Liver pink pigs Flashcards
What is portal hypertension?
Abnormally high BP in the portal venous system of 10mmHg (when the normal is 3mmHg).
Intrahepatic causes of portal HTN.
Cirrhosis of the liver
What is the most common cause of portal hypertension?
Fibrosis and obstruction caused by cirrhosis of the liver!!!
What is a prehepatic problem for portal HTN?
Thrombosis
What are varices?
Distended, torturous, collateral veins.
Prolonged elevation of pressure in the portal vein and systemic veins and their transformation into varices, primary in the esophagus and stomach but also over the abdominal wall.
What happens if varices rupture?
Life threatening hemorrhage
What can cause varices rupture?
Pressure (ex:vomiting)
What are some causes for portal HTN?
Right sided heart failure, cardiomyopathy, constrictive pericarditis.
What is the most common clinical manifestation of portal hypertension?
Vomiting of blood from bleeding esophageal varices.
Rupture is a combination of erosion. Y gastric acid and elevated venous pressure. Most individuals die within 1 year
What are the types of varices?
Lower esophagus, rectum, and stomach
What do we mainly see cirrhosis with?
Alcoholism
What does the liver do?
Metabolizes bilirubin, byproduct of the destruction of old RBCs.
What would happen if the liver failed?
Decreased in detoxification reactions (build up of ammonia from breakdown of proteins) , resulting in the accumulation of toxic substances in the blood, which can lead to HEPATIC ENCEPHALOPATHY
What occurs in hemolytic jaundice?
Excessive hemolysis of RBCs or absorption of a hematoma
What jaundice causes the breakdown of RBCs?
Hemolytic jaundice
What is elevated in liver disease?
Prothrombin time;’due to lack of synthesis of clotting factors
** elevated PT is more associated with acute liver disease, and decreased albumin is generally associated with chronic liver disease.
What is jaundice?
A yellow or greenish pigmentation of the skin from hyperbilirubinemia.
What is hepatorenal syndrome?
Renal failure
What is hepatorenal syndrome caused by?
Portal HTN, Peripheral vasodilation, and alcoholic cirrhosis.
What does hepatorenal demonstrate?
Oliguria, sodium and water retention, and peripheral vasodilation.m
What causes those symptoms?
Advances in the liver disease
What is hepatitis?
Inflammation of the liver
In non-viral contagious?
No
Is viral contagious?
Yes
What increases your chances of getting vital hepatitis?
Advancing age and co morbidity
What hepatitis is more common with age and co morbidity?
B and C
What does liver damage result in!
Hepatic cell necrosis
What is reversible?
Fatty liver
How is hepatitis A transmitted?
Fecal-oral
What are the clinical manifestations of hep A?
FEVER!!!
Never becomes chronic
How many of the worlds population have hep A?
40%
How is hepatitis B transmitted?
Blood transfusion, needle sticks, sexual, and across the placenta
What are the clinical manifestations of hep B?
Hepatic necrosis, encephalopathy, and organ failure. 10% become chronic!!
What percentage of population have Hep B?
5%
How is hepatitis C transmitted?
Blood transfusion, needle sticks, sexual, across the placenta
What are the clinical manifestations of hep C?
50% get chronic!! Cirrhosis, hepatic ellipse carcinoma.
What percentage of population have hep C?
20%
How is hepatitis D transmitted?
Blood transfusion, needle sticks, sexual, across the placenta.
What are clinical manifestations of hep D?
HBV and HDV are acquired at same time and cause and accrue hepatitis. Fulminant hep and cirrhosis.
You cannot have….
Hepatitis D without B!!!
What is hepatitis E?
Same as A
What is the leading cause of death in the US?
Cirrhosis!!!
What percentage of children have hep B?
90%
Is cirrhosis reversible?
NOOOOOPPEEE
What is the first phase of hepatitis?
Incubation phase: two weeks after exposure
What is the prodromal phase of hepatitis?
2 weeks after exposure and ends with the appearance of jaundice. INFECTION IS HIGHLY TRANSMISSIBLE IN THIS STAGE
What is the icteric phase?
1-2 weeks after prodromal phase and lasts 2-6 weeks. ACTUAL PHASE OF ILLNESS
What is the recovery phase of hepatitis?
Resolution of jaundice, 6-8 weeks after exposure.
