Liver Failure Flashcards
The liver has a very large functional reserve, but the loss of __% function will result in failure.
80% or more
What is the mortality rate for liver failure?
50% mortality
What are a few possible causes of liver failure?
3
- Cirrhosis
- Toxic liver damage
- Fulminant hepatitis
What is fulminant hepatitis?
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
Hepatic insufficiency results in:
Multi organ failure
What affect does liver failure have on hematology?
Causes deficient hemostasis and anemia
Explain why hemostasis is affected by liver failure?
The clotting factors and fibrinogen are synthesized by the liver = no clotting = hemorrhage = anemia
What is a cause (excluding hemorrhage) that may result in anemia as a result of liver failure?
Impaired marrow function = erythropenia (leukopenia and thrombocytopenia as well)
What condition may arise as a result of the inadequate clearance of activated clotting factors?
Disseminated intravascular coagulation
Why does an increase amount of hemolysis occur in pts with liver failure?
Defective lipids forming = altered lipid membranes on RBCs = hemolysis
What does the inadequate processing of bilirubin result in?
Jaundice
What is the urea cycle? What affect does liver failure have on the urea cycle?
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
What is the fancy shmancy word for elevated levels of ammonia in the blood?
Hyperammonemia
What 2 things may be caused by hypoalbuminemia?
- Edema
2. Ascites
Why is there elevated levels of estrogen in pts with liver failure?
- There is a decreased amount of estrogen catabolism
- Androgens are weak
What are some effects of hyperestrogenism?
- Loss of libido
- Amenorrhea
- Impotence
- Impotence
- Sterility
- Gynecomastia
What is gynecomastia?
A condition that makes breast tissue swell in boys and men
What effects does liver failure have on the renal system?
- May cause severe renal ischemia
- Oliguria
- Azotemia
- Increased creatinine
What is azotemia?
A buildup of nitrogenous wastes
- eg urea, ammonia
What does creatinine mark?
Kidney failure
Why might a pt with liver failure experience neurological symptoms?
Because the liver is largely responsible for detoxifying waste materials, so with liver failure these toxic materials still present, there can be neurological ramifications
What are the early mnfts of hepatic encephalopathy?
- Asterixis
- Hypereflexia
What is asterixis?
Characterized by flapping of the palms
Other mnfts include:
- Confusion
- Coma
- Death
What is the treatment for liver failure?
- Reverse the cause if possible
- Treat the mnfts and complications
- Administer purgative
- Non-absorbable Abx
- Liver transplant
What is a purgative and why is it a possible treatment for liver failure?
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
Why is a non-absorbable Abx used as a treatment for liver failure?
To limit, not eradicate, the normal flora in the bowel because they are a source of ammonia
