Liver 4 Flashcards
Common physiologic changes in the patient with cirrhosis include all of the following EXCEPT:
a. respiratory acidosis
b. increased cardiac output
c. right-to left shunt
d. decreased GFR
a. respiratory acidosis
Cirrhosis is characterized by
cell death where nodules and fibrotic tissue replace healthy hepatic tissue
Cirrhosis reduces the number of
functional hepatocytes as well as the number of sinusoids
Why does portal hypertension occur with cirrhosis?
the number of blood vessels passing through the liver is also reduced which creates portal hypertension
The following can be used to predict the risk of perioperative mortality with cirrhosis:
the MELD score & child-pugh class
Severe liver disease impairs the liver’s ability to
clear vasodilating substances from the systemic circulation
The liver’s impedance to clearing vasodilating substances from the systemic circulation leads to
a hyperdynamic circulation (high cardiac output & low SVR)
______________ introduces a stent between the portal vein and hepatic vein to bypass an increased hepatic vascular resistance
A transjugular intrahepatic portosystemic shunt (TIPS procedure)
____________ is a significant risk of a TIPS procedure
Hemorrhage
Etiologies of cirrhosis include
non-alcoholic fatty liver disease
alcohol abuse
alpha-1-antitrypsin deficiency
biliary obstruction
chronic hepatitis
right-sided heart failure
hemochromatosis
Wilson’s disease
The most common cause of liver disease is
non-alcoholic fatty liver disease
Hemochromatosis causes
iron overload
Wilson disease is
genetic (copper accumulates in the tissues)
Right-sided heart failure leads to
increased hepatic vascular resistance
Biliary obstruction and chronic hepatitis lead to
inflammation and tissue destruction
Alcohol abuse and non-alcoholic fatty liver disease lead to
fatty infiltration
To partially offset the increased resistance, the body creates collateral vessels that bypass the liver, these are called
portosystemic shunts