Liver - hepatitis Flashcards

1
Q

What is cirrhosis?

A

Irreversible damage to liver

Microscopically - liver will be fibroses - area of nodular regeneration

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2
Q

Cause cirrhosis?

A

Alcohol, infection hep B or C

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3
Q

What is jaundice?

A

Yellow pigmentation skin, sclerae and mucosa causing excess plasma bilirubin

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4
Q

What is pre-hepatic jaundice?

A

Excess bilirubin production
Liver become rate limiting step - build up of uncojugated bilirubin in skin
Faeces still brown as still have conjugated bilirubin

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5
Q

How is bilirubin produced?

A

Product of harm degradation = liver normally conjugate and excrete bilirubin

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6
Q

Why is faeces brown?

A

Bacteria break down stercobillogen into stercobillin which is responsible for brown faeces

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7
Q

What is post-hepatic jaundice?

A

Blockage of bile duct - conjugated bilirubin produced but not release into intestine for excretion
Cause pale stools and dark urine

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8
Q

What is intra-hepatic jaundice?

A

Happen when liver function is reduced

Conversion into bilirubin becomes slower - still some conjugated therefore usually avoid pale stool

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9
Q

What is ascites?

A

Accumulation of protein-containing fluid within abdomen

common cause = portal hypertension

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10
Q

How investigate liver function?

A

FBC
LFT - when damaged releases enzymes into blood and liver produced proteins decrease
Coag screen - inc. platelet count and bleeding time

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11
Q

Why is problem w/ haemostats in liver disease?

A
  1. Thrombopoetin not produced
  2. Liver dependent clotting factors reduced
  3. Splenic sequestration of platelets (related portal shunt)
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12
Q

Administering LA in hepatic pt?

A

2-3 fold decrease in mod-severe impairment

LA - amides metabolised in liver - toxic reaction at lower expected dose

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13
Q

Why haematemesis in hepatic pt?

A

Arise from oesophageal varies due to hypertension

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14
Q

Function of liver

A
  1. Detoxification

2. Conjugation - change uncharged fat-soluble to charger water-soluble particles that can be exerted

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15
Q

How much bilirubin for jaundice?

A

> 5mg dl-1 in blood

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16
Q

What is problem caused by porto-systemic shunt?

A
  • Haematemesis - rupture oesophageal varices

- Encephalopathy

17
Q

3 routes of porto-systemic shunting?

A
  1. Rectum = haemorrhoids
  2. Abdomen = captures medusa
  3. Oesophageal