Liver Disease Flashcards
What is Cirrhosis
Widespread scarring throughout liver caused by inflammation produce nodules, blocks blood flow
Types of Cirhrosis (4)
NASH
Postnecrotic ( hep or drug)
Laennac’s -> chronic alcohol
Billary Cirrhosis
Is cirrhosis reversible
yes if its caught early and whats causing is removed but many people don’t realize they have cirrhosis later in disease
Uncompensated
Vs. Compensated
Decompensated-> liver failure with symptoms
Compensated -> scarring present but liver can still function
What is Portal HTN
- increase in pressure by 5mm hg
- Blood meets resistance as it tries to flow through liver
- vein becomes dilated
- new bvs form and unfilter blood enters circulation
What is ascites
- Collection of fluid in peritoneal cavity
-plasma protein leaks out of vessels
What can the liver not make properly?
Albumin
Esophageal varices
- Cause by portal HTN
- backflow into esophageal vein
- varices become distended
- ITS an emergency if they start bleeding
Esophageal varices causes and what it may lead to
Causes: heavy lifting, exercise, dry hard food
- may occur spontaneously as well
- Leads to death
Hepatic Encephaothy or porta systemic ecephalpathy?
cognitive disorder resulting from liver failure
What are early sign of hepatic encephalopathy
Sleep disturbances, mood disturbances, mental status changes, and speech problems.
What are late signs of HE
- Altered LOC, Altered cognition, neuromuscular problems, Coma
Common meds for HE
Lactulose and lactulose enemas if in coma
Causes of HE
- GI bleed, hgih protein diet, infection, hypovolemia, hypokalemia, constipation
Ascites contributes to what?_____ via what process______
hepatorenal syndrome, vasoconstriction
hepatorenal is often triggered by what _____
GI bleeds, HE
What would you see with Hepatorenal syndrome and is the prognosis good?
Urinary output of less than 500mL per day as well as elevated BUN/ creatinine and no prognosis is poor
Risk Factors for Liver disease
- Hep B and C , Alcohol/ Drugs, Sexual Hx, Tattoos, Jaundice, Billary tract disorders, Blood transfusions, obesity, lipids, liver injury
-A;; baby booomers should be screened for Hep C
Early signs of Liver disease
Fatigue, wt changes, GI problems, abd pain, RUQ tenderness, brusing/ petechaie, red palms, Gi bleeding, jaundice , and ascites, edema in LE
More symptoms
- spider angiomas, hypotension, asterixis, fruity breath, amenorrhea, Gynecomastia, impotence, mental state/ neuro assessment
For ascites what should you be concerned about? (5)
Measure, weights (best indicator) everyday, breathing, balance,hernias
assess for bleeding, fall risk
Caput medusae
umbillical veins not in use
WHat labs are expected what is increased esp in early liver disease
AST, ALT, LDH, AST/ALT Ratio, and Bilirubin
What labs are expected to be decreased
Albumin and platelets
