Liver and gall baller disease - hepatobilary system

Question 1

where is the liver located

Answer 1

upper right side of abdomen

Question 2

flow of blood through the liver

Answer 2

Arterial blood flowing from the heart
entering the liver through hepatic artery
back to heart through hepatic portal vein

Question 3

the portal circulation the 3rd arm

Answer 3

blood from gut through liver, portal viein blood poor in O2 but rich in nutrients

Question 4

bile flow

Answer 4

produced in liver
bile duct
common bile duct enters bile into circulatory system

Question 5

liver roles

Answer 5

detoxification
immune funcitions
synthesis of clotting factors, proteins, enzymes, glycogen
production of bile/breakdown bilirubin
energy storage regulation of fat metabolism
ability to regenerate

Question 6

what is the liver regulated by

Answer 6

endocrine glands e.g. pancreas, adrenal, thyroid

nerves

Question 7

how to catagorise liver injury

Answer 7

time line
pattern
presentation
severity

Question 8

presentation of acute liver injury

Answer 8

asymptomatic
abnormal LFTs and coaglopathy
malaise, nausea and anorexia
jaundice

Question 9

presentation of chronic liver injury

Answer 9

abnormal LFTs
hepatomegaly
malaise 
itching
ascites, oedema
confusion
easy bruising
jaundice
confusion

Question 10

serum liver function tests

Answer 10

1) albumin
2) bilirubin
low A and high B tells you liver is not working

Question 11

what is jaundice colouring due to

Answer 11

higher bilirubin

Question 12

bilirubin

Answer 12

breakdown product of haemoglobin
metabolised in liver
excreted via intestine and renally

Question 13

causes of jaundice

Answer 13

pre hepatic (haemolysis)
hepatic (cirrhosis, acute hepatitis) 
post hepatic (gall stones, external compession such as pancreatitis etc)

Question 14

common causes of liver diseases

Answer 14

NAFLD and NASH
alcohol
viral hepatitis
less common:
auto immune
metabolic
vascular
drugs

Question 15

what does the non invasive liver screen look at

Answer 15

viral serology
autoantibodies
storage disorders and enzyme deficiency
lipids

Question 16

what is a common cause of cirrhosis

Answer 16

alcohol liver disease

Question 17

risk factors for non alcoholic fatty liver disease

Answer 17

diabetes
obesity
hypertension
dyslipidaemia

Question 18

what can cause chronic viral hepatitis

Answer 18

only Hep B/C generally

Question 19

Hep B vs Hep C

Answer 19

Hep B 
DNA virus
persists in liver even if no longer in blood
can reactivate
vaccine available
Hep C
RNA virus
once cleared cleared
reinfection possible
no vaccine

Question 20

stages of chronic liver disease

Answer 20

NCPH - non cirrhotic portal hypetension
pre cirrhotic
liver cirrhosis