Liver Pathology

Question 1

Where does the liver get its blood supply from?

Answer 1

Portal vein - 70% - from bowel
Hepatic artery - 30% - from stomach/intestine

Question 2

What are the 7 main functions of the liver?

Answer 2

Protein metabolism - albumin
Carb metabolism - glycogen store
Lipid metabolism - triglycerides store
Bile acid metabolism - production of bile
Protein degradation - ammonia from kidney
Drug and hormone metabolism
Immunological - kupffers cells

Question 3

What are the main causes of liver disease?

Answer 3

Alcohol
Hepatitis
TB, AIDS
Autoimmunity
Drugs
Iron/copper overload
Obstruction

Question 4

What are clinical features of liver disease?

Answer 4

Jaundice
Spider veins
Palmar erythema
Clubbing
Bruises
Delayed healing
Confusion

Question 5

What is hepatitis?

Answer 5

Inflammation of the liver
Causes enlargement, tenderness, deranged function

Question 6

What is hepatitis caused by?

Answer 6

Viral infection - A B C D E
EBV HIV and rubella too

Question 7

What is cirrhosis?

Answer 7

Necrosis of liver cells
Fibrosis
Nodule formation

Question 8

What does cirrhosis cause?

Answer 8

Disruption of blood flow
Loss of liver function

Question 9

What are the causes of cirrhosis?

Answer 9

Alcohol
Hep B and C
Autoimmune
Wilsons - copper

Question 10

What is the dental relevance of liver disease?

Answer 10

Drugs can affect liver function
Post op haemorrhage
Cross infection hep B C
Portal hypertension
Avoid IV

Question 11

How are gall stones formed?

Answer 11

Imbalance of bile pigments, salts and cholesterol

Question 12

What are complications of gallstones?

Answer 12

Gallbladder - colic, infected cholecystitis
Bile ducts - jaundice, pancreatitis
Gut - gallstone ileus

Question 13

How much of the cardiac output to kidneys receive?

Answer 13

25%

Question 14

What are the 4 main functions of the kidney?

Answer 14

Excretion of waste
Homeostasis
Blood pressure
Hormone synthesis

Question 15

What are the main causes of renal failure and damage?

Answer 15

Diabetes
Hypertension

Question 16

What is the dental relevance of renal disease?

Answer 16

Renal failure
Dialysis
Transplant

Question 17

What are the clinical features of renal problems?

Answer 17

Painful pee
Haematuria
Urinary retention
Urine volume

Question 18

When does renal failure occur?

Answer 18

Kidneys have a reduced GFR

Question 19

What is acute renal failure caused by?

Answer 19

Over a few hours or days
Pre-renal - blood
Renal - glomerulonephritis
Post-renal - obstruction

Question 20

What is the treatment for acute renal failure?

Answer 20

Treat underlying cause
Fluid balance and dialysis

Question 21

What are the difference in clinical features between acute and chronic renal failure?

Answer 21

Acute - due to uraemia - polyuria, weakness, fatigue
Chronic - anaemia, hypertension, disturbed urine

Question 22

What is the treatment for chronic renal failure ?

Answer 22

Dialysis
Kidney transplant

Question 23

What are the 2 types of dialysis?

Answer 23

Haemodialysis - AV fistula in forearm, 4/5 hours 3x a week
Peritoneal -permanent catheter or intermittent in bed

Question 24

What is the dental relevance of renal failure?

Answer 24

Avoid NSAIDs
Hypertension
Dialysis - treat on non dialysis days
Ulcers, candidiasis, Lytic lesions on jaw - hyperparathyroidism

Question 25

What is chronic renal failure and how is it caused?

Answer 25

End stage renal disease Caused by diabetes, hypertension, glomerulonephritis

Question 26

What is dialysis?

Answer 26

Removal of waste products from blood Toxins diffuse across semi permeable membrane

Question 27

What are complications of dialysis?

Answer 27

Peritonitis Sepsis Endocarditis CV disease

Question 28

What is pyelonephritis, the cause and treatment?

Answer 28

Ascending infection of kidney Obstruction, calculi, tumours Treat with antibiotics

Question 29

What is glomerulonephritis, the cause and treatment?

Answer 29

Infection of glomerulus Step infection, HIV, infective endocarditis, NSAIDs Treat with antipyretics, diuretics

Question 30

What are renal calculi and their treatment?

Answer 30

Kidney stones Treat with analgesia, retrieval, surgery

Question 31

What are the 2 types of urinary tract infection?

Answer 31

Bacteriuria - bacteria in urine Pyuria - pus in urine Treat with antibiotics

Question 32

What are the carcinomas of the bladder and kidney in children vs adults?

Answer 32

Wilms tumour - nephroblastoma in children Adenocarcinoma - adults

Question 33

What are the 4 types of syphilis?

Answer 33

Primary - painless ulceration Secondary - symptomatic, snail ulcers in mouth, warts on genitals Latent - asymptomatic tissue damage Tertiary - lesions, tissue destruction, neuro, cardio

Question 34

What is the dental relevance of syphilis?

Answer 34

Chancre on lip (sore) Snail track ulcers

Question 35

What is the treatment for syphilis?

Answer 35

Penicillin

Question 36

What are the clinical features of gonorrhoea?

Answer 36

Discharge Dysuria Eye infection Skin lesions

Question 37

What is the treatment for gonorrhoea ?

Answer 37

Antibiotics

Question 38

Where does chlamydia infect?

Answer 38

Urethra Cervix Eye - reciters syndrome Uterus Similar symptoms to gonorrhoea

Question 39

What is the treatment for chlamydia?

Answer 39

Tetracycline

Question 40

What is the treatment for HPV?

Answer 40

Vaccine

Question 41

What are the 2 types of herpes?

Answer 41

Type 1 - sex Type 2 - saliva

Question 42

What are the clinical features of herpes?

Answer 42

Painful lesions Ulcer Tender lymph nodes Painful urine

Question 43

What is the treatment for herpes?

Answer 43

Acyclovir