Liver Failure

Question 1

what is liver failure

Answer 1

a loss of 80% or more of liver function

Question 2

is liver failure acute or chronic

Answer 2

both forms

Question 3

why is there such a high mortality rate

Answer 3

because it affects other organs

Question 4

Etiology

Answer 4

Fulminant hep - acute form
toxic liver damage - acute form
cirrhosis - chronic form

Question 5

Hematology

Answer 5

impaired hemostasis (can't bring bleeding under control)
impaired protein synthesis (proteins produced by liver)
depressed marrow function (needs resources from the liver = in inadequate cell formation)
DIC: disseminated intravascular coagulation: liver removes clots via fibrinogen
ruptured varies keep bleeding

Question 6

Metabolism

Answer 6

inadequate bilirubin clearance
Hypoalbuminemia (deficiency of albumin)
- decrease osmotic pressure = deem/ascites
Defective Urea Cycle
- urea build up is toxic
Hyperammonemia
- by product of protein break down, isn’t being excrete or converted to urea
Decrease estrogen catabolism
- can’t break down estrogen = hyperestrogenism

Question 7

Hepatorenal Syndrome

Answer 7

severe damage to renal perfusion (portal HTN means increase blood to that one are and a decrease to the kidneys)
Oliguria
Azotemia

Question 8

Hepatic Encephalopathy

Answer 8

toxic components in the blood that get to the brain
- portosystemic shunts
Dehydration of the brain
- increased ammonia = increases glutamate = increased osmotic pressure

Question 9

Manifestations

Answer 9

Early: asterixis (tremor of hands)
hyperreflexia

Late: confusion
coma
death

Question 10

Treatment

Answer 10

reverse the cause
purgative (potent laxative) to clear the gut of proteins there fore not have the by product of ammonia
non absorbable antibiotics
- not absorbed in the gut