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Alimentory System > Main functions of the liver > Flashcards

Main functions of the liver Flashcards

1
Q

what are the role of the liver

A

production of the clooting factors
bile acids
carohyrades production, gluconugesi
protein synstes
lipdis
hormones

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2
Q

how does the liver detodxy

A

removal of urea
detoxifciation of drugs
bilirubin metabolism
breakdown of insulin and hormones

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3
Q

what is the immune function of liver

A

clearning blood of particel and infectiosn including bacteria
nutrilsing and destroying all drugs and toxins

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4
Q

what does hte liver store

A

vid d, a, b12 and k

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5
Q

what type of bilirubin is bond to albumin

A

unconjugated

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6
Q

is unconfugae soluble in water

A

no

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7
Q

can unconjuaged bilirubi pass through brain barrier

A

yes

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8
Q

what are amniotransferases

A

enzymes present in the hepatocytes

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9
Q

which is mroe speici, alt or ast

A

alt

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10
Q

what chemical sratin piotns toward ald

A

ast, alt

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11
Q

what is alkaline phosphatas

A

enzyme presnet in bile duct with is elvetated in liver obstion or infaiton,

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12
Q

where can alkaline phosphatise be found

A

bile ducts, obstuaiotn and livver infaltion, bones, placent and intestines

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13
Q

what does radiwd gamma gt mean

A

alchol use or drug suc as nsaids

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14
Q

what does low levels of albumin mena

A

kidney disoroer or chronci liver diseaes

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15
Q

what is a low prothorbin time indicitiv off

A

liver dysfuctoin

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16
Q

what does creatine mean

A

determes surfial from liver deia nad need for transplant

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17
Q

what can a low platelte count indicate

A

hyperslenism

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18
Q

what is the platlet count an indirect mraker of

A

portal hypertension

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19
Q

symptoms of liver failure

A

jaundice
ascites
variceal bleed
hepatic encephalopathy

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20
Q

causes of preheaptic jandice

A

increased quantity of bilirubin
imparied transprot

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21
Q

hepatic causes of jaundice

A

defectvie uptake of bilirubin
defective conjugation
defective excretion

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22
Q

post hepatic jaundice cause

A

defective tranport of bilirubin by th biliary ducts

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23
Q

what are the cues on hisrotyr for pre hepatic jaundice

A

anemica
acholuri jaundice

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24
Q

clues on history for hepatic jaundice

A

risk foactr for liver diesea e.g. ivdu
decompresation - acidtes, varicela bleed, encephalopahty

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25
Q

clues on history for post hepatic jaundice

A

abdomial pain
cholestatis - pale stool, high colured urine, prutitus

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26
Q

what is seen on clical examination for pre hepatic jaundice

A

pallor, splenomegaly

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27
Q

what is seen on clincial examion for hepatic jaundice

A

stigmata of cld,
ascites
asterixis

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28
Q

what is seen on clinal examintion for post hepatic jaundice

A

palpable gall bladder

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29
Q

what blood investigation can be done for jandice

A

hep b and c serology
auto antibody porife
caerulopasmin and copper
ferritin and transferrin saturation
alph 1 antitrypsin
fasting glucose adn lipid profile

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30
Q

what can be seen for ultra sound in jaundice patins

A

see where the obstion is and wherther it is extraphatic or intra hepatic
delinetas site of obstuciotn
cause of obstruction
portal hypertension
see cancer spread

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31
Q

main benift of ct/mri over sultrat

A

higher senityite, betteer for pancrease

32
Q

what is ercp

A

uses endoscpoe and x ray to diagnose paites

33
Q

what is mrcp

A

a scan using mri and contrast maerks, no die is added

34
Q

what is endoscopic retrograde cholangiopancreatography

A

placing an endocpy in paitent and using radiation to highlight areas of issues
uses markers

35
Q

how can ercp be usedd therpatuily

A

dilate bialry tree
acute gaoll stones
stenting of ulary tract obsiton

36
Q

complicaton of ercp

A

sedation
pancratis,
cholangistis
sphincteromeoty

37
Q

what is choleecocholithiaiss

A

gall sotnses in common bile duct

38
Q

what is the role of the percutaneous transhepathic cholangiogarm

A

when ercp not possible due to duodeal obstuoi fo previous serve
hilar stengin
injects die into skin tgehn use ct to look at it

39
Q

what is main differece in ercp and ptc

A

ercp more invaise, it uses a dye injected into liver through skin, does not require endosocpty

40
Q

does mrcp use contrast

A

no

41
Q

what is endoscopic ultrasound

A

a tiney proe is enter into the skin and used for biypys

42
Q

what can endoscopic biopsy be used for

A

characterin pancreatic masses, stadging of tumours, fine needle aspiarto of tumor and cysts, excluding biliar mcirocalculi

43
Q

what can be found with a liver biopsy

A

certain conditions sucha s autoimmune hepatitis
confirm diagnos e.g. pbc, drug induced liver injury

important for staing of severity e.g. alcholich hepatis, nafld

44
Q

what is chornic liver diese

A

liver diase that lasts more than 6 months

45
Q

what are the causes of cirrhosis

A

alchol
autoimmune - primary biliary cholangitis, primary schlerosis cholangitis
haemochromatosi
chronci viral hepatisis b,c
non alcholic fatty liver disease
drugs - amiodarne
cysitic fibrosis, a1 antipyin difice, wilsons disese
vascualr probls - portal hypertion
cyrpotgenic
sacodois
amyloid
schistomiasis

46
Q

what pathological change is seen in liver as a result of cirrhosis

A

infilataiton of lymphocytes
apotopic heapcyts (enlagemnet and change in nucli)
kupffer cel acited
suinoi lumne with increased resistance to blood flow

47
Q

what are the presentaion of componseaeted chronic liver diseae

A

screening tests
abnomal liver funcion tests

48
Q

what are the presenation of decompansted liver disese

A

hepatorenal syndome
ascites
varicela bleeding
hepatic encephalopahty

49
Q

what are acites

A

fluid in the free space in abdomen

50
Q

how to confirm ascites

A

ultrasound

51
Q

what are the periphal signs of ascites

A

spiders neivie, palmar erythema, abdomial veins, fetor hepaticus, umilical nodule
jvp
flank haematoma

52
Q

what tests are needed for new onset asciteis

A

proetin and albumin concentation
cell count and differentials
sagg - serum
cell count

53
Q

what does 1.1g /dl cut of mean

A

if hte serum asice graide is great than 1.1g/ dl it is proal hyptension related
if less than 1.1. it is non portla hyperaion related

54
Q

causes of ascities

A

portal hypertension
Low serum albumin causing reduced plasma oncotic pressure
Hypoperfusion of the kidneys leading to activation of the renin-angiotensin system leading to salt and water retention

55
Q

what extra tests could be done for asciti fludi

A

tb culture
cytolgy
triglueride
bilirubuin

56
Q

cause of sagg above 1.1.

A

portal hypertoisn
chf
constrictive pericarditis
budd chiarri
myxedema
massive liver metates

57
Q

what cause sagg below 1.1

A

malignancy, tb, chylous asciteis, pancretic, biliary ascietes, nephrotic syndrome, serositis

58
Q

what are the treatment options for ascites

A

diuretics
large volume paracenties
tips
aquareetics
liver transplations

59
Q

what is heptarenoal sydrome

A

artiers in kidney deteriorate due to increase in rass, and the heart increase contagion due to tachycardia

60
Q

what cuawes heptaroenal syndoem

A

sever liver cirrhosis

61
Q

what is the treamte for heptaorenla syneom

A

vasosuppersi, liver transoalt , voluem exspantoin of albium

62
Q

what cuase viceral heamorages

A

portal hyperension

63
Q

where are portaoysmpysci astomsie

A

skin - caput medusa
oesophagel and gastric
rectal
posterial abdomal wall
stomal

64
Q

what are the varices with portal hyptension

A

caput medusae, rectal varices, oesophagel varcies

65
Q

whis the treatmen for varcies hemoargese

A

recussitiaon, iv treatnem, endocopy band ligation, teripressin for contoal, sengestilblakemore tube , tipss for rebleed after banding

66
Q

what is hepatic encephalopathy

A

confusion due to liver disease, due to toxin buildup

67
Q

what is seen with hepatic encoepy symptions

A

gi bleed, infection, constipation, dehydration,
Asterixis - flapping tremor
foetoer hepatics - choronci bad breath

68
Q

what is the terament for hepatic encephaly

A

underliing cause traament
antiboitix including neopycin and broad spectrino
laxatives - phsphe enemas nd lactulse

69
Q

what is the most common liver cancer

A

hepatoceluar carcinoma

70
Q

presenationof hepatcelluar carcinoma

A

abdmoial mass
abdomial pain
weight loss
bleeding form tumouur

71
Q

what ar the radiolical tests for hepatocellular carcinoma

A

ultrasound, ct, mri

72
Q

what are the turmor markers for heptacolluar carcinoma

A

afp

73
Q

treatment for hepaceluar carcinoma

A

hepatic rection
liver transpland
chemotharpy - local or systematic
alcohol injection
radioterhfatoin ablation
tki inhitoar
hormonal therapy

74
Q

ways to deliver local chaimrey

A

trasncatherter arterlial chemoa embolization

75
Q

tki infoar for hepacelluar carciaons

A

sorafenib

76
Q

hormone therapy for hepacelluar cancer

A

tamoxifen

77
Q

what is used to stop bleeding of oepsygal vercies

A

terrepressin

Alimentory System (31 decks)

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