Liver Flashcards
Liver functions 7
Metabolism, detox, bile synth, ammonia to urea, storage, Blood cell breakdown, blood clotting, conjugation of bil
Kupffer cells are responsible for
Phagocytosis in the liver
Bilirubin
and unconjugated vs conjugated
A pigment from the breakdown of Hemoglobin.
Unconjugated- Lipid soluble Initial waste product, travels from bloodstream to liver via albumin.
Conjugated-Converted from unconjugated in the liver. It is water soluble and is turned into bile and is ultimately excreted.
Normal Lab values for Bilirubin total direct and indirect
Total- 0.2-1.2mg/dl
Direct-0.1-0.3mg/dl
Indirect-0.1-1.1mg/dl
Direct is
and indirect is
and when they are elevated it is a sign of?
Conjugated
uncongugated
Liver dysfunction
What does it mean when there is an increase in direct bilirubin lab?
Indirect?
Direct-usually from blockage, indirect-hemolytic
normal protein level in the blood?
normal albumin level in the blood?
and what does liver damage do to these?
and when is that seen?
albumin- 3.5-5 g/dl
total 6.4-8.3 g/dl
low levels
not seen until there is mod-severe damage
What is ammonia?
normal level?
Increased level shows, leads to blank and blank.
Toxic product of protein breakdown and is turned into urea and excreted through the kidneys.
15-45mcg/dl
shows liver dysfunction, leads to neuro problems and hepatic encephalopathy.
PT is normal value? what happens in liver dysfunction?
Prothrombin time 11-16 seconds and time increases with dysfunction.
INR normal range is blank based on blank and increases can?
2-3 PT indicate liver dysfunction.
What do liver enzymes do when there is liver failure?
They increase
ALP range
38-126 u/l
AST range
10-30
ALT range
10-40
GGT
0-30
Normal cholesterol value and what happens with liver dysfunction?
less than 200mg/dl it is high
Jaundice is and one sign that is not yellowing
A build up of bilirubin in the body clay colored stools
What is hepatitis and 6 causes
Hepatic inflammation. Virus, alcohol, medications, chemicals, autoimmune diseases, and metabolic problems.
Patho of viral Hep
Hepatocytes are targeted directly by virus or by the cell mediated response.
one thing to know about the Manifestations of acute hep
many people do not have s/s
Manifestations of HEP 5
Loss of smell, skin rash, flu like symptoms, right upper quad pain, pruritus
Pruritus
Itching from the build up of bile salts beneath the skin
Three stages of viral hep
prodromal
icteric
posticteric (convalescence)
Prodromal hep 3 things
Loss of smell/cigs taste bad, megalies/ max infectivity
icteric stage 2 things
Jaundice/pruritus
Posticteric stage name and
convalescence- fatigue, splenomegaly might subside,
Hep A how do you get it? How do you prevent it? one more thing? Therapy?
I Ate it food, milk,water from f-o Vaccine no chronic None but can use immunoglob
Hep B how do you get it? How do you prevent it? one more thing? Therapy?
Blood or Body fluids
vaccine hand washing avoid fluids
Usually recover
Hep C how do you get it? How do you prevent it? one more thing? Therapy?
sex and blood and drugs
screening decrease risky behaviors
currently no vaccine
antivirals that block protein for replication
Hep C blank progresses to blank
most common cause of 3
Chronic infection progresses to liver disease
Most common cause of cirrohisis and cancer and liver transplants
Hep c screening
people born between 1945 and 1965
and those who received blood products before 1992
two things to remember about HIV and the liver
HIV meds are hepatotoxic and Hep C and HIV are a terrible combo,
Hep D how do you get it? How do you prevent it? one more thing? Therapy?
from Hep b
Prevent B
No vaccines
Antiviral or interferon
Hep E
How do you get it?
Everywhere but here
/Contaminated water fecal oral
when do liver enzymes return to normal?
Post ic stage
Complications of hep 4
Cancer, cirrhosis, chronic hep, acute liver fail
Nutrition for Hep
high cal not high fat small frequent meals,
Hep b vaccine time
At birth, one month and s months
Hep a Vaccine time
1 year
What is metabolic syndrome 4 and what does it have to do with the liver?
Obesity, diabetes, hyperlipedema, HTN also the risk factors for NAFLD
how do you treat NAFLD?
Reduce modifable factors
Acute liver failure
Severe impairment of liver function associated with hepatic encephalopathy
What causes acute liver failure? 6
Acetaminophen and alcohol, TB, Sulfa, NSAIDS , HBV
time acute liver fail
8-26 weeks
S/S of ALF and what is the first one? 6
First-Change in mentation, jaundice, coagulation, encephalopathy, elevated bilirubin and enzymes.
what can alf lead to 6
Cerebral edema, renal failure, hypoglycemia, metabolic acidosis, sepsis, mod
What are we watching out for with ALF? 2
renal and cerebral function
