liver, pancreas, peritonitis - Sheet1 Flashcards
What is hepatic failure?
Acute liver failure (fulminant) occurs in patients with no prior history. End-stage liver disease (ESLD) is the progression from compensated to decompensated liver state.
What is the mechanism of hepatic failure?
Results from intrahepatic necrosis or decreased blood supply to the liver, leading to impaired metabolic processes, such as altered carb, protein, and fat metabolism, and decreased detoxification and storage functions.
What are the manifestations of hepatic failure?
Asymptomatic initially. Prodromal stage includes anorexia, N/V, abdominal pain, fatigue. Fulminant hepatic failure can cause hyperexcitability, irritability, jaundice, fever, coma, and convulsions.
How is hepatic failure diagnosed?
H&P, labs, abdominal CT/ultrasound, antibody testing for hepatitis types.
What are the complications of hepatic failure?
Includes unstable glucose levels, hypoglycemia, malnutrition, ascites, edema, bleeding, infection, DVTs/PEs, hepatic encephalopathy, portal hypertension, and variceal bleeding.
What is hepatitis?
Inflammation of the liver caused by viruses (e.g., hepatitis A, B, C, D, E; CMV; Epstein-Barr), alcohol, medications, chemicals, autoimmune diseases, or metabolic abnormalities.
How is hepatitis transmitted?
Via blood, blood products, saliva, semen, vaginal fluids, mucous membranes, or contact with infected fluids or objects.
What is cirrhosis?
End stage of liver disease after years of chronic liver disease. Characterized by fibrotic scar tissue and regenerative nodules in the liver.
What causes cirrhosis?
Alcohol, Hepatitis C, hepatosteatosis, other hepatitis viruses, autoimmune diseases.
What are the manifestations of cirrhosis?
Early: Fatigue, hepatomegaly, normal LFTs (compensated). Late: Jaundice, scleral icterus, peripheral edema, ascites, anemia, thrombocytopenia, hypoglycemia, and abnormal LFTs (decompensated).
How is cirrhosis diagnosed?
H&P, labs, abdominal CT/ultrasound, antibody testing for hepatitis types.
What is hepatic encephalopathy?
Neuropsychiatric manifestation of liver disease, primarily due to elevated ammonia levels.
What are the manifestations of hepatic encephalopathy?
Asterixis (early sign), altered LOC, confusion, impulsive behavior, impaired judgment, motor deficits, and coma.
How is hepatic encephalopathy diagnosed?
H&P, serum ammonia levels.
What is portal hypertension?
Abnormally high blood pressure in the portal system caused by resistance to blood flow. Normal: 3 mmHg; Portal HTN: >10 mmHg.
What causes portal hypertension?
Cirrhosis, which leads to structural changes in the liver and obstructed blood flow, increasing pressure in liver vasculature.
What are the manifestations and complications of portal hypertension?
Abdominal distention, increased girth, weight gain, dyspnea, edema. Complications include varices, ascites, and splenomegaly.
What is liver cancer?
Includes hepatocellular carcinoma (HCC) and intrahepatic cholangiocarcinoma. HCC accounts for 75% of cases. 5th most common cancer globally, but 2nd leading cause of cancer death.
Where does liver cancer commonly metastasize?
To the lungs.
What are the manifestations of liver cancer?
Symptoms of cirrhosis plus unexplained weight loss, palpable mass, RUQ pain.
How is liver cancer diagnosed?
Ultrasound, CT, MRI, and biopsy if needed.
What is acute pancreatitis?
Acute inflammatory process of the pancreas caused by spillage of pancreatic enzymes into surrounding tissue, leading to autodigestion and severe pain.
What are common etiologies of acute pancreatitis?
Gallstones (women), chronic alcohol intake (men), smoking, biliary sludge, hypertriglyceridemia, and ERCP.
What are less common etiologies of acute pancreatitis?
Trauma, viral infections, penetrating duodenal ulcers, cysts, and abscesses.
