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GI > Liver Function And Pathology > Flashcards

Liver Function And Pathology Flashcards

1
Q

What are the 3 main functions of the liver?

A

Storage

Synthesis

Metabolism

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2
Q

What are is the liver an important storage organ for?

A

Glycogen
Vitamins
Iron
Copper

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3
Q

What is the livers synthetic function?

A

Glucose
Lipids/cholesterol
Bile production
Clotting factors
Albumin (main plasma protein)

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4
Q

What are the livers metabolic functions?

A

Bilirubin (Hb metabolism)
Ammonia metabolism
Drugs
Alcohol
Carbohydrate + Lipid metabolism

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5
Q

How is the liver important in maintain blood sugar levels?

A

Acts as a store of glycogen which can be broken down into glucose

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6
Q

What vitamins does the liver store?

A

B12

Fat soluble vitamins (A,D,E and K)

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7
Q

What anabolic metabolic process is carried out by the liver and is important in maintaining blood glucose levels?

A

Gluconeogensis

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8
Q

What are some vague non specific symptoms of liver disease?

A

Nausea
Vomiting
Loss of appetite
Abdominal pain
Fatigue

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9
Q

What conditions do all forms of chronic liver disease lead to?

A

Liver cirrhosis

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10
Q

What are some specific symptoms of liver disease?

A

Jaundice
Oedema/ascites
Bleeding (easy bruising)
Confusion

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11
Q

What is jaundice/what causes it?

A

Yellowing of skin and eyes due to buildup of bilirubin in the body

Since the liver is unable to metabolise it effectively

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12
Q

What is ascites?

A

Build up of fluid in the peritoneal cavity

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13
Q

Why can liver dysfunction/disease lead to ascites/oedema?

A

Liver able to produce less albumin

Blood has reduced oncotic pressure
Less water drawn back in from the interstitium into the blood (Hydrostatic > oncotic)
More water in the tissues = oedema/ascites

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14
Q

Why are individuals with liver dysfunction prone to bleeding/bruising?

A

Liver cant produce sufficient clotting factors
More likely to easily bleed/bruise, have more nosebleeds or prolonged bleeding after minor injuries

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15
Q

Why can a patient with liver dysfunction develop confusion?

What is this condition called?

A

Metabolic dysfunction means less detoxification can occur, toxins like ammonia build up and go to brain

HEPATIC ENCEPHALOPATHY

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16
Q

What are the characteristic presentations of hepatic encephalopathy?

A

Altered mental state
Confusion
Coma

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17
Q

What is acute liver failure?

A

Sudden onset of the liver disease specific symptoms with no previous underlying history of symtoms/disease

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18
Q

What are some examples of things that can cause acute liver failure?

A

Acute excess alcohol intake
Paracetamol OD
Viral infection (EBV, CMV, acute hepatitis)
Mediations like aspirin

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19
Q

Why do we avoid giving aspirin to children?

A

Can cause liver failure

20
Q

What is liver cirrhosis?

A

Permanent irreversible damage to the liver that results in impairment of liver function that damages the architecture of the liver

Happens due to chronic inflammation of the liver

21
Q

Describe the process that changes the liver in liver cirrhosis:

A

Chronic I inflammation —> fibrosis and necrosis of hepatocytes -> nodules form

22
Q

What are the 5 main categories of causes of Liver Cirrhosis/chronic inflammation of the liver?

A

Drugs
Infection
Deposition
Autoimmune
Other

23
Q

What drugs that are given to patients can affect the liver causing cirrhosis?

A

Iatrogenic (aspirin)
Alcoholic liver disease (the most common)

24
Q

What are the changes that occur in alcoholic liver disease?

A

Fatty changes leading to hepatomegaly (weeks)

Alcoholic hepatitis (years)

25
Q

What is occurring in the fatty changes stage of Alcoholic liver disease?

A

Excess alcohol metabolism occurring
Excess Glucose -> TAGs
Makes liver larger

This stage occurs over weeks and is reversible

26
Q

What occurs in the alcoholic hepatitis stage of Alcoholic liver disease?

A

Inflammatory cells with fatty change

More sever symptoms (jaundice, RUQ pain, Hepatomegaly possibly Ascites, confusion)

This still can be reversed before liver cirrhosis stage is met

27
Q

How do you treat alcoholic liver disease?

A

Reduce alcohol intake
Treat symtoms

28
Q

What are some viral infections that can cause chronic liver disease/cirrhosis?

A

Hepatitis B
Hepatitis C

29
Q

What is the more common Hepatitis virus in Europe?

A

Hep C
Since transmitted blood borne via IV lines

30
Q

Does Hep B have a cure and a vaccine?

A

Vaccine
No cure

31
Q

Does Hep C have a cure and a vaccine?

A

Cure
No vaccine

32
Q

Since Hep B and Hep C cause chronic inflammation which can lead to liver cirrhosis, what can it also lead to//a big increase in risk in developing?

A

Hepatocellular carcinoma

Anything causing chronic inflammation increases risk of Hepatocellularcarinoma/malignancy

33
Q

What are some deposition causes of chronic livier disease/cirrhosis?

A

Fatty liver disease/Non Alcoholic Fatty Liver Disease (NAFLD)

34
Q

What is the cause of Non Alcholic Fatty Liver Disease? (NAFLD)

A

Insulin resistance leads to glucose levels in liver being high

Glucose -> TAGs

Fatty liver disease
If enough fat builds up causing inflammation condition is called NASH (Non alcoholic Steatohepatitis)

35
Q

What is Non Alcoholic Steatohepatitis (NASH)?

A

Chronic inflammation of the liver due to the build up of a fatty liver that has nothing to do with alcohol intake (Non Alcoholic Fatty Liver Disease/NAFLD)

36
Q

Why is NASH becoming more prevalent?

A

Obesity
Metabolic syndromes

All more prelavent so more NAFLD

37
Q

What are the 2 other deposition causes of chronic liver disease/Cirrhosis ?

A

Hereditary Haemochromatosis

Wilsons disease

38
Q

What is hereditary Haemochromatosis?

How can it lead to liver cirrhosis?

What other dangerous condition can it increase the risk of developing?

How is it treated?

A

Autosomal recessive mutation of HFE gene

Leads to over absorption of Iron
Increased deposition of iron in liver
This causes liver damage

Increases risk of Hepatocellular carcinoma

Venesection = treatment (removing blood from patient to reduce iron levels)

39
Q

What is Wilsons disease?

What protein transports copper?

A

Genetic disorder of issue with Cu metabolism

Decreased secretion of Cu from Billary system into circulation to be removed

This leads to it building up in tissues like the liver

Ceruloplasmin transports copper

40
Q

How is Wilsons disease treated?

A

Drugs for symptoms

Ultimately liver transplant

41
Q

What are some autoimmune immune causes of autoimmune hepatitis that directly attack the hepatocytes?

A

ASMA
ANA

42
Q

What are 2 autoimmune conditions which affect the bile ducts leading to liver cirrhosis/chronic inflammation?

A

Primary Biliary Cirrhosis

Primary Sclerosing Cholangitis

43
Q

What is primary biliary cirrhosis?

A

Progressive autoimmune destruction of bile ducts can lead to cirrhosis

44
Q

What is primary sclerosing cholangitis?

A

Autoimmune cause of inflammation and scarring of bile ducts leavening to liver damage and cirrhosis

45
Q

What disease is Primary Sclerosing cholangitis closely linked to?

A

Inflammatory bowel disease like ulcerative colitis

46
Q

What are some rare condition causing liver cirrhosis?

A

Alpha 1 antitrypsin deficiency

Glycogen storage disorders

Budd-chiari syndrome

47
Q

What is budd-chairi syndrome?

A

When hepatic veins get blocked

GI (35 decks)

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