Liver disease

Question 1

What does the liver structure contain.

Answer 1

R/L hepatic duct, liver, cystic duct, gallbladder, sphincter of Oddi, bile duct, hepatic duct, pancreas, pancreatic duct, duodenum.

Question 2

What are the livers functions (7)

Answer 2

1- catabolism and excretion of bilirubin. 2- Glucose homeostasis. 3- Metabolism of cholesterol and triacylglycerols. 4- Production of clotting factors. 5- Detoxification of drugs. 6- Catabolism of amino groups to urea. 7- Protein synthesis.

Question 3

What tests can be made to test liver function (6)

Answer 3

1- ALT (alanine aminotransferase)
2- AST (aspartate aminotransferase)
3- ALP (alkaline phosphatase)
4- Total bilirubin.
5- Albumin.
6- GGT (gamma glutamyl transpeptidase)

Question 4

How do the ALT and AST tests work

Answer 4

ALT and AST are enzymes important in amino acid metabolism. They are abundant in hepatocytes, so ALT and AST increases in liver failure.

Question 5

How do ALP and GGT tests work

Answer 5

ALP is an enzyme present in membrane of hepatocytes close to biliary ducts.

Question 6

How do albumin tests work

Answer 6

Albumin is synthesized in the liver and is a carrier of proteins, a low level of albumin indicates moderate/severe liver disease.

Question 7

How do bilirubin tests work.

Answer 7

Bilirubin is a waste product of hemoglobin. Conjugated in the liver.

Question 8

what are the 5 main types of liver disease.

Answer 8

1- Hepatitis
2- Cholestasis
3- Mixed
4- Tumour
5- Alcoholic

Question 9

What is hepatitis

Answer 9

An autoimmune virus, A, B, C.

Question 10

What abnormalities are in hepatitis

Answer 10

ALP increases x2 normal, bilirubin usually x3-4 normal. Bilirubin appears brown in urine, clotting may be impaired.

Question 11

What are side effects in massive hepatitis

Answer 11

• Hypoglycaemia
• Hypoalbuminaemia
• severe clotting problems
• very high bilirubin
• very high ALT and AST
• very high ammonia

Question 12

What is cholestasis

Answer 12

The slowing or stalling of bile duct from the liver

Question 13

What are some abnormalities of cholestasis

Answer 13

ALP increases 2-20 times, ALT and AST increase 3-4 times, and bilirubin increases 5-15 times. Bilirubin appears in stool and in severe cases, stool is pale due to no bile pigments in stomach.

Question 14

What happens when you have mixed hep and chol.

Answer 14

Both the hepatocytes and cells of bile ducts are damaged

Question 15

what side effects are there with both hap and chol

Answer 15

Aminotransferases and ALP are mildly to moderately raised

Question 16

What happens with a liver tumour.

Answer 16

Cant be spotted in tests until it is already advanced. usually raises AFP (alpha feto protein)

Question 17

What happens with an alcoholic liver.

Answer 17

GGT increases, fatty liver, rapid plasma urate, acute hepatitis.