Liver Pathology Flashcards

1
Q

Where does the liver get its blood supply from?

A

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

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2
Q

What are the 7 main functions of the liver?

A

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

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3
Q

What are the main causes of liver disease?

A

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

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4
Q

What are clinical features of liver disease?

A

Jaundice
Spider veins
Palmar erythema
Clubbing
Bruises
Delayed healing
Confusion

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5
Q

What is hepatitis?

A

Inflammation of the liver
Causes enlargement, tenderness, deranged function

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6
Q

What is hepatitis caused by?

A

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

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7
Q

What is cirrhosis?

A

Necrosis of liver cells
Fibrosis
Nodule formation

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8
Q

What does cirrhosis cause?

A

Disruption of blood flow
Loss of liver function

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9
Q

What are the causes of cirrhosis?

A

Alcohol
Hep B and C
Autoimmune
Wilsons - copper

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10
Q

What is the dental relevance of liver disease?

A

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

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11
Q

How are gall stones formed?

A

Imbalance of bile pigments, salts and cholesterol

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12
Q

What are complications of gallstones?

A

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

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13
Q

How much of the cardiac output to kidneys receive?

A

25%

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14
Q

What are the 4 main functions of the kidney?

A

Excretion of waste
Homeostasis
Blood pressure
Hormone synthesis

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15
Q

What are the main causes of renal failure and damage?

A

Diabetes
Hypertension

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16
Q

What is the dental relevance of renal disease?

A

Renal failure
Dialysis
Transplant

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17
Q

What are the clinical features of renal problems?

A

Painful pee
Haematuria
Urinary retention
Urine volume

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18
Q

When does renal failure occur?

A

Kidneys have a reduced GFR

19
Q

What is acute renal failure caused by?

A

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

20
Q

What is the treatment for acute renal failure?

A

Treat underlying cause
Fluid balance and dialysis

21
Q

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

A

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

22
Q

What is the treatment for chronic renal failure ?

A

Dialysis
Kidney transplant

23
Q

What are the 2 types of dialysis?

A

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

24
Q

What is the dental relevance of renal failure?

A

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

25
Q

What is chronic renal failure and how is it caused?

A

End stage renal disease
Caused by diabetes, hypertension, glomerulonephritis

26
Q

What is dialysis?

A

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

27
Q

What are complications of dialysis?

A

Peritonitis
Sepsis
Endocarditis
CV disease

28
Q

What is pyelonephritis, the cause and treatment?

A

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

29
Q

What is glomerulonephritis, the cause and treatment?

A

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

30
Q

What are renal calculi and their treatment?

A

Kidney stones
Treat with analgesia, retrieval, surgery

31
Q

What are the 2 types of urinary tract infection?

A

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

32
Q

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

A

Wilms tumour - nephroblastoma in children
Adenocarcinoma - adults

33
Q

What are the 4 types of syphilis?

A

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

34
Q

What is the dental relevance of syphilis?

A

Chancre on lip (sore)
Snail track ulcers

35
Q

What is the treatment for syphilis?

A

Penicillin

36
Q

What are the clinical features of gonorrhoea?

A

Discharge
Dysuria
Eye infection
Skin lesions

37
Q

What is the treatment for gonorrhoea ?

A

Antibiotics

38
Q

Where does chlamydia infect?

A

Urethra
Cervix
Eye - reciters syndrome
Uterus
Similar symptoms to gonorrhoea

39
Q

What is the treatment for chlamydia?

A

Tetracycline

40
Q

What is the treatment for HPV?

A

Vaccine

41
Q

What are the 2 types of herpes?

A

Type 1 - sex
Type 2 - saliva

42
Q

What are the clinical features of herpes?

A

Painful lesions
Ulcer
Tender lymph nodes
Painful urine

43
Q

What is the treatment for herpes?

A

Acyclovir