Liver Flashcards
Hepatitis A transmission
oral-fecal; contaminated food or water
Hepatitis A symptoms
fever, fatigue, nausea, diarrhea, anorexia, jaundice, RUQ pain
Hepatitis B transmission
blood; transfusion, IV drug, sexual contact, hemodialysis
Hepatitis C transmission
blood; transfusion, IV drug, sexual contact
Fulminant hepatitis
rare and frequently fatal form of acute Hep B in which the pts condition rapidly deteriorates, with hepatic encephalopathy, necrosis of the hepatic parenchyma, coagulopathy, renal failure, and coma
Peginterferon
used to treat chronic hepatitis B and C; reduces the amount of hepatitis virus in the body and helps immune system fight the infection
Lamivudine - HBV
used to treat hepatitis B; not a cure and does not prevent passing to others; slows the growth of the virus , decreasing the liver damage caused by the virus
Adefovir
used to treat chronic viral infection of hepatitis B; slows the growth of the virus; not a cure and does not prevent passing to others
Entecavir
used to treat hepatitis B; helps to decrease the amount of hep B in the body; antiviral
Telbivudine
used to treat hepatitis B; helps to decrease the amount of hep B in the body; antiviral; not a cure and does not prevent spread of virus to others
Ribavirin
used in combination with other antivirals; used to treat hep C; reduces the amount of hep C virus in the body
Alcoholic or nutritional cirrhosis (Laennec’s)
assoc with chronic ETOH abuse; “when was your last drink”; withdrawal symptoms from 2-12 hrs after last drink (mild anxiety and shakiness to seizures and delirium tremens; thiamine should be administered before glucose as energy source; at risk for Wernicke syndrome; ETOH causes metabolic changes in liver; fat accumulates in liver; potentially reversible if ETOH consumption ceases
Post necrotic cirrhosis
results from complication viral hep (esp hep C), and certain other drugs or toxins; liver shrinks because lobules have been destroyed; broad bands of scar tissue form within the liver
Biliary cirrhosis (cholestatic)
assoc with chronic biliary obstruction, autoimmune disease, or infection; retained bile damages and destroys liver cells causing fibrosis of liver; ERCP is done
Endoscopic Retrograde Cholangiopancreatogram (ERCP)
checks the ducts that drain the liver, gallbladder, and pancreas; can treat certain problems found during the test (biopsy an abnormal growth, remove gallstone in the common bile duct, dilate a narrowed bile duct by inserting a stent, measure the pressure inside the bile ducts)
Cardiac cirrhosis
results from long-standing severe right sided heart failure; elevated central venous pressure can cause stasis of blood in veins of liver which leads to fibrosis
Causes of cirrhosis - Hep C
leading cause; infectious blood borne illness that causes chronic disease; inflammation caused by infection leads to progressive scarring; usually takes decades to develop; ETOH use in combination with Hep C may speed process
Causes of cirrhosis - Hep B
causes inflammation and low grade damage over decades; can ultimately lead to cirrhosis
Causes of cirrhosis - Hep D
infects the liver in people who have Hep B
Causes of cirrhosis - ETOH
has a direct toxic effect on the hepatocytes; causes liver inflammation; liver becomes enlarged with cellular degeneration and infiltration by fat, leukocytes, and lymphocytes; inflammatory process decreases and destructive phase increases; scar formation is caused by fibroblast infiltration and collagen formation; damage to liver progresses as malnutrition and repeated exposure to ETOH continue; if ETOH is withheld, the fatty infiltration and inflammation is reversible; if ETOH continues, widespread scar tissue formation and fibrosis infiltrate the liver as a result of cellular necrosis
Causes of cirrhosis - biliary
occurs as a result of obstruction of the bile duct; pts with PBC typically have a predisposition to the disease
Cirrhosis Pathophysiology
end-stage of chronic liver disease; progressive - leads to liver failure; insidious onset with prolonged course; twice as common in men; hepatocytes are destroyed and portal htn develops; liver cells attempt to regenerate; regenerative process is disorganized; functional liver tissue is destroyed; scarring of liver occurs; new fibrous connective tissue distorts liver’s normal structure with impeded blood flow
Liver dysfunction - Neurologic findings
asterixis; paresthesias of feet; peripheral nerve degeneration; portal-systemic encephalopathy; reversal of sleep-wake pattern; sensory disturbances
Liver dysfunction - GI findings
abdominal pain; anorexia; ascites; clay-colored stools; diarrhea; esophageal varices; fetor hepaticus; gallstones; gastritis; GI bleeding; hemorrhoidal varices; hepatomegaly, hiatal hernia; hypersplenism; malnutrition; nausea; small nodular liver; vomiting