Liver Failure Flashcards

1
Q

what is acute liver failure?

A

sudden loss of liver function

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2
Q

how can rapid death occur in someone suffering from acute liver failure?

A
  • bleeding

* encephalopathy

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3
Q

why does excessive bleeding occur in liver failure patients?

A

the ability to make proteins and clotting factors is reduced/stops

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4
Q

why is meant by encephalopathy?

A

body has no ability to decontaminate blood toxins which leads to IMPAIRMENT OF BRAIN FUNCTION

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5
Q

what are examples of diseases that fall under the ‘chronic’ liver disease spectrum?

A
  • cirrhosis
  • primary liver cancer
  • secondary liver cancer
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6
Q

what can cause cirrhosis of the liver?

A
  • alcohol
  • Primary Biliary Cirrhosis (autoimmune)
  • viral disease
  • autoimmune chronic hepatitis
  • cystic fibrosis
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7
Q

what are the signs and symptoms of cirrhosis?

A
  • often NONE
  • acute bleeding
  • jaundice
  • oedema & ascites
  • encephalopathy
  • spider naïve
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8
Q

what is meant by ascites?

A

fluid accumulation in the peritoneal area

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9
Q

what can happen due to ascites?

A
  • high portal venous pressure

* low plasma protein synthesis

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10
Q

what are osophageal varices?

A

dilation of little veins at the bottom end of oesophagus

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11
Q

what functions of the liver are lost during liver failure?

A
  • loss of synthetic function

* loss of metabolic function

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12
Q

what tests are used to detect liver failure?

A

• International Normalised Ratio (INR)

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13
Q

what will rise in the presence of liver failure?

A

hepatic cell enzyme levels (ALT, GGT)

• raised in liver inflammation

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14
Q

what does the INR test?

A

measures PROTHROMBIN time against a control (lab worker)

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15
Q

what is the normal INR value and how does this differ with other diseases/medications?

A
  • normal value = 1

* if on warfarin the therapeutic range = 2.0-4.0

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16
Q

what is signified if the INR value is not normal?

A

SIGNIFICANT liver synthetic dysfunction (e.g. not enough clotting factors)

17
Q

what occurs in patients that suffer from liver failure?

A
  • ascites
  • raised INR & prolonged bleeding
  • portal hypertension
  • inability to remove “waste”
  • build up of haem breakdown products
18
Q

what is portal hypertension & what can it lead to?

A
  • inability of GI blood to re-enter the vena cava

* leads to oesophageal vein dilation (Varices)

19
Q

what treatment options are there for liver failure patients?

A
  • supportive treatment (end stage disease)
  • transplantation
  • artificial liver systems
20
Q

what is an example of an artificial liver system?

A

Molecular Adsorbent Recirculating System (MARS)

21
Q

how can end stage liver disease affect dentistry?

A
  • patients have clotting disorders
  • patients have abnormal drug metabolism
  • reduced ‘gamma globulin’ so more prone to infection
22
Q

what analgesics are suitable for liver failure patients? which are NOT?

A
  • paracetamol probably safest option

* NSAIDs increase bleeding risk so NO

23
Q

does local anaesthetic effect liver failure patients?

A

NO! metabolised in the plasma, not the liver