Liver Flashcards

1
Q

liver function

A

processes blood and breaksdown, balances and creates nutrients. metabolises drugs and produces clotting factors

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

acute liver failure

A

sudden insult to liver, function lost is rapid

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

aetiology of acute liver failure

A

paracetomol poisoning, toxins, cancer

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

consequences of acute liver failure

A

rapid death from bleeding, encephalopathy [impairement of brain function due to high toxin level in blood]

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

treatment for acute liver function

A

acetylcystein to block alternative pathways
recover over time, transplant only option

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

chronic liver failure

A

occurs over many years

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

aetiology of chronic liver failure

A

hepatitis, alcohol abuse, toxins, autoimmune disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

consequences of chronic liver failure

A

cirrhosis, ascites, oesophageal varices

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

cirrhosis

A

damage, fibrosis and regeneration of liver structure, portion of liver lost each recovery
gradual loss of liver, loss of normal function

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

cirrhosis aetiology

A

alcohol, biliary cirrhosis, viral disease, autoimmune, hepatitis, haemocrhomatosis, cystic fibrosis
more than one cause

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

cirrhosis signs/symptoms

A

often none, acute bleed, jaundice, oedema, ascities, encephalopathy
spider naevi + palmar erythema [redness]
portal hypeetension, hepatic dysfunction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

ascites

A

fluid accumulating in peritoneal, around bowel
high portal venous pressure, low plasma protein synthesis
needs manual draining
cause - build up of fluid moving into tissue

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

oesophageal varices

A

dilations of little veins at end of oesophagus
build-up of blood products, could rupture when swallowing, internal bleeding = death

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

hepatitis

A

inflammation of liver, function affected
through virus, toxins, medications
fever, weight loss, jaundice, none
conseq - cirrhosis, malfunction, jaundice

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

liver function tests

A

hepatic cell enzyme levels [ALT, GGT] = raised in liver inflammation
INR = synthesis of clotting factor, if not 1, significant liver dysfunction, not enough clotting factors [not on warfarin]

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

management of liver failure

A

very little, identify risk, reduce damage
supportive, transplant [need abstainance]
- risky, high change of bleed/death
artificial liver systems

17
Q

consequences of liver failure

A

too much fluid in brain, cerebral oedema
drug metabolism different
clotting factors too little, bleeding problems
infections, kidney failure

18
Q

liver disease and dental aspecta

A

end stage - clotting disorder and abnormal drug metabolism [extractions]
prolonged sedative effect, avoid IV
reduce drug dose - careful antifungals, use paracetmol, NSAIDS INCREASE BLEEDING RISK
bleeding increased
more prone to infections
no issues with LA

19
Q

extractions and liver disease

A

lower clotting ability, higher chance of bleeding
apply pressure, haemostatic gauze, suture gums
prescribe paracetomol not NSAIDS

20
Q

jaundice

A

skin, whites of eyes turn yellow. sign of liver disease
accumulation of bilirubin in the skin, not metabolised properly

21
Q

haem circulation + bilirubin

A

haem from RBC is converted t bilirubin.
needs conjugated and secreted from liver to form bile, if not, it will go into blood and skin and present as jaundice
if conjugated - into bile

22
Q

3 classifications of jaundice

A

pre-hepatic - incrased haem load [autoimmune, spleen, abnormal RBC]
hepatic - liver cell failure [cirrhosis, hepatitis]
post-hepatic - biliary, gall bladder, pancreatic disease

23
Q

pre-hepatic jaundice

A

excess bilirubin, accumulation in blood
due to factors before liver metabolism
haemolytic anaemia, post transfusion, neonatal

24
Q

hepatic jaundice

A

issues with hepatic cell, not conjugated passed into bowel or blood. no pigment in stool/urine
due to liver failure - cirrhosis, drug induced
no metabolism of RBC

25
post-hepatic jaundice
bilirubin conjugated, blockage causes backflow, pale stools/dark urine obstruction - biliary sclerosis, gall stones, pancreatic carcinoma
26
clinical features of jaundice
colour changes in urine / faeces pale stool/dark urine = post hepatic urine/stool normal = pre hepatic
27
gall bladder
accumulation site for bile being produced, stored until needed
28
gall stones
block biliary tree, cause jaundice, inflammation
29
acute cholecystis
inflammation of gall bladder
30
symptoms of gall stones
pain in shoulder tip, abdominal pain on right radiating to back, pain by eating fatty food
31
investigations for jaundice
ultrasound - bile channels, biliary tree radiograph - shows gall stones ERCP - cannula, dye injected, contrast of biliarybtree
32
cholangiocarcinoma and pancreatic cancer
tumour blocking biliary tree / pancreas both obstructing biliary tree
33
pancreatic disease
secretions blocking pancreatic pathways cystic fibrosis, diabetes pancreatic maligancy = poor prognosis
34
management of jaundice
pre hep - identify and treat cause post - remove obstruction biliary tree stent prevent gall stone recurrence - remove gall bladder, low cholesterol diet
35
neonatal jaundice
birth trauma, premature, brain-blood barrier not formed serious managed by phototherpay to break down bilirubin and pass through kidney, blue light
36
hepatitis C in mouth
bleeding issues, predisposed to white/red ulcerations in mouth strogen syndrome