liver and infectious diseases Flashcards
name 4 dental impacts of liver disease
impaired wound healing
impaired clotting
risk of blood borne viruses e.g. Hepatitis
drug prescribing due to impaired drug metabolism
what is the main function of the liver?
metabolism including of drugs
what are the causes of acute liver disease? 2
hepatitis
drug induced liver injury - antibiotics and NSAIDs
what is another name from chronic liver disease?
cirrhosis
what is cirrhosis?
occurs when the liver has been repeatedly damaged over a long period of time so it is trying to regenerate
what are the causes of chronic liver disease (cirrhosis) 4
non-alcoholic fatty liver disease NAFLD
alcohol
chronic viral hepatitis - B and C
others
what is jaundice?
yellowing of the skin due to too much bilirubin caused liver disease
increased production of bilirubin and failure of excretion
what is hyperbilirubinemia and its cause
too much bilirubin in the blood. Bilirubin is produced when red blood cells break down and it normally gets filtered out the blood stream by the liver
what is the normal range for bilirubin?
<17
when is bilirubin clinically detectable?
> 40
name 3 liver function tests (not true liver function tests)
ALT/AST
alkaline phosphatase ALP
GGT
what does ALT/AST liver function test show
marker of liver damage
what does alkaline phosphatase ALP levier function test show?
enzyme higher in obstructive jaundice
what does GGT liver function test show?
enzyme higher in obstructive jaundice
name 3 TRUE liver function tests
bilirubin
albumin
prothrombin time
what does bilirubin liver function test show?
if elevated signs that the liver isn’t excreting properly
what does albumin liver function test show?
signs of failure of synthesis
what does prothrombin time liver function test show?
prolonged prothrombin time shows the liver isn’t producing the proteins needed to clot.
remember
the liver makes procoagulant and anticoagulant factors. in liver disease these sets of proteins are reduced so buffering is reduced
small insult can cause a lot of bleeding
can also get blood clots
is hep A blood borne?
no
Hep a effect and treatment
acute illness
pt recovers spontaneously
is hep B blood borne
yes - blood, sex, mother to child
treatment of Hep B
cure with alpha interferon (30%)
suppression of viral replication - tenofovir and entecavir
is Hep C blood borne?
yes - blood, sex, mother to child
is there a vaccine for Hep C
no
treatment for Hep C 3
NS3/4A protease inhibitors
NS5A inhibitors
NS5B polymerase inhibitors
is Hep D blood borne
yes but can only cause infection in the presence of Hep B
is Hep E blood borne
not blood borne
