Jaundice and Chronic liver disease Flashcards
6 things the liver produces
clotting factors
bile acids
carbohydrates
porteins
lipids
hormones
detoxification actions of the liver
urea produced from ammonia
detoxifies drugs
bilirubin metabolism
breakdown of insulin and hormones
storage function of the liver
stores glycogen
stores vitamin A, D, B12, K
stores iron and copper
bilirubin is the product of what?
haeme metabolism
alkaline phosphatase is the enzyme present in …….. and is elevated when there is a
bile ducts
obstruction or liver infiltration
gamma GT is a non specific
liver enzyme
gamma GT is elevated with
alcohol use
albumin is an important test for measuring
synthetic function of the liver
low levels of albumin suggest
chronic liver disease
prothrombin time is an important test for
liver function
tells degree of liver dysfunction
creatinine test tells us
kidney function
determines survival from liver disease
platelet count is an indirect marker of
portal hypertension
symptoms of liver failure
jaundice
ascites
variceal bleeding
hepatic encephalopathy
Jaundice definition
yellowing of the skin sclerae and other tissues causes by excess circulating bilirubin
Jaundice investigations
LFTs
ultrasound
MRI
what is ultrasound so important in liver investigations?
differentiates between extra and intra hepatic obstruction
shows site of obstruction
cause of obstruction is shown
shows any evidence of portal hypertension
can show if there is any cancer spread
ERCP
endoscopic retrograde cholangiopancreatography
therapeutic ERCP can be used in
dilated biliary tree
acute gallstone pancreatitis
stunting of biliary tract obstruction
post-operative biliary complications
cirrhosis
late stage scarring/fibrosis of the liver
can be caused by various different liver conditions
clinical presentation of cirrhosis
abnormal LFTs
chronic liver disease
ascites
vatical bleeding
hepatocellular carcinoma
Hepatic encephalopathy
Neuro abnormalities in people with liver issues
clinical features of ascites
physical exam reveals dullness in flanks and shifting dullness
spider nevi
palmar erythema
abdominal veins
JVP elevated
treatment options for ascites
diuretics
large volume paracentesis
aquaertics
liver transplant
aquaertics are drugs that allow for the….
excretion of water without electrolyte loss
portal hypertension can lead to what 3 conditions?
caput medusae
oesophageal varices
rectal varices
management of Variceal haemorrhage
Good IV access
blood transfusion
endoscopy
hepatocellular carcinoma is associated with
hep B and C
cirrhosis
hepatocellular carcinoma presentation
decompensation of liver disease
abdominal mass
abdominal pain
weight loss
bleeding from tumour
diagnosing hepatocellualr carcinoma
tumour markers (AFP)
ultrasound
CT scan
MRI
liver biopsy
hepatocellular carcinoma treatment
hepatic resection
liver transplant
chemo
