Liver Disorders

Question 1

Definition Pre-eclampsia

Answer 1

A BP of >140/90 along with the presence of protein in urine in a pregnant woman.

Question 2

Cause of Pre-eclampsia

Answer 2

Unknown however thought to be involved in genetics, immunology and placental factors

Question 3

Predisposing Factors of Pre-eclampsia

Answer 3

• Prims
• Ages <19 or >40
• Primiparity
• Prev hx
• Family hx
• BMI >35
• Pre-existing medical condition
• Multiple pregnancy

Question 4

Symptoms of Pre-eclampsia

Answer 4

• Headache
• Blurred vision
• Oligura
• HELLP
• Shortness of breath
• Oedema
• Raised urea, creatine and urate and impaired liver function

Question 5

Care

Answer 5

Mild (149/99): - Admit to hospital, measure bp 4x daily, bloods 2x weekly
Moderate (159/109): - Admit, labetalol, bp 4x daily, bloods 3x weekly.
Sever (160/110): - Admit, labetalol, bp >4x daily, bloods 3x weekly.

Question 6

Definition of Liver

Answer 6

• A large lobed, glandular organ that is responsible for metabolic processes

Question 7

Functions of the Liver

Answer 7

• Metabolises drugs
• stores iron
• clears bilirubin
• regulates blood clotting
• produces proteins

Question 8

Changes to the Liver in Pregnancy

Answer 8

• size stays same
• displaces due to growing uterus
• liver function reduces
• stores more glycogen

Question 9

Definition of Hyperemesis Gravidarum

Answer 9

A condition in pregnancy that causes excessive and prolonged nausea and vomiting leading to weight loss and dehyrdation

Question 10

Symptoms of Hyperemesis Gravidarum

Answer 10

• Excessive nausea and vomiting
• Dehydration
• weight loss
• Low BP
• Ketotic urine

Question 11

Treatment for Hyperemesis Gravidarum

Answer 11

• anti-emetics
• vitamins
• iv fluids
• dietry advise
• accupuncture
• pressure wrist bands

Question 12

Definition of Intrahepatic Cholestasis of Pregnancy (ICP)

Answer 12

A potentially serious condition of the liver during pregnancy caused by a build up of bile acids in the body when they would usually flow

Question 13

Symptoms of Intrahepatic Cholestasis of Pregnancy

Answer 13

• Itching without rash, usually on hands or feet
• pale pool
• dark urine
• jaundice

Question 14

Treatment

Answer 14

No cure, goes once baby is born. Topical creams and medication can ease itch

Question 15

Definition of HELLP syndrome

Answer 15

A rare disorder of the liver that can occur in pregnancy. Haemolysis, elevated liver enzymes and low platelet count

Question 16

Symptoms of HELLP

Answer 16

• Headaches
• Visual changes
• Nausea and vomiting
• Diarrhoea
• Jaundice
• shoulder/neck pain
• R ^ quad pain

Question 17

Treatment for HELLP

Answer 17

• deliver asap

Question 18

Definition of Acute Fatty Liver of Pregnancy

Answer 18

A serious, potentially life threatening disorder of the liver that can occur in the 3rd and final trimester of pregnancy. It causes a build up of fat on the liver and liver cells, leading to the liver function to be reduced.

Question 19

Cause of Acute Fatty Liver of Pregnancy

Answer 19

Thought to be caused by mitochondrial dysfunction

Question 20

Symptoms of Acute Fatty Liver of Pregnancy

Answer 20

• Nausea and vomiting
• Jaundice
• Fatigue
• Malaise
• Thirst