Liver Disease Flashcards
What are some examples of congenital liver diseases? (liver diseases present at birth)
- Biliary Disease/Biliary Atresia (the destruction of the bile ducts. Causes issues in production of bile)
- Storage Disease (too much glycogen is stored)
- Wilsons Disease (inability to clear out copper from the blood)
[Funny memory hack- wilsons disease causes a ring of copper around the eye. At CPS Wilson wore glasses]
What are some causes of Acquired Liver Disease
Causes of Hepatocytic Liver Diseases:
1. Drugs & Toxins (eg. paracetamol. lithium, mushrooms)
2. Hepatitis (Hep B, Hep C)
3. Viral Infections (glandular fever, chicken pox)
4. Fatty liver (liver stores high levels of fats which impairs function)
5. Bacteria infections
6. Fungal infections
7. Autoimmune diseases
8. Cholecystitis (inflammation of gallbladder)
There are 4 stages of liver disease. What are they? and what can cause each stage?
Liver Disease:
1. Acute Liver Injury (acute, sudden damage to a previously healthy liver. eg. from paracetamol OD, alcohol binge, heat stroke, sepsis)
2. Acute Liver Failure (rapid loss of liver function secondary to acute liver injury)
3. Chronic Liver Disease (progressive destruction of liver. caused by liver chirrosis [scarring of liver] secondary to hepatitis, chronic alcoholism etc.)
4. Chronic Liver Failure (loss of liver function secondary to chronic liver disease)
What is Cholecystitis and how can paramedics test for it?
Cholecystitis is the swelling of the gallbladder secondary to gall stones which block the tubes that drain bile from the gallbladder
Pyrexia is a common sign of liver disease. What does pyrexia mean?
Pyrexia= fever
Jaundice is a common sign of liver disease. What is jaundice and what causes it?
Jaundice= yellow discolouring of skin & eyes
Caused by:
Red blood cells break down and create bilirubin (a yellow pigment). It is excreted from the liver in the bile (where it then goes into the digestive tract & is eliminated in stool). If it can’t get out of the liver (eg. from damaged bile ducts) then it goes back into the blood, builds up and causes yellow pigment in the skin
Pruritus is a common sign of liver disease. What is pruritus, and what causes it?
Pruritus= Itchy skin
Caused by bile build up (secondary to liver dysfunction)
What are some red flags in someones stool that would suggest liver disease?
If their stool is light coloured & it floats. This occurs because with liver disease, bilirubin is in high quantities in the blood but cant get into the poo (which is what would usually make the stool dark)
[but remember, it can get into the urine & thats why the urine becomes dark]
Hepatosplenomegaly is a common sign of liver disease. What does Hepatosplenomegaly mean?
[Hint- think of what ‘Megaly’ means in the medical world]
Hepatosplenomegaly= swelling & enlargement of liver & spleen
[Memory hack- Hep (Liver) Splen (spleen) Megaly (enlargement)
Why do people with liver disease often bleed more?
Bleeding tendencies occur because there is a lack of production of clotting factors
What are some common signs of liver disease? (don’t include signs of portal hypertension)
Liver disease signs:
Pyrexia (fever), Jaundice, Pruritus (itchy skin), Right upper quadrant pain, Dark urine, light stools that float, hepatosplenomegaly (swelling/enlargment of liver), bruising, bleeding tendencies, clubbing of fingernails
Why do people with liver disease often have dark urine?
Because high levels of bilirubin & red blood cells pass out in the urine making it dark in colour
What is hepatic encephalopathy?
Hepatic Encephalopathy is the build up of ammonia and toxins in the body as the liver is unable to effectively break them down. This results in neurological and cognitive deficits (eg. fatigue, speech changes, tremors, seizures, coma)
What is portal hypertension?
Portal Hypertension occurs secondary to liver disease. It is when scarring of the portal vein increases the pressure in the portal veins. When this portal hypertension (which can cause varices) is coupled with the lack of clotting factors, portal hypertension can have fatal consequences
What are some signs/symptoms that patients may develop from having portal hypertension?
Portal Hypertension can lead to- caput medusae (swollen veins on abdo surface), spider nevi (red spider web shape under skin), haemorrhoids (swollen veins often in rectum), oesophageal varices (swollen veins in oesophagus), Acites (abdominal distension from fluid build up)
What are oesophageal varices and what can cause them?
Oesophageal Varices are swollen veins in the oesophagus which occur secondary to portal hypertension in patients with chronic liver disease (as the portal vein supplies blood flow to the oesophagus). Having these puts the patients at a very high risk of death as if they rupture, their lack of clotting factors (also from liver disease), plus the high pressure in their veins, means they are likely to bleed out and die.
If someone has damage to their liver (eg. acute liver injury), which quadrant of their abdomen will be painful?
The liver is in the RIGHT UPPER QUADRANT, so the patient will have RUQ pain
People with Liver disease & subsequent portal hypertension may develop CAPUT MEDUSAE. What does this look like?
[Hint- think about the origin of the word ‘Medusa’]
CAPUT MEDUSAE= Swollen veins under surface of abdomen
[Memory Hack- Medusa is the name of a greek god who had snakes as hair- this looks like Caput Medusae]
