liver diseases Flashcards
what is acute liver disease
- Usually self-limiting
- Results in hepatocyte inflammation/damage
- Occasionally results in liver failure
- Generally caused by drugs or viruses
what is chronic liver disease
- Inflammation present for over 6 months
- Results in permanent damage with structural changes resulting in cirrhosis
- Most common cause is alcohol abuse (cirrhosis and occasionally cancer)
what is the progression of liver damage
- chronic injury
- inflammation - damage starts
- early fibrosis
- late fibrosis and cirrhosis
- transplant/cancer
what is fatty liver
a reversible condition wherein large vacuoles of triglyceride fats accumulate in liver cells via the process of steatosis
what are the stages of fatty liver disease
- healthy
- fatty liver - increased TGs, LFTs and liver fat
- non-alcoholic fatty liver disease - inflammation, fibrosis
- cirrhotic liver
- cancer
which viruses can cause liver damage
hep A, B, C, D, E, G
how is hep A passed on and how does it cause liver damage
fecal-oral causing acute inflammation that generally resolves spontaneously
how is hep B passed on and how does it cause liver damage
body fluids, acute infection progressing to chronic inflammation resulting in cirrhosis
how is hep C passed on and how does it cause liver damage
bodily fluids, chronic inflammation resulting in cirrhosis
how is hep D passed on and how does it cause liver damage
bodily fluids - requires concomitant infection with hep B for it to survive
how is hep E passed on and how does it cause liver damage
contaminated food and water - usually self limiting
how is hep G passed on and how does it cause liver damage
body fluids - chronic infection similar to HCV
how can drugs cause liver damage
Hepatocytes become temporarily inflamed or permanently damaged by medicines
what are some examples of drugs and natural products that can cause liver damage
statins, abx, mtx, vit A in high doses, some mushrooms
how can alcohol cause liver damage
directly toxic to liver cells - causes inflammation which can progress to fatty liver and eventually fibrosis which alters structure and blood flow leading to portal hypertension and eventual failure
what is cholestasis
a lack of bile due to hepatocyte damage or bile duct obstruction
what are the symptoms of acute liver disease
general malaise
anorexia
fever
jaundice
what are the symptoms of chronic liver disease
fatigue
weight loss
N&V
abdominal swelling
jaundice
gum/nose bleeding
symptoms of cirrhosis
easy bruising
gynaecomastia
impotence
confusion
ascites
portal hypertension
oesophageal varicies
what is jaundice
yellow discolouration of skin and eyes caused by cholestasis or hepatocellular damage
what is ascites
Abnormal accumulation of fluid in the peritoneal cavity due to pressure imbalance between inside the circulation (high) and outside in the peritoneal cavity (low)
what is portal hypertension
Blood flow reduced in liver when disease and therefore pressure builds up in portal vein
what are oesophageal varices
Oesophageal varices are swollen veins in the oesophagus - If pressure too high, they can rupture and bleed – uncontrolled bleeding leads to shock and death
what is hepatic encephalopathy
Neurological abnormality caused by build-up of substances (mainly ammonia) normally metabolised by liver in the blood and crosses blood brain barrier
what is Wernicke encephalopathy
due to deficiency of thiamine, with decreased mental function
how can kidney disease cause anaemia
Effects iron homeostasis
Reduction in clotting factor synthesis
