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302 - Content > Liver > Flashcards

Liver Flashcards

1
Q

What is the portal vein responsible for?

A

Bring blood into the liver (not a real vein)

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2
Q

What is the hepatic vein responsible for?

A

Taking blood away from the liver

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3
Q

Main function of the liver

A

Removes toxins/waste from the blood into the bile

Also synthesis: glucose, clotting factors and bile salts

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4
Q

Explain the metabolism of bilirubin

A

• a green bile pigment formed by the breakdown of RBC heme
• it travels to the liver where it becomes conjugated- additional of glucuronic acid.
• it is now called water soluble conjugated bilirubin
• it is excreted in the bile

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5
Q

Where is bilirubin removed from the body

A

Feaces

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6
Q

When the blood levels of conjugated bilirubin is high due to liver impairment, where does the excess go and leave the body

A

Urine

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7
Q

Which quadrant is the liver located

A

RUQ

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8
Q

Liver metabolism- phase 1

A

CYP450 enzyme makes compound more hydrophilic via oxidation, hydrolysis and reduction

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9
Q

Liver metabolism phase 2 - conjunction

A

Compound undergoes congugation to become more hydrophobic, in order to be excreted in urine more easily

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10
Q

LFTs are used to distinguish between..

A

Heptocellular activity and cholestasis

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11
Q

Types of LFT?

A

• billirubin (used to detect bile obstruction)
• albumin
• prothrombin time
• total protein

Ultrasounds and biopsy

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12
Q

Which drugs can cause liver abnormalities

A

• paracetamol
• penicillin
• NSAIDs
• phenytoin
• methotrexate
• statins
• herbal supplement
• tuberculosis drugs

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13
Q

What complications are associated with liver disease

A

• Varices
• Ascites
• itching skin
• abdominal pain (RUQ)
• portal hypertension
• bleeding
• odema
• encephalopathy
• jaundice

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14
Q

What is Varices- symptoms and management

A

? Abnormally dilated veins in the oesophagus, which can bleed

Symptoms: blood in vomit & dark stool

Treatment: propranolol (beta blocker)

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15
Q

What is Ascites and the management

A

? Accumulation of fluid in the abdominal region

Management
• decrease sodium and water intake
• Spiractalone
• fluid drainage

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16
Q

What is Hepatic encephalopathy, signs and management

A

? Brain is unable to clear out toxins (ammonia) properly due to liver dysfunction

Sign: confusion

Management:
• lactulose
• lower ammonia

17
Q

Model of end-stage liver disease uses which serums to predicate morality at 3 months?

A

• billirubin
• creatinine
• INR

  • only for >12s *
18
Q

What is the weekly recommended alcohol amount

A

14 units/ week with alcohol free days

19
Q

How much grams and ml of pure alcohol is in one unit

A

8grams
10ml

20
Q

List the steps of alcohol metabolism

A
  1. ADH metabolises alcohol into acetaldehye
    • this forms NADH
    • NADH promotes the synthesis of fatty acids, causing: nicrosis, fibrosis, cirrhosis and inflammation
  2. acealdehyde is metabolised into acetate by ALDH
  3. Acetate is converted into CO2 and H2O
21
Q

Alcoholic liver disease -

What is the management of acute alcohol withdrawal?

A

Benzodiazepine or carbamazepine

22
Q

Alcoholic liver disease - what is the management of delirium tremens

A

Oral lorazepam

23
Q

Alcoholic liver disease - what is the management of wernickies encepalopathy and what are the symptoms?

A

IV thiamine 100mg, for 5 days

wernickies encepalopathy - confusion and double vision

? Due to thiamine deficiency
- weakness in eyes muscles
- loss of muscle control in arms and legs
- confusion

24
Q

Which 3 drugs are used for alcohol withdrawal and their MOAs ?

A

Naltrexone hydrochloride 50mg
- opioid antagonist

Acamprostate 333mg
- stimulates GABA & inhibits glutamate

Disulifram 20mg
- inhibits ALDH

25
Q

What is alcoholic hepatitis?

A

Excess alcohol triggering immune system, causing inflammation

26
Q

Symptoms?

A

• N&V
• fever and pain
• change in appetite
• jaundice

27
Q

Diagnosis

A

Liver biopsy

28
Q

Treatment

A

Corticosteroids

29
Q

What is malnutrition

A

Consuming too much or too little nutrients to sustain a healthy body

30
Q

What can iodine deficiency lead to to

A

Thyroid issues

31
Q

What can vit A deficiency lead to

A

Problems with eyes

32
Q

What can zinc deficiency lead to

A

Issues with Enzyme synthesis

33
Q

What can vit D and calcium deficiency lead to

A

Rickets

34
Q

What can thiamine (B1) deficiency lead to

A

Wernicke encephalopathy

35
Q

Who does malnutrition impact the most

A

• women
• infects
• children
• adolescents

36
Q

What is Korsakoff syndrome

A

Neurological disorder with severe amnesia (memory loss)

37
Q

Korsakoff syndrome - Causes

A

• thiamine defiency
• severe head injury
• severe chronic alcoholism
• brain disorders

302 - Content (44 decks)

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