Liver (Exam 2)

Question 1

Cirrhosis is a

Answer 1

Irreversible, inflammatory, fibrotic liver disease. Scarring

High death rate = 26%

Structural changes from injury (alc/viruses) and fibrosis

Question 2

Chaotic fibrosis leads to obstructive biliary channels and blood flow

Answer 2

this leads to jaundice and portal hypertension

Question 3

Regeneration is disrupted by

Answer 3

hypoxia, necrosis, atrophy, and liver failure

Question 4

Cirrhosis Common Causes

Answer 4

HEP B and C

Excessive Alcohol Intake

Idiopathic

Non-alcoholic fatty liver disease

Question 5

Alcoholism and Liver Disease

Answer 5

Alcoholic fatty liver (mildest -asymp) (reversible)

Alcoholic steatohepatitis (Precursor to cirrhosis - inflammation and degeneration of hepatocytes) (Becoming irreversible)

Alcoholic cirrhosis (Fibrosis and scarring alter liver structure)

Question 6

Cirrhosis: Pathogenesis

Answer 6

Liver cells are destroyed and the cells try to regenerate. This procoss is disorganzied and leads to abnormal growth which causes poor blood flow and scar tissue. The scar tissue causes hypoxia leading to necrosis and liver failure

Question 7

Cirrhosis: Early manifestations

Answer 7

GI disturbances

Fever and weight loss

Palpable liver

Question 8

Cirrhosis: Late manifestations

Answer 8

Jaundice

Peripheral edema

Decrease albumin and PT

Ascites

Skin lesions

Hematologic problems (bleeding and anemia)

Endocrine problems

Esophageal and anorectal varices

Encephalopathy

Question 9

Portal Hypertension leads to

Answer 9

varices and ascites

Question 10

Portal Hypertension can causes

LONG LIST

Answer 10

Systemic hypotension
Vascular underfilling
Stimulation of vasoactive (RAAS system)
Plasma volume expansion
Increase cardiac output

All of these lead to varicies and increase ascites

Question 11

Portal Hypertension: Complications

Answer 11

Variceal hemorrhage, ascites, peritonitis, hepatorenal syndrome

Question 12

Portal Hypertension: Treatment

Answer 12

Prevent and treat complications

Can’t do anything for portal hypertension except liver transplant

Question 13

Hepatic Encephalopathy

Answer 13

Happens in 30-45% of cirrhosis patients

LOC is the primary driver of diagnosis

Question 14

Hepatic Encephalopathy is graded by

Answer 14

Severity

Liver not filtering toxins

These toxin build up in the brain and cause confusion and LOC changes

Question 15

Hepatic Encephalopathy LOC correlates with

Answer 15

Ammonia which is primary chemical driver of LOC changes

Ammonia is neurotoxins that cross the BB and causes problems

NEVER DIAGNOSE BASED OFF THIS LEVEL

Question 16

Acute Liver Failure

Answer 16

Fulminant liver failure

Separate liver failure not caused by cirrhosis or other type of liver disease

Question 17

Most common cause of Acute Liver Failure

Answer 17

Acetaminophen overdose

Question 18

Acute liver failure patho

Answer 18

Edematous hepatocytes and patchy areas of necrosis and inflammatory cell infiltrates and disrupts the liver tissue

Question 19

Acute liver failure can occur

Answer 19

6-8 weeks after a viral hepatitis or metabolic liver disease.

5 days to 8 weeks after an acetaminophen overdose

Question 20

Acute liver failure symptoms

Answer 20

Similar to cirrhosis

Question 21

Acute liver failure treatment

Answer 21

Not much

Liver transplant