Liver Flashcards

1
Q

What is ammonia

A

Nitrogen waste (primarily from protein deamination)

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2
Q

What is ammonia converted to

A

urea via glucose/alanine cycle in the liver

*urea secreted in urine

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3
Q

Where is AST found

A

within the mitochondria of the liver
*ETOH more commonly effect mitochondria

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4
Q

Where is ALT found

A

within the cytosol of hepatocytes
*more specific to the liver

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5
Q

Where is ALT found

A

within the cytosol of hepatocytes
*more specific to the liver

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6
Q

What causes AST to elevate

A

when there is damage to hepatocytes

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7
Q

How much with AST elevate with viral hepatitis?

how about obstruction?

A

20x
10x

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8
Q

When is the AST/ALT ratio elevated

A

with alcoholic cirrhosis or Rhabdo

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9
Q

What do you think of if the AST/ALT ratio <1

A

acute hepatitis

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10
Q

When will Alk Phos be elevated

A

this will increase with an obstruction of the biliary tree and cholestatic hepatitis

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11
Q

When does LDH increase

A

with hypoxic damage and primary liver damage

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12
Q

When does unconjugated bili increase

A

with hemolysis
*70% of T-bili

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13
Q

When will conjugated bili increase

A

when there is damage to hepatocytes or with obstruction

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14
Q

What physically indicates hyperbilirubinemia

A

jaundice

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15
Q

What is the cause of conjugated hyperbilirubinemia

A

defect in bilirubin transport
biliary obstruction
intrahepatic cholestasis

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16
Q

What are the causes of unconjugated hyperbilirubinemia

A

increased bili production
increased breakdown of hgb
impaired bili uptake
decreased conjugation

17
Q

What is the spectrum of disease caused by chronic ETOH

A

steatosis
steatohepatitis
fibrosis
cirrhosis
increased risk of HCC

18
Q

What in ETOH damages hepatocytes

A

acetaldehyde

19
Q

What is steatosis

A

reversible increased lipid deposition within the liver that begins in the central vein

20
Q

What is occurring in the liver with cirrhosis

A

inflammation cause an activation of Kupffer cells and this releases inflammatory mediators and ultimately activation of fibrogenic hepatic stellate cells

21
Q

What does the fibrosis in the liver cause with cirrhosis

A

it will change/block the flow of bile or blood within the liver lobule

22
Q

What causes the liver to be nodular with cirrhosis

A

fibrotic bands

23
Q

What are the common causes of intrahepatic portal hypertension

A

thrombosis
inflammation
fibrosis
infectious hepatitis
schistosomiasis

24
Q

What are the causes of post hepatic portal hypertension

A

prosthetic thrombosis
RV failure

25
Q

What are the main causes of ascites

A

portal HTN
malignancy
nephrotic syndrome
malnutrition
right heart failure

26
Q

What is ascites

A

transudative effusion associated with change in hydrostatic pressure that outweighs capillary osmotic pressure

27
Q

What is the physiologic cause of ascites

A

increased HTN + low albumin causes water to be forced into the peritoneal cavity

28
Q

What is Hep A most commonly associated with

A

travel to endemic areas
*fecal-oral route

29
Q

What type of virus is hep A

A

nonenvelgped RNA picornavirus

30
Q

What type of virus is Hep B

A

double stranded DNA

31
Q

What type of hepatitis is linked with HCC

A

Hep B
*blood borne

32
Q

What type of virus is Hep C

A

Enveloped ssRNA

33
Q

What is the most common cause of fulminant liver failure

A

acetaminophen