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Human Disease > Liver Disease > Flashcards

Liver Disease Flashcards

1
Q

Liver is the:
How many lobes does liver have?
Where is it located?
What is its blood supply?

A

Second largest organ in the body
Has Four lobes
Located in right hypochondrium

Blood supply - portal and hepatic vein and hepatic artery

First pass metabolism centre

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2
Q

What are the four lobes of the liver?

A

Right lobe
Left lobe
Caudate lobe
Quadrate lobe

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3
Q

What are the functions of the liver?
(4)

A

Metabolism, breakdown and excretion of drugs + endogenous products

Production of albumin, blood clotting factors, complement, transporter proteins, cholesterol + bile components

Storage of substances eg vitamin A, D, E + K, B12, folate

Maintenance of body homeostasis by regulating glucose and cholesterol blood levels

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4
Q

Liver disease

A

Causes problems + interferes with liver function
Many causes
5th common cause of death

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5
Q

Liver disease
CAUSES?
(4)

A

1) infections - viral - Hep A,B,C,D,E , EBV, CMV
Bacterial - TB, syphilis
Parasitic - malaria

2) toxic and drugs - drug misuse -paracetamol + ecstasy
- alcohol

3) Metabolic:
Non alcoholic fatty liver disease (overweight/obese, type 2 diabetes, HBP, hypercholesterolaemia)
Wilson’s disease
Haemochromatosis

4) Autoimmune - SLE , Primary biliary cirrhosis (PBC)

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6
Q

Liver disease
Acute and chronic

What is compensated liver disease?
What is decompensated liver disease?

A

COMPENSATED = liver is coping with working at a reduced capacity

DECOMPENSATED = liver is failing to cope with functional demands

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7
Q

Liver disease
Signs and symptoms of ACUTE LIVER DISEASE

A

Loss of appetite
Weight loss
Jaundice

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8
Q

Liver disease
Signs and symptoms of CHRONIC LIVER DISEASE

A

Spider naevi
Palmar erythema
Clubbing
Jaundice
Oedema / ascites ( swelling of tummy )

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9
Q

What is Jaundice?
What are the three types of jaundice?

A

Yellowing of skin and sclerae due to build up of bilirubin in the blood and body’s tissues

Types of jaundice:
1) Pre-hepatic - Sickle cell anaemia, Thalassaemia
2) Intra-hepatic - Hepatitis, alcohol, glandular fever, drug misuse, cirrhosis, Gilbert’s syndrome
3) Post-hepatic - Gallstones, tumours

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10
Q

What are the symptoms of LIVER FAILURE?

A

Bleeding/ Bruising
Hypoglycaemia
Infections
Ascites
encephalopathy

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11
Q

Cirrhosis
What does it result from?
What are the causes of cirrhosis?

A

Results from necrosis of liver cells followed by fibrosis and nodule formation -> interference of blood flow through liver and loss of liver function

Cirrhosis is a histological diagnosis made by biopsy

Causes :
Common - alcohol, viral - hep B and C
Less common - autoimmune, drugs, haemochromatosis, Wilson’s disease

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12
Q

Investigations for liver cirrhosis

A

Blood tests - LFT’s - ALT, AST, GGT, bilirubin, albumin

Imaging tests ( USS - ultrasound, CT, MRI)

Liver biopsy

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13
Q

Alcohol-related liver disease
What are the complications?
Signs and symptoms?

A

Complications = Alcoholic hepatitis + cirrhosis

Signs and symptoms - feeling sick
weight loss
loss of appetite
jaundice
Swelling in tummy and ankles
Confusion and drowsiness
Vomiting blood or passing blood in stools

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14
Q

Non alcoholic fatty liver disease
What are the four stages?

A

Similar to ARLD

Build up of fat within liver cells ( overweight, obese, HBP, hypercholesterolaemia, type 2 diabetes )

4 stages:

1) Steatosis
2) Non alcoholic steatohepatitis
3) Fibrosis
4) Cirrhosis

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15
Q

Gallstones
RISKS
What are the risks for getting gallstones?

A

Five Fs

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16
Q

Gallstones signs and symptoms

A

Central tummy pain (intermittent or persistent)
Jaundice
Fever

17
Q

Gallstones diagnosis

A

Bloods,
USS
Other imaging

18
Q

Gallstones differential diagnoses
Treatment

A

Treatment - depends on severity of disease

19
Q

Hepatitis B
What does hepatitis mean?
Is it an acute or chronic disease?
Can hepadnavirus survive outside body?
How is Hep B transmitted?
How prevented?

A

Hepatitis = inflammation of liver

Hep B is both acute and chronic disease

VIRAL hepatitis

Hepadnavirus can survive outside body for at least 7 days

Hep B transmitted through contact of blood or other bodily fluids of an infected person

Important occupational hazard for health workers

Prevention : vaccine

20
Q

Hepatitis C
Is acute or chronic?
Are hep B or Hep C more likely to develop chronic infection?
How is Hep C transmitted?
Treatment?

A

Hep C can be acute or chronic
VIRAL hepatitis

80% of people are asymptomatic

People with Hep C are more likely to develop chronic infection than hep B

Transmitted through contact with blood or other bodily fluids of an infected person

Important occupational hazard for health workers

NO VACCINE But anti viral medicines can cure 90% of hep C peopel

21
Q

Are hep B or Hep C more likely to develop chronic infection?
Is Hep B or Hep C more common?

A

People with Hep C are more likely to develop chronic infection than hep B

HEP B IS MORE COMMON THAN HEP C

22
Q

Symptoms of Hep B and Hep C?

A

Flu like symptoms
Feeling sick
Lack of appetite
Jaundice

23
Q

Dental Relevance of liver disease

A

Cross infection risk ( Needle-stick injury )

Altered drug metabolism

Post op haemorrhage ( vitamin K and clotting factor deficiency )

Delayed wound healing

LA is safe , relative anaesthetic is preferable to iv sedation with benzodiazepine

24
Q

Dental relevance of liver disease
liver disease due to SLE?
Liver disease due to PBC?
Non alcoholic fatty liver disease due to type 2 diabetes or HBP?

A

Liver disease due to SLE :
Sjogren’s syndrome
Lichenoid reaction

Liver disease due to PBC :
Sjogren’s syndrome

Non alcoholic fatty liver disease due to type 2 diabetes or HBP:
Dry mouth???
Lichenoid reaction???

25
Q

Dental relevance of liver disease
Disorders associated with an early rise in conjugated bilirubin serum levels eg Rhesus disease?

A

Dental hypoplasia
Green discolouration of teeth

Human Disease (18 decks)

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