Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

YR 3 - Illness and Wellbeing > Liver Disorders > Flashcards

Liver Disorders Flashcards

1
Q

what are the basic functions of the liver? (7)

A

protein metabolism
- produces circulating proteins - clotting factors and albumin

nitrogen excretion
- amino acids break down into ammonia
- pass out into urine

carbohydrate metabolism
- glucose homeostasis

lipid metabolism

bile production

bilirubin metabolism
- breakdown product of RBC

hormone/drug inactivation
- broken down by the liver

immunological functions
- manages bacteria from the GIT

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

what is the function of albumin

A

maintaining osmotic pressure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

what percent of innate immune proteins are produced by the liver?

A

80-90%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

where is the liver?

A

upper right quadrant of abdominal cavity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

what is the weight of the liver?

A

usually 1.5kg in adults

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

what are liver cells called?

A

hepatocytes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

describe the blood supply of the liver.

A

70% comes from portal vein - from intestines and spleen

30% from hepatic arteries from branch of aorta called coeliac axis

  • blood enters via portal tracts, travels through liver through the sinusoids (gaps between hepatocytes)
  • blood leaves via hepatic vein in the centre of the lobule
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

describe bile in the liver

A

produced by the liver
- leaves the liver via bile duct out of the portal tract
- travels against the blood flow

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

describe the organisation of the liver.

A

comprised mostly of hepatocytes
- arranged in rows

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

what are the potential implications if the liver fails?

A

protein metabolism
- impaired clotting
- reduced albumin - leads to oedema and ascites

nitrogen exretion
- excess ammonia in blood
- mimic neurotransmitters
= impaire cognitive function

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

what is ascites?

A

when fluid collects in spaces within the abdomen

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

what is bilirubin?

A

a breakdown product of red blood cells

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

describe the pathway of bilirubin from the blood and being passed out.

A
  • not water soluble
  • must be bound with albumin to travel in the blood = unconjugated
  • becomes conjugated in the liver = water soluble
  • bilirubin travel via bile duct into gut

in the gut
- bilirubin converted into:
- urobilinogen - travel out in urine or enterohepatic circulation - back through the liver
- or stercobilinogen - travel out in faeces
- some absorbed back into the blood

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

what is jaundice?

A

excess bilirubin in the blood

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

what are the 3 types of Jaundice? describe them.

A
  1. Pre-Hepatic
    - the liver is fine
    - too much bilirubin is produced
    - seen in haemolytic anaemia
  2. Hepatic
    - acute diffuse liver cell injury from end stage chronic liver disease or metabolic disorders
    - = too few functioning liver cells
    - unable to process bilirubin normally
  3. Post-Hepatic
    - the liver is fine
    - bile duct obstruction
    - stones, strictures, tumours
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

how much bilirubin accumulates in the blood to become visible for jaundice?

A

more than 40 micromol/litre

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

how can liver disease be detected? (5)

A
  • detect liver enzymes
  • albumin levels
  • clotting
  • ultra-sounds
  • biopsies
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

what two places can liver enzymes leak from, showing indications for liver disease?

A
  • from damaged hepatocytes
  • from damaged bile duct cells
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

which 2 liver enzymes leaking from damaged hepatocytes can indicate liver disease?

A

ALT - alanine aminotransferase
AST - aspartate aminotransferase

  • mild, slow, progressive increase = chronic liver disease
  • rapid, large increase = severe acute liver disease
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

which liver enzyme leaking from damaged bile duct cells can indicate liver disease?

A

ALP - alkaline phosphatase

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

how can albumin levels indicate liver disease?

A
  • synthesised by the liver
  • have a long half life
  • if the levels drop = chronic liver disease
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

how can clotting indicate liver disease?

A
  • look at how well the blood is clotting
  • clotting factors produced by the liver
    = short half life
  • can indicate acute and chronic
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

how can ultrasounds be used to detect liver disease?

A
  • check for dilated bile ducts
  • if dilation = obstruction
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

when would biopsies be taken to investigate liver disease? what is the most common case found when undergoing this investigation

A

after ultrasound
- if bile ducts aren’t dilated = no obstruction
- best to visualise the abnormalities within the liver

= most cases are due to acute hepatitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
what is hepatitis? what are the 2 types
inflammation of the liver, defined by raised liver enzymes - describes any liver disease which isnt neoplastic acute and chronic
26
what are the causes of acute and chronic hepatitis?
viral alcohol obesity drugs inherited conditions autoimmune conditions
27
describe acute hepatitis
- caused by something that goes away - short-lived - resolves by itself - no signs - often only noticed by blood tests
28
give 6 conditions arising from acute hepatitis, in increasing order of rarity and severity
1. asymptomatic 2. malaise - general feeling of discomfort 3. jaundice - high bilirubin levels 4. coagulopathy - affected blood clotting 5. encephalopathy - brain function affected 6. death
29
give 3 inherited disorders which can cause hepatitis.
Haemochromatosis - iron accumulation Wilson's disease - copper accumulation Alpha-1-antrypsin deficiency
30
describe chronic hepatitis
- caused by persistent liver injury - persistent cycle of damage and repair = long term liver damage
31
what does chronic hepatitis progress to?
cirrhosis
32
what is a big cause of chronic hepatitis?
non alcoholic fatty liver disease NAFLD
33
what 2 things does the severity of acute hepatitis depend on?
- how many hepatocytes are damaged as a result - how well the liver is able to regenerate the lost cells
34
what is cirrhosis?
a irreversible change in the liver due to chronic liver disease
35
describe the pathology of chronic liver disease/cirrhosis
- hepatocytes injured and repaired continuously - causes scarring - scar tissue links vascular structures - portal tract and hepatic vein = bridging fibrosis - liver tissue becomes into separated nodules - end stage = cirrhosis
36
cirrhosis is clinically silent, what does this in turn mean?
means that you find out when the liver function fails (decompensation) and leading to liver failure and portal hypertension
37
what are the 4 complications of cirrhosis?
liver failure portal hypertension infection hepatocellular carcinoma
38
is cirrhosis a disease?
NO cirrhosis is the end point of all chronic liver diseases
39
what effect can alcohol gradually have on the liver?
fatty changes alcohol induced liver inflammation = alcoholic steatohepatitis cirrhosis
40
what does alcohol liver injury depend on?
dosage and susceptibility
41
how does steatohepatits appear under the microscope?
fatty changes ballooned hepatocytes with mallory body - pink things inflammatory cells
42
what condition is regarded as the most common cause of liver disease?
non alcoholic fatty liver disease
43
describe the pathogenesis of NAFLD.
- fat accumulation = steatosis - steatohepatitis - cirrhosis - hepatocellular carcinoma
44
how is NAFLD treated?
need to address the metabolic syndrome - obesity - diabetes - hyperlipidaemia
45
what are the 5 hepatitis virus' and which other 3 viruses can cause hepatitis?
A B C D - only found in people with B E - faecal-oral transmission via infected water EBV - epstein-barr virus CMV - cytomegaloblastic virus HSV - herpes
46
define hepatotoxic
toxins which cause injury to the liver
47
what are the two types of hepatotoxic drugs? describe them.
intrinsic - when excessive doses are administered - liver injury is predictable idiosyncratic - liver injury is rare and unpredictable - happens from metabolic and immunological response variability
48
can drug-induced liver injury be reversed?
yes can stop taking the drugs time of onset for injury is variable and can be months
49
what is the most common symptom of drug induced liver injury?
jaundice
50
describe paracetamol overdose
- 2-3 days massive hepatocellular necrosis - liver looks all pink - no inflammation - just around the central vein - death if no transplant
51
describe Haemochromatosis - the pathogenesis and treatment
- inherited disorder of iron metabolism of the HFE gene - increase iron absorption in the gut - iron deposited in various organs - pancreas - can cause diabetes - skin - pigmentation - heart - cardiomyopathy - liver - chronic hepatocellular injury - cirrhosis - increase risk of HCC hepatocellular carcinoma treatment - venesection - reduce 1 unit of RBC per week
52
describe a Haemochromatosis biopsy
use Perl's Stain - highlights iron in the tissues = blue
53
describe Wilson's Disease and the treatment
- rare - autosomal recessive - mutation of ATP7B gene - impairs the excretion of copper - copper accumulates - in liver - chronic liver injury - cirrhosis - in eye - Kaiser-Fleisher ring - in brain - psychiatric treated by removing the copper - using penicillamine
54
describe Alpha-1-Antitrypsin deficiency and another condition which it causes, relating to the lungs.
A-1-A = protein in blood - inactivates neutrophil elastases = digestive enzyme produced by neutrophils in the liver - deficiency - process impaired - A-1-A not secreted - accumulates in blood - lots of PAS+ globules in liver - chronic liver injury - cirrhosis also causes emphysema in the lungs - neutrophil elastase damages lung tissues - lose ability to recoil - traps air in lungs = emphysema
55
describe how liver diseases can occur from autoimmunity.
- normal immune regulation disturbed - self-antigens are recognised - manifest destruction of hepatocytes = autoimmune hepatitis or - damage to bile ducts = autoimmune biliary diseases - primary sclerosing cholangitis - primary biliary cirrhosis
56
autoimmune hepatitis - describe the diagnosis, biopsy and treatment.
diagnosis - autoantibodies - raised IgG, ALT biopsy - interface hepatitis - lots of plasma cells treatment - immunosuppression to avoid progression to cirrhosis
57
what are the 2 autoimmune biliary diseases? describe them
primary biliary cholangitis - anti-mitochrondial antibodies - increased IgM, ALP - bile duct granulomas - progresses to cirrhosis primary scelorising cholangitis - associated with ulcerative colitis - pANCA antibodies - diagnose with imaging - periductal onion skin fibrosis around bile duct - progresses to cirrhosis
58
what is acute liver failure?
when there is sudden and severe liver damage
59
why would some people with cirrhosis not know they have it?
the liver can compensate - have some residual function
60
what is decompensated liver?
liver loses all function = liver failure
61
give 4 features related to impaired liver function due to cirrhosis
hypoalbuminemia/clotting factor deficiencies - bruising and bleeding ascites - low albumin - aldosterone disturbances encephalopathy - due to impaired breakdown of nitrogen substances gynaecomastia - due to impaired oestrogen breakdown
62
describe portal hypertension as a result of cirrhosis, what does it cause? (3)
- liver is structurally abnormal - blood flow is impaired - pressure build up - back pressure build up in portal vein - blood can't get through the liver - causes ascites and splenomegaly - due to pressures - porto-systemic shunts
63
what are porto-systemic shunts? (cirrhosis portal hypertension), how does this happen (3) and what do they lead to (2)?
blood attempts to bypass the liver - oesophageal varices - haemorrhoids - caput medusae - patient becomes prone to bleeding and ruptures - due to weak vessels and paths - bypasses the liver function
64
what cells in the liver act to fight infection?
Kuppfer cells
65
what is a malignant tumour of hepatocytes called?
Hepatocellular Carcinoma
66
give 4 other benign liver tumours
haemangioma bile duct adenoma focal nodular hyperplasia hepatocellular adenoma
67
give 3 malignant liver tumours
hepatocellular carncoma cholangiocarcinoma metastatic tumours
68
what other tumour is metastasis of the liver observed?
colorectal cancer
69
how does liver disease affect dental treatment?
- coagulopathies - may be carrying infections - hepatitis - drug-toxicity can be different due to lower metabolisms
70

YR 3 - Illness and Wellbeing (31 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions