Hepatic system disease Flashcards
What are some functions of the liver? [8]
1) Xenobiotic detoxification and metabolism
2) Decomposition of erythrocytes and excretion of bilirubin
3) Bile production
4) Cholesterol synthesis
5) Carbohydrate Metabolism
6) Protein synthesis
7) Hormone production
8) Storage
What is jaundice?
An elevation of serum biirubin above the normal limit (9mmol/L) 35 mmol/L
How is bilirubin metabolised in circulation?
Erythrocytes are broken down which releases haemoglobin
What happens to haemoglobin after breaking down?
The globin is metabolised and amino acids are recycled
The haem is converted to bilirubin, bound to albumin
How is bilirubin metabolised in the liver?
Dissociates from albumin and enters hepatocytes
What two components is bilirubin conjugated with?
Two glucouronic acids
Which enzyme causes the conjugation?
UDP-glucuronyl transferase
What property of bilirubin allows it to be secreted into the biliary canaliculi and bile?
It is water-soluble
What can bilirubin be digested into?
Urobilinogen
How is neonatal jaundice caused?
Bilirubin accumulates due to low glucuronyl transferase
What happens to unconjugated bilirubin in blood of babies?
It increases which causes diffusion into basal ganglia causing toxic encephalopathy
How do you treat jaundice in babies?
Expose the baby to blue fluorescent light as it converts bilirubin to a water-soluble isomer hence they can be excreted into bile without conjucation to glucoronic acid
What is Haemolytic Jaundice?
XS RBC lysis where bilirbuin if produced faster than the rate of conjugation by the liver
What happens to the blood, urine and stool during haemolytic jaundice?
Increase in unconjugated bilirubin in the blood
In urine the urobilinogen is increased
Stool is normal
What is Hepatocellular Jaundice?
Conjugated bilirubin is not efficiently secreted into bile.
What happens to the blood, urine and stool during haemolytic jaundice?
Blood- increased BOTH unconjugated and conjugated bilirubin
ALT & AST levels are markedly elevated
Urine-Bilirubin is present in urine, yellow brownish
Stool- Normal to Pale
What is obstructive jaundice?
Bile duct obstruction wherein conjugated bilirubin is prevented from passing to intestine; passed to blood increasing circulatory conjugated bilirubin
What happens to the blood, urine and stool during obstructive jaundice?
Blood: increased conjugated bilirubin ALT is mildly elevated
Urine: Bilirubin in urine, urobilinogen reduced
Stool: Pale (low stercobilin)
What is hepatitis?
Inflammation of the Liver
What is acute hepatitis?
Inflammation develops quickly and lasts short
What are examples of viral hepatitis?
Hepatits A
Hepatitis B
Hepatitis C
Hepatitis E
Give some information on Hepatitis A?
RNA Virus
Short incubation period
No chronic state
No carrier state
What is Hepatitis E?
Acute, self-limited, more severe liver damage, it is not lifelong, no treatment
What is Hepatitis B?
DNA Virus Spread by blood products, sexually Long incubation Carriers Fever malaise,anorexia, nausea 5-10%
