Liver 2

Question 1

What are the key features of chronic liver disease, specifically cirrhosis?

Answer 1

• Scarring and fibrosis of the liver tissue
• Impaired liver function, affecting metabolic and synthetic processes
• Altered blood flow within the liver

Question 2

What preventive measures can be taken to manage liver disease?

Answer 2

• Hepatitis vaccination
• Reduction in alcohol consumption
• Limitation on over-the-counter (OTC) paracetamol use

Question 3

what are other management strategies for liver disease aside from prevention?

Answer 3

• Largely supportive
• Nutrition
• Drug choice
• Optimise remaining function
• Transplant

Question 4

where is the pancreas situated ?

Answer 4

• besides the liver
• pancreatic secretions drains through the common bile duct
• it sits in the middle of the abdomen behind upper small intestine

Question 5

What are the exocrine functions of the pancreas?

Answer 5

• Exocrine: Produces digestive enzymes (amylase, protease, lipases) in response to low pH(when stomach empties its gastric acid contents in the duodenum) , fat, and vagal stimulation. These enzymes are secreted as pro-enzymes and activated in the duodenum.

Question 6

what are the endocrine functions of the pancreas?

Answer 6

• Endocrine: Produces insulin, glucagon, and somatostatin in the Islets of Langerhans. Insulin and glucagon regulate blood glucose levels.

Question 7

What is the common pathway through which the liver, gall bladder, and pancreas drain into the duodenum?

Answer 7

• bile duct

Question 8

what would happen if there’s an obstruction to the distal part of the common bile duct?

Answer 8

leads to issues with the flow of bile and pancreatic secretions

Question 9

what is pancreatitis ?

Answer 9

Inflammation of the pancreas
- Obstruction of secretions (amylase, protease, lipase) causes autodigestion of pancreas.

Question 10

What are some risk factors for pancreatitis?

Answer 10

Trauma, gallstones, diabetes, gallbladder surgery, excessive alcohol consumption, pancreatic cancer, and certain drugs such as azathioprine. Obstruction of pancreatic secretions, including amylase, protease, and lipase, can lead to the autodigestion of the pancreas.

Question 11

Signs and Symptoms of Pancreatitis?

Answer 11

Severe upper abdominal pain
Radiates to the back Vomiting
Weight loss
Very unwell
Steatorrhoea
Jaundice
DM
Increased serum amylase test (blood test) level of amylase will be high in blood stream if positive

Question 12

management of pancreatitis

Answer 12

Mostly supportive
Fluids
Correct glucose/electrolyte imbalance
Antibiotics if signs of sepsis
Surgery to remove physical obstruction (stones)

Question 13

what are gall stones?

Answer 13

Gallstones are formations that can occur in the gallbladder when cholesterol deposits from bile solidify.

Question 14

what are some risk factors associated with gall stone formation?

Answer 14

Age, risk increases in older people
Gender: F>M
- BMI: Increases risk with high BMI
- Affluence: more common in rich people
- Diet: high fat diet

Question 15

what are the signs and symptoms of gall bladder disease?

Answer 15

Most gallstones are asymptomatic
- Only cause problems if they obstruct drainage of bile and/or pancreatic secretions
Signs of gall bladder disease
- Abdominal pain, right upper quadrant
- Biliary colic: pain worse at meal times (stimulates contraction of the gall bladder.

• Nausea/vomiting
• Fever (if infected-cholecystitis)
• Jaundice (serum bilirubin raised) - if sufficient obstruction to stop bilirubin circulation
• bilirubin in urine which turns urine dark

Question 16

how do we manage gall disease?

Answer 16

diet - stop high fat diet
treat acute infection
cholecystectomy - remove gall bladder and stones