Liver Pathology Flashcards
What is fulminant hepatic failure?
Hepatic encephalopathy occurring within 2 weeks of onset of other symptoms of acute liver failure
What is acute liver disease?
Rapid development of hepatic dysfunction without prior liver disease - less than 6 months duration
Give some causes for acute liver failure
Drugs (paracetamol, co-amoxiclav, Flucloxacilin, NSAIDs, co-codamol)
alcohol
Chronic liver disease (acute on chronic)
Viral hepatitis (C,B,A)
CMV and EBV
Budd Chiari (thrombosis of hepatic veins)
AFLP
What investigations are carried out for acute liver failure?
LFTs
PT
USS
Virology
Treatment for acute liver failure
Rest up to 6 months NO alcohol Fluids Monitor and supplement electrolytes Observations for FHF
Complications of FHF
Encephalopathy Hypoglycaemia Coagulopathy Infection circulatory failure renal failure
Treatment for FHF
Supportive
Inotropes and fluid
management of raised ICP
Renal transplantation if required
What is hepatic encephalopathy?
neurological disorder caused by metabolic failure of the hepatocytes and shunting of blood around the liver
Symptoms of hepatic encephalopathy
Disturbances in consciousness
Liver flap tremor
Fluctuating neurological signs (muscular rigidity and hyper-reflexia)
Treatment for Hepatic encephalopathy
look for cause and treat it
Lactulose - to clear gut of NH4
Rifaximin
Nutrition and fluid
What does an increased BMI do to risk of liver disease?
Increase it
How is cirrhosis defined?
Common end point for liver disease
irreversible
bands of fibrosis separating regenerative nodules of hepatocytes
What is alpha feto-protein?
A tumour marker for hepatocellular and testicular carcinoma
How is cirrhosis defined?
Common end point for liver disease
irreversible
bands of fibrosis separating regenerative nodules of hepatocytes
What is alpha feto-protein?
A tumour marker for hepatocellular and testicular carcinoma
What is a liver cell adenoma?
A benign epithelial tumour of the liver
associated with OCP use
usually single solitary lesions
require close monitoring
What is NAFLD a result of?
Fat inflammation & streaks of collagen laid down
disease of genetic susceptibility but strongly associated with obesity
How is simple steatosis diagnosed?
Bright liver on USS
What is the treatment for steatosis?
Weight loss and exercise
What is NASH?
fatty changes with inflammation and hepatocellular injury or fibrosis
risk of progression to cirrhosis
How is NASH diagnosed?
Liver biopsy
What are the symptoms of NASH?
malaise
fatigue
RUQ or diffuse abdo discomfort
