Liver disease Flashcards
What are the principle functions of the liver?
Cholesterol metabolism, drug metabolism, CHO metabolism, fatty acid metabolism, ammonia metabolism, protein synthesis and bile formation.
What are the functions of bile?
Cholesterol/phospholid homeostasis, electrolyte balance, conjugated bilirubin excretion, functional bile acid secretion and drug excretion.
What are the four common clinical situations involving the liver?
Acute hepatitis, chronic liver disease, extra-hepatic biliary obstruction and fatty liver disease.
What are the features of the hepatitis A virus?
RNA virus, faeco-oral transmission, replicates in hepatocytes, causes hepatocyte necrosis and lymphocyte infiltration.
What are the features of chronic liver disease?
Permanent and usually progressive pathological change throughout the liver. Lobular architecture deranged. Fibrosis and nodular regeneration (cirrhosis).
What are the most common causes of cirrhosis?
Alcohol, fatty liver, Hep B&C, primary biliary cirrhosis, primary sclerosing cholangitis and autoimmune liver disease.
What are the morphological results of cirrhosis?
Hepatocytes damaged and function poorly, sinusoidal/canalicular pathways disturbed, disrupted intrahepatic biliary drainage and disturbed vascular perfusion.
What are the clinical effects of cirrhosis?
Jaundice, ascities, encephalopathy, portal hypertension, splenomegaly, bleeding risk, endocrine abnormalities, renal failure and hepatocellular carcinoma.
What is biliary obstruction?
Obstruction of the extrahepatic biliary system. Commonly due to gallstones or pancreatic cancer. Decreased excretion of bile.
What are the cilnical effects of biliary obstruction?
Jaundice, dark urine, pale stools, itching, pain, steatorrhoea, weight loss, vit deficiencies and disturbed lipid metabolism.
What is the metabolic syndrome ‘deadly quartet’?
Abdominal obesity, HTN, DM and dyslipidaemia.
