Liver Failure Flashcards

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1
Q

The liver has a very large functional reserve, but the loss of __% function will result in failure.

A

80% or more

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2
Q

What is the mortality rate for liver failure?

A

50% mortality

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3
Q

What are a few possible causes of liver failure?

3

A
  • Cirrhosis
  • Toxic liver damage
  • Fulminant hepatitis
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4
Q

What is fulminant hepatitis?

A

A rare syndrome of massive necrosis of liver parenchyma and a decrease in liver size that usually occurs after infection with certain hepatitis viruses, exposure to toxic agents, or drug-induced injury
- Acute onset, very severe

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5
Q

Hepatic insufficiency results in:

A

Multi organ failure

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6
Q

What affect does liver failure have on hematology?

A

Causes deficient hemostasis and anemia

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7
Q

Explain why hemostasis is affected by liver failure?

A

The clotting factors and fibrinogen are synthesized by the liver = no clotting = hemorrhage = anemia

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8
Q

What is a cause (excluding hemorrhage) that may result in anemia as a result of liver failure?

A

Impaired marrow function = erythropenia (leukopenia and thrombocytopenia as well)

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9
Q

What condition may arise as a result of the inadequate clearance of activated clotting factors?

A

Disseminated intravascular coagulation

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10
Q

Why does an increase amount of hemolysis occur in pts with liver failure?

A

Defective lipids forming = altered lipid membranes on RBCs = hemolysis

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11
Q

What does the inadequate processing of bilirubin result in?

A

Jaundice

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12
Q

What is the urea cycle? What affect does liver failure have on the urea cycle?

A

The urea cycle converts ammonia (NH3) to urea, which is excreted. Liver failure causes abnormalities to occur in the urea cycle and this results in a buildup of ammonia in the body

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13
Q

What is the fancy shmancy word for elevated levels of ammonia in the blood?

A

Hyperammonemia

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14
Q

What 2 things may be caused by hypoalbuminemia?

A
  1. Edema

2. Ascites

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15
Q

Why is there elevated levels of estrogen in pts with liver failure?

A
  • There is a decreased amount of estrogen catabolism

- Androgens are weak

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16
Q

What are some effects of hyperestrogenism?

A
  • Loss of libido
  • Amenorrhea
  • Impotence
  • Impotence
  • Sterility
  • Gynecomastia
17
Q

What is gynecomastia?

A

A condition that makes breast tissue swell in boys and men

18
Q

What effects does liver failure have on the renal system?

A
  • May cause severe renal ischemia
  • Oliguria
  • Azotemia
  • Increased creatinine
19
Q

What is azotemia?

A

A buildup of nitrogenous wastes

- eg urea, ammonia

20
Q

What does creatinine mark?

A

Kidney failure

21
Q

Why might a pt with liver failure experience neurological symptoms?

A

Because the liver is largely responsible for detoxifying waste materials, so with liver failure these toxic materials still present, there can be neurological ramifications

22
Q

What are the early mnfts of hepatic encephalopathy?

A
  • Asterixis

- Hypereflexia

23
Q

What is asterixis?

A

Characterized by flapping of the palms

24
Q

Other mnfts include:

A
  • Confusion
  • Coma
  • Death
25
Q

What is the treatment for liver failure?

A
  • Reverse the cause if possible
  • Treat the mnfts and complications
  • Administer purgative
  • Non-absorbable Abx
  • Liver transplant
26
Q

What is a purgative and why is it a possible treatment for liver failure?

A

A potent laxative, used to evacuate the bowel of proteins because when proteins are broken down into amino acids which are a source of ammonia

27
Q

Why is a non-absorbable Abx used as a treatment for liver failure?

A

To limit, not eradicate, the normal flora in the bowel because they are a source of ammonia