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Journey through GI > Liver Disease > Flashcards

Liver Disease Flashcards

1
Q

what are the main functions of the liver

A 
metabolism 
digestion
immunity
detoxification
storage energy / nutrients
production of proteins
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2
Q

what is the largest organ in the body

A

liver and has the largest surface area

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3
Q

how much of the cardiac output does the liver receive

A

25%

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4
Q

what are the symptoms of liver disease

A

jaundice

ascites

puritis

change in faeces or urine colour

fat in faeces

blood clotting irregularity

cutaneous signs

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5
Q

what is jaundice

A

a condition in which the skin, whites of the eyes and mucous membranes turn yellow because of a high level of bilirubin, a yellow-orange bile pigment.

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6
Q

what is ascites

A

condition in which fluid collects in spaces within your abdomen. If severe, ascites may be painful

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7
Q

what is puritis

A

Pruritus is the medical term for itchy skin.

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8
Q

what does lft stand for

A

liver function tests

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9
Q

what are some examples of LFTs

A

Generally blood tests

mainly liver enzymes and proteins normal ranges vary

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10
Q

what are 3 further investigations that can be carried out after lfts

A

imagine
biopsy
further blood tests e.g. for hepatitis

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11
Q

what is biopsy

A

biopsy is a medical procedure that involves taking a small sample of body tissue so it can be examined under a microscope

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12
Q

What are 4 standard LFTS

A

ALT alanine transminase
AST aspartate transaminase
ALP alkaline phosphatase
GGT gamma glutamyltransferase

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13
Q

what are amino transferases

A

they are inflammation indicators

damaged hepatocytes release both into blood stream and this is highest in viral infection.

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14
Q

what does the AST to ALT ratio mean

A

> 2 indicates an alcoholic liver disease

< 1 indicates non alcoholic liver disease

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15
Q

what is ALT more specific to

A

liver

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16
Q

what is ALP specific too

A

bile

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17
Q

what is GGT specific too

A

liver

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18
Q

what does raised alp and ggt indicate

A

block of bile ducts

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19
Q

what are 3 protein based LFTs

A

Bilirubin

Albumin

Prothrombin

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20
Q

what does a high amount of bilirubin cause

A

it can cause jaundice and high levels can predict liver disease

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21
Q

what is bilirubin a product of

A

breakdown of haemoglobin

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22
Q

what is albumin synthesized by

A

the liver

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23
Q

what is albumin responsible for

A

Oncotic pressure in the blood and transport as well as binding of nutrients and drugs

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24
Q

what can a decrease in albumin cause

A

fluid retention and indicate liver disease

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25
Q

what can severe deficit of albumin be due to

A

malnutrition

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26
Q

What are two clotting factors

A

prothrombin and prothrombin time

27
Q

what is prothrombin time

A

time taken for blood to clot following sample

28
Q

what does a longer pt time indicate

A

reduction in clotting factors produced by liver

29
Q

how is clotting factors expressed

A

international normalised ratio (INR)

30
Q

what is the target international normalised ratio

A

2-3 and higher levels will indicate clotting

31
Q

state some different types of liver condition

A 
acute liver damage
chronic liver disorders
alcoholic hepatitis
cirrhosis
bile duct obstruction
cancer
autoimmune
32
Q

How can liver disease be defined

A

by time course

33
Q

what are the two main catagory of liver disease

A

acute and chronic

34
Q

what is acute liver disease

A

a self limiting episode with a history of disease being less than 6 months

35
Q

what is chronic liver disease

A

long term damage to the liver with longer than 6 month history

36
Q

what does chronic liver disease have the potential to change

A

it has potential for permanent structural changes

alchohlic cirrhosis
non alcoholic fatty liver disease
non alcoholic steatohepatitis
viral infection
hereditary conditions
37
Q

what does the term acute on chronic mean

A

sudden deterioration in stable chronic patient

38
Q

what can liver disease also be classified by

A

classified by damage

39
Q

what are two types of damage by which livers can be classified

A

Cholestatic

hepatocellular

40
Q

what is cholestatic in reference too

A

bile flow is reduced or blocked/impaired

elevated ALP, GGT, Bilirubin, Bile acids and Choleserol build

41
Q

what is hepatocellular in referennce too

A

damage to hepatocytes
ALT and AST release by damaged cells
Serum levels may be elevated

42
Q

what can both hepatocellular and cholestatic damage cause

A

fibrosis

43
Q

what symptoms are often associated with severe liver disease

A

Fluid retention
Ascites
Portal hypertension
Jaundice

44
Q

what is hepatic encephalopathy

A

neuropsychological syndrome seen in 70% of patients with cirrhosis

45
Q

what % of patients will develop sever hepatic encephalopathy

A

30 - 45%

46
Q

what is the most common cause of cirrhosis

A

alcoholic liver disease

47
Q

what causes the damge in alcoholic liver disease

A

inflammation PM3A causes the damage

48
Q

what are the 3 stages of alcoholic liver disease

A

stage 1 - alcoholic fatty liver disease
stage 2 - alcoholic hepatitis
stage 3 - cirrhosis

49
Q

describe the stage 1 of alcoholic liver disease

A

alcoholic fatty liver disease is caused asymptomaticly and is normaly reversibly by taking a break from drinking

50
Q

describe the 2nd stage of alcoholic liver disease

A

alcoholic hepatitis is mainly due to the chronic alcohol use over a long period of time and again progression can be halted by stopping drinking

51
Q

describe the 3rd stage of alcoholic liver disease

A

cirrhosis means that if they continue they will die within 5 years

52
Q

what are the main ways to manage alcoholic liver disease

A

prevention of use of alcohol

53
Q

how can we treat alcohol withdrawal

A

delirium tremens - diazepam

54
Q

what are the 4 stages of non alcoholic fatty liver disease

A

stage 1 fatty liver asymptomatic and may be detected by LFTS

stage 2 NASH (non alcoholic steatohepatitis

stage 3 fibrosis

stage 4 cirrhosis

55
Q

who is at risk of non alcoholic fatty liver disease

A

Diabetes Type II, Obese, Hypertension, Hypercholesterolemia, smokers, over 50

56
Q

what is hpatitis

A

inflamation to the liver

57
Q

what are the 5 types of viral hepatitis

A

common A B C

Rare D E

58
Q

What are A and E viral hepatitis caused by

A

contaminated food and water

59
Q

What are B - D viral hepatitis caused by

A

caused by infected body fluids and blood products

60
Q

What are the initial symptoms of hepatitis a

A 
nausea
vomiting
diarrhoea
malaise
abdominal discomfort 
mild fever
61
Q

what other symptoms might they experience if they have hepatitis a

A 
jaundice 
liver enlargement
skin 
rash
pale stoole
62
Q

is hepatitis a acute or chronic

A

acute

63
Q

how long does hepatitis b take to present

A

1 to 3 months

Journey through GI (30 decks)

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