Human Disease L39: Liver disease and viral hepatitis for the dentist Flashcards
how does a patient having some form of liver disease impact dentist when operating them
patients with liver disease will have
impaired wound healing
impaired clotting: deficient clotting factors and reduced platelets
they will have a risk of blood borne viruses
the liver plays a vital role in metabolism, list the many metabolic function of liver
protein metabolism
carbohydrate metabolism
lipid metabolism
bile acid metabolism
hormone and drug metabolism
immunological defence
The most critical aspects of protein metabolism that occur in the liver are: Deamination and transamination of amino acids
explain the function of each one
Typically in humans, deamination occurs when an excess in protein is consumed, resulting in the removal of an amine group, which is then converted into ammonia and expelled via urination.
transamination: the transfer of an amino group from one molecule to another, especially from an amino acid to a keto acid.
- which hepatic duct sits on the right lobe of the liver?
- what is the name of the duct after the gall bladder?
- what comes first the common hepatic duct or the common bile duct?
- right hepatic duct
- cystic duct
- common hepatic duct
what is jaundice
Jaundice is when your skin and the whites of your eyes turn yellow. Because of a high level of bilirubin
what is the normal range for bilrubin
bilrubin can be clinicaly detectable at what range
normal range of bilrubin <17 mmol/l
bilrubin clinically detectable at >40 mmol/l
what are the three types of liver disease causing jaundice
acute liver disease (hepatitis, alcohol, drug abuse)
chrnoic liver disease (cirrhosis)
jaundice secondary to biliary obstruction
one of the clinical features of jaundice is pale stools, why is this?
The normal brown color of stool occurs due to the presence of bilirubin. Bilirubin is formed as a breakdown product of hemoglobin (from red blood cells) in the liver and is secreted into the bile, which enters the intestines.
if there is an obstruction then bile will not reach the intestines, giving stool their pale colour.
one of the clinical features of jaundice is dark urine, why is this
in obstructive jaundice the serum bilirubin is principally conjugated.
conjugated bilirubin is water soluble and is excreted in the urine, this gives urine its dark colour.
what can increased haemolysis and ineffective erythropoiesis cause
the increase in both processes can cause jaundice
jaundice, occurs when essentially normal liver cells are unable to transport bilirubin either through the hepatic-bile capillary membrane, because of damage in that area, or through the biliary tract, because of anatomical obstructions such as gallstones or cancer.
what type of jaundice is being described
cholestatic jaundice
what are the three true liver function test
bilirubin
albumin
prothrombin time
what does the bilirubin, true liver test for
A bilirubin test measures the levels of bilirubin in your blood, if there is a normal amount present then this would indiccate the health of the liver.
albumin is the principal protein the body makes, if someone is showing low serumm level of albumin, but are not presenting with symptoms of jaundice, what can this indicate.
albumin in the first protein that is utilised and broken down when the body undergoes starvation or sepsis
patient could suffering from anorexia
if there is an increase in prothrombin time (ability to clot blood), what could this indicate.
the proteins that are required to clot the blood are produced by the liver. if a prothrombin test is done, and it takes longer to clot the blood, this could indicate that there is some form of disease.
in a healthy patient clotting is controlled, meaning they want bleed or clot unnecessarily.
patients with cirrohosis have reduced clotting factors and anti clotting factors.
patients with cirrohosis will swing from normal clotting to having a tendancy to bleeding.
why cant we give clotting factors to pateints with cirrohosis
because we can promote thrombosis, assuming the patinets has swung to normal clotting.
