Liver and cirrhosis- microscopic anatomy Flashcards
Alcohol toxicity death
Caused by depression of the respiratory centre
Stages of chronic alcohol liver disease
- Steatosis- fatty liver
- Hepatitis- fatty and inflammation
- Cirrhosis- fibrosis
GGT is usually raised in chronic liver disease caused by alcohol
Liver function tests
Bilirubin
ALT (alanine transaminase)
ASP (aspartate transaminase
ALP (alkaline phosphatase)
GGT (gamma glutamyl transferase)
Albumin
Bleeds in chronic liver disease
Bleeding caused by lack of clotting factors- especially Vit. K
Reflux oesophagitis
Haemorrhagic gastritis
Peptic ulcers
Oesophageal ulcers
Causes iron deficient anaemic in CLD
Pathogenesis of alcoholic steatosis
- Increased precursors of fat synthesis
- Reduced lipolysis
- Reduced hepatic excretion of lipids
- Steatosis- reversible
Non-alcoholic causes of steatosis [6]
- Type II diabetes
- Drugs
- Obesity
- Hyperlipidemia
- Hep. C
- Rapid weight loss
Alcohol hepatitis
Inflammation of the live.
- Can be acute of chronic
Acute:
- Very unwell patient
- May show jaundice
- Acute inflammation
Chronic:
- Risk of progression into fibrosis and cirrhosis
- Chronic inflammation (lymphocytes0
Causes of cirrhosis
Alcohol (most cases)
Viral hepatitis
Primary biliary cirrhosis
Primary hematochromatosis- genetic
Wilson’s disease- excess cooper
Alpha-1-antitrypsin deficiency- associated with emphysema
Cryptogenic- all known causes have been excluded
Complications of cirrhosis
Portal hypertension
- Oesophageal varices
Ascites
Liver failure:
- Jaundice
- Bleeding
- Hepatic encephalopathy
Hepatocellular carcinoma
Mallory Weiss tear
Cause of bleeding in alcoholic patient
Tear at the oesophago-gastric junction.
Hepatocellular carcinoma
Liver tumour
- Can arise from chronic alcohol use
Test:
- Alpha feto protein raised in some cases indicated HCC
Complications of gallstones [7]
Biliary colic pain
Acute cholecystitis
Empyema/ perforation of gallbladder
Liver abscess
Pancreatitis
Obstructive jaundice
