic encephalopathy
Why should you restrict protein in hepatic encephalopathy?
protein breakdown creates ammonia
Treatment for hepatic encephalopathy. how does it work?
Lactulose - makes ammonia into ammonium so it can pass thru GI tract
Arise from parenchymal cells
80% associated with cirrhosis
Men>women
Chronic hepatitis B and C infections, Etoh, hemochromatosis, NASH (non alcoholic steato? hepatitis)
Hepatocellular Carcinoma
