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BAMS Bds2 > Liver and Biliary System Disease > Flashcards

Liver and Biliary System Disease Flashcards

1
Q

What are the main functions of the liver?

A

Digestion: Bile production
Storage: Glycogen, vitamins (A, B12, D, E, K), copper, iron
Synthesis: Coagulation factors, albumin, thrombopoietin, IGF-1
Breakdown: Drugs, alcohol, toxins, ammonia, bilirubin
Immune: Blood filtration, Kupffer cells
Metabolism: Carbohydrate, protein, lipids
Regeneration capacity

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2
Q

What is the blood supply to the liver?

A

Hepatic artery (25%)
Hepatic portal vein (75%): Carries nutrient-rich blood from GI tract

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3
Q

What are the main components of liver lobules?

A

Hepatocytes
Portal triad (arteriole, venule, bile duct)
Central vein

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4
Q

List causes of acute liver failure.

A

Paracetamol overdose
Viral hepatitis (A, B, E)

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5
Q

What are the symptoms of liver disease?

A

Cachexia
Encephalopathy
Jaundice
Excoriations
Coagulopathy
Bruising
Ascites
Peripheral oedema
Palmar erythema
Gynaecomastia

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6
Q

How is paracetamol overdose managed?

A

Critical care
NAC (N-acetylcysteine)
Supportive measures: IV fluids, glucose, vitamin K, blood products
Liver transplant consideration

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7
Q

What is the maximum daily dose of paracetamol for an adult?

A

4000 mg in 24 hours (2 tablets every 4-6 hours)
Body weight <50kg =2000 mg in 24 hours (1 tablet every 4-6 hours)

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8
Q

What are the symptoms of paracetamol overdose?

A

Nausea and vomiting (first 24 hours)
Right upper abdominal pain (2-3 days)
Signs of acute liver failure (3-4 days)

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9
Q

What are the causes of chronic liver failure?

A

Alcohol
Non-alcoholic fatty liver disease (NAFLD)
Viral hepatitis (B, C)
Other causes (haemochromatosis, autoimmune, Wilson’s disease)

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10
Q

What is cirrhosis?

A

Cirrhosis is characterized by chronic inflammation and damage to liver cells, leading to fibrosis and loss of function

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11
Q

What is the Child-Pugh classification used for?

A

The Child-Pugh classification grades the severity of cirrhosis

It helps in assessing prognosis and treatment options.

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12
Q

What is portal hypertension?

A

Increased resistance to hepatic portal vein blood flow leading to back pressure in the portal system

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13
Q

What is non-alcoholic fatty liver disease (NAFLD)?

A

Excessive fat deposition in liver tissue resulting in impaired hepatocyte function

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14
Q

Name the most common infectious causes of chronic liver disease.

A

Hepatitis B (vaccine available, antiviral treatment)
Hepatitis C (effective antiviral treatment, no vaccine)

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15
Q

Mention other causes of chronic liver disease

A

Haemochromatosis: Inherited condition causing “iron overload” in the liver and other organs.
Autoimmune Hepatitis: Immune system attacks hepatocytes with antibodies.
Wilson’s Disease: Inherited condition leading to “copper overload” in the liver and other organs.

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16
Q

What are the dental implications of liver disease?

A

Bleeding risk
Reduced coagulation factor production
Impaired drug metabolism
Oral cancer risk

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17
Q

What blood tests are commonly used to assess liver disease?

A

Full Blood Count (FBC)
Liver Function Test (LFT)
Coagulation screen
INR

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18
Q

True or False: Hepatitis B has an available vaccine.

A

True

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19
Q

Fill in the blank: Chronic liver failure can progress to _______.

A

cirrhosis

Cirrhosis represents the end-stage of chronic liver disease.

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20
Q

What is the primary function of the biliary system?

A

Production and delivery of bile and pancreatic enzymes

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21
Q

What is bile?

A

Fluid that emulsifies lipids to aid in digestion and absorption of fat from diet

22
Q

Which organ produces bile?

A

Liver

23
Q

What is the role of the gallbladder?

A

Stores and concentrates bile, releases bile when fat is detected in small intestine

24
Q

What does the common bile duct do?

A

Carries bile to duodenum

25
Q

What enzymes does the pancreas produce?

A

Lipase
Amylase
Trypsin

26
Q

What is the duodenum?

A

First part of small intestine

27
Q

What are the main components of bile?

A

Water (97%)
Bile pigments (conjugated bilirubin)
Bile salts
Cholesterol
Phospholipids

28
Q

What happens when there is a blockage to the flow of bile?

A

Build up of bilirubin in blood circulation resulting in jaundice

29
Q

How is bilirubin formed?

A

From breakdown of haem in RBCs (120 days)

30
Q

What role do hepatocytes play in bilirubin processing?

A

Conjugate bilirubin and then excrete it in bile

31
Q

How does bilirubin exit the body?

A

Excreted into duodenum
Exits body in faeces as stercobilin
Small percentage exits in urine as urobilin

32
Q

What is jaundice?

A

Yellowish discoloration of skin or sclera due to high levels of bilirubin in blood

33
Q

What are the causes of jaundice?

A

Pre-hepatic
Intra-hepatic
Post-hepatic

34
Q

What are examples of pre-hepatic causes of jaundice?

A

Increased RBC breakdown
Hemolytic anemia
Malaria

35
Q

What are examples of intra-hepatic causes of jaundice?

A

Alcoholic hepatitis
Viral hepatitis
Cirrhosis
HCC (Hepatocellular carcinoma)

36
Q

What are examples of post-hepatic causes of jaundice?

A

Gallstones
Pancreatic cancer

37
Q

What are symptoms associated with jaundice?

A

Pale stools
Dark urine

38
Q

What are gallstones?

A

Small stones that form in gallbladder and can block flow of bile

39
Q

What do gallstones form from?

A

Concentrated bile salts

40
Q

What are the risk factors for gallstones?

A

Fair
Female
Forty
Fat

41
Q

What are the symptoms of gallstones?

A

Can be asymptomatic or painful

42
Q

What can happen if gallstones block the flow of bile?

A

Pain (especially after fatty foods)
Jaundice
Pancreatitis

43
Q

What imaging techniques are used for gallstones?

A

Ultrasound
CT scan
ERCP (Endoscopic Retrograde Cholangio-Pancreatography)

44
Q

What is the treatment for gallstones?

A

Laparoscopic cholecystectomy

45
Q

What is the primary organ located deep within the upper abdomen?

A

Pancreas

The pancreas has both exocrine and endocrine functions.

46
Q

What are the exocrine functions of the pancreas?

A

Into pancreatic duct:
Lipase
Amylase
Trypsin

These enzymes aid in digestion.

47
Q

What are the endocrine functions of the pancreas?

A

Into bloodstream:
Insulin
Glucagon

These hormones regulate blood sugar levels.

48
Q

What type of cancer is most commonly associated with the pancreas?

A

Adenocarcinoma

This type accounts for the majority of pancreatic cancer diagnoses.

49
Q

What age group is most commonly diagnosed with pancreatic cancer?

A

60 - 80 years old

This age range accounts for 80% of diagnoses.

50
Q

What is the prognosis for pancreatic cancer?

A

Poor due to late detection and early metastatic spread.

51
Q

What can be a symptom of pancreatic cancer related to bile duct compression?

A

Post-hepatic jaundice

This occurs due to the compression of the common bile duct.

52
Q

What are the management options for pancreatic cancer?

A

Management options include:
Palliative care (stent)
Chemotherapy
Surgery (Whipple’s procedure)

BAMS Bds2 (5 decks)

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