Liver Flashcards
Describe the blood supply of the liver.
20% from hepatic artery
80% from portal vein
What are the main functions of the liver?
Storage of glycogen and fat soluble vitamins
Synthesis of proteins (albumin)
T cell proliferation
Clearance/metabolism
Describe the 4 main liver function tests.
Bilirubin- break down of red blood cells
Gamma-glutamyl transferase- raised in recent alcohol consumption
Alanine aminotransferase- can indicate hepatocyte injury
Prothrombin time- represents levels of clotting factors being produced
What liver test results can be indicative of hepatocyte damage?
Raised AST, ALT, gamma-GT, total bilirubin
What liver test results can be indicative of cholestatic damage (blockage)?
Increased conjugated bilirubin, alkaline phosphate, cholesterol
What is acute liver disease?
Liver disease lasting less than 6 months due to inflammation/damage to hepatocytes
What are the major causes of acute liver disease?
Drugs
Acute hepatitis
What are the most common causes of hepatitis A?
Recent travel
What are the most common causes of hepatitis B?
Tattoos
Blood transfusions
What is the treatment for hepatitis B?
Healthcare professionals are given vaccinations
Tenofovir/entecavir with interferon alpha 2a
What are the most common causes of hepatitis C?
Blood transfusions
IV drug use
What is the treatment of hepatitis C?
Ribavarin
Interferon alpha 2b
In what conditions can hepatitis D cause liver damage?
Can only propagate in the presence of hepatitis B.
What is hepatitis E?
Self limiting but does not cause chronic disease.
What is type A drug induced liver disease?
Predictable, dose dependent and affects most patients with sufficient dose.
What is type B drug induced liver disease?
Dose independent with a latent period of weeks to months
Give examples of drugs causing type B drug induced liver disease?
Isoniazid
Chlorpromazine
What is acute hepatitis?
Presents with jaundice but spontaneously recovers
What is chronic liver disease?
Liver disease lasting over 6 months
What are the common causes of chronic liver disease?
Hepatitis C Alcohol consumption Primary biliary cirrhosis Autoimmune hepatitis Cancer
Why can liver disease be difficult to detect?
Symptoms are vague such as fatigue, fever, nausea
Give examples of specific liver disease symptoms.
Spider naevi Gynecomastia Splenomegaly Oedema Clubbing Xanthelasmas
What are the symptoms are end stage liver disease?
Hepatic flap
Ascites
Neurological changes
Oesophageal varices
What is the most common cause of liver disease in the UK?
Alcohol
What is pruritus?
Build up of bile salts in the skin leading to itching
What is ascites?
Build cup of fluid in abdominal cavity, treated with diuretics
What are the symptoms of hepatic encephalopathy?
Abnormal mental state
Hepatic flap
Fetor hepaticus breath (sweet but fecal)
What is hepatic encephalopathy?
Build up of toxins, mainly nitrogenous due to reduced liver function
What is oesophageal varices?
Dilated submucosal veins, large amount of blood loss
What is the treatment for alcohol withdrawal?
Reducing regime of chlordiazepoxide
Vitamin B co-strong and thiamine
Water soluble vitamin K
