Liver injury Flashcards
What does the liver do?
Glucose + fat metabolism
Detoxification + excretion
Protein synthesis
Defence against infection
What proteins does the liver synthesise?
Albumin
Clotting factors
What things does the liver detoxify and excrete?
Bilirubin (breakdown of haem) Ammonia Drugs Hormones Toxins
What’s the difference between acute and chronic liver injury?
Acute: one of attack on the liver, the liver returns to normal after
Chronic: attack every day for years takes a toll on the liver, it regenerates but not very well
What are the outcomes of acute liver injury?
Recovery
Liver failure
Chronic liver injury
What can chronic liver injury result in?
Recovery
Cirrhosis
Liver failure
What would you see on a liver biopsy of someone with acute liver injury?
Apoptosis and necrosis of cells
Influx of neutrophils
What would you see on a liver biopsy of someone with chronic liver injury?
Damaged hepatocytes and other cells
Scarring, leaving islands of hepatocytes amongst the scar tissue
What causes acute liver injury?
Viral hepatitis Drug Alcohol Vascular, ischaemia Obstruction Congestion
What causes chronic liver injury?
Alcohol
Viral
Autoimmune
Metabolic: iron, copper
Presentation of acute liver injury?
Malaise
Nausea
Anorexia
Jaundice
Confusion
Bleeding
Liver pain
Hypoglycaemia
Presentation of chronic liver injury?
Ascites Oedema Haematemesis due to varices Malaise Anorexia Wasting Easy bruising Itching Hepatomegaly Jaundice Confusion
