Liver Problems Flashcards

1
Q

What is hepatitis?

What are the causes of hepatitis?

A

Liver inflammation

Causes:
- Viral (most common), A, B, C, D, E
- Drugs (Alcohol), Chemicals
- Autoimmune diseases
- Metabolic abnormalities

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2
Q

How does acute liver infection cause liver damage?

What can liver inflammation cause in relation to bile?

A

Infected cells are killed by the immune system

It can interrupt the flow of bile (Cholestasis)

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3
Q

Can liver function return to normal after an ACUTE liver infection is resolved?

A

Yes, liver cells can regenerate after the resolution of an acute infection

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4
Q

Can liver function return to normal during a CHRONIC infection?

A

No, prolonged infection results in liver fibrosis/scarring, which can then progress to liver cirrhosis

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5
Q

What are the symptoms that may arise due to the antigen-antibody complexes and complement system activation from liver infection?

A

Rash
Angioedema
Arthritis
Fever
Malaise
Cryoglobulinaemia
Glomerulonephritis
Vasculitis

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6
Q

Do all patients exhibit symptoms of hepatitis?

A

No, many are asymptomatic

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7
Q

What are some acute symptoms of hepatitis?

A

Malaise
Anorexia
Weight loss
Fatigue
Nausea/vomiting
Abdominal discomfort
Distaste for cigarettes
decreased sense of smell
Low-grade fever
Joint stiffness
Skin rashes

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8
Q

What are some assessment findings associated with the acute phase of hepatitis?

A

Enlarged liver and enlarged spleen and/or lymph nodes
+/- Jaundice, and if so patient may also have:
- Dark urine
- Light or clay-coloured stools
- Itchy skin as a result of bile salt buildup under skin

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9
Q

What happens to symptoms as a hepatitis infection shifts from the acute to the convalescent phase?

A

Jaundice starts disappearing
Malaise and ease of fatigue persists
Enlarged liver persists, enlarged spleen subsides

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10
Q

What diagnostic tests can detect viral hepatitis?

A

CT Scan
Liver biopsy (More common in chronic hepatitis than acute)
Viral genotype testing
Liver function tests
Physical assessment findings

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11
Q

What is the management plan for hepatitis?

A

Well-balanced diet +/- vitamin supplements
Rest depending on the severity
Avoiding alcohol intake and drugs detoxified by the liver (e.g. paracetamol)
Notification of possible contacts

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12
Q

What are some complications of hepatitis?

A

Cirrhosis
Ascites
Osesphageal and gastric varices
Hepatic encephalopathy

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13
Q

What is cirrhosis?

How does this affect the liver?

A

A chronic, progressive disease of the liver where cells attempt to regenerate but are disorganised

The disorganised regeneration results in abnormal architecture, overgrowth of fibrous connective tissue and impeded blood flow, resulting in decreased liver function

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14
Q

What is the difference between compensated and decompensated cirrhosis?

A

Compensated - No other liver complications
Decompensated - One or more complications

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15
Q

What are the signs and symptoms of cirrhosis?

A

Early symptoms:
- Fatigue

Late symptoms:
- Jaundice
- Peripheral oedema
- Ascites
- Skin, haematologic, endocrine and neurologic disorders

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16
Q

What is ascites?

What are symptoms associated with ascites?

A

Accumulation of serous fluid in the peritoneal cavity

Symptoms include:
- Abdominal distension
- Weight gain
- Signs of dehydration
- Decreased urine output
- Hypokalaemia

17
Q

How is ascites managed?

A

Sodium restriction
Albumin
Diuretics
Parancetesis
- Fluid removal from the abdomen

18
Q

What are oesophageal and gastric varices?

What are strategies for managing oesophageal and gastric varices?

A

Dilated veins resulting from increased portal hypertension

Prevent bleeding/haemorrhage
- Avoid alcohol, aspirin, and irritating foods
- Screen for presence with endoscopy
- Nonselective beta-blockers to reduce pressure

If bleeding occurs
- Stabilise patient
- Manage airway
- Provide IV therapies and blood if needed

19
Q

What is hepatic encephalopathy?

What are strategies for managing hepatic encephalopathy?

A

A change in the neurological and mental state/responsiveness of the patient resulting from a buildup of ammonia in the blood when the liver can’t convert ammonia into urea

Management:
- Reduce ammonia formation
- Neurological assessments regularly
- Preventing constipation
- Encourage fluids

20
Q

How is cirrhosis managed?

A

Rest
Administration of B-complex vitamins
Avoiding alcohol, aspirin, acetaminophen, NSAIDs
Nutritional therapy
- High calorie diet
- High carbohydrates and moderate to low fat
- Protein supplements for protein-calorie malnutrition
- Low sodium diet for patients with ascites and oedema