Manifestations of Liver Disease Flashcards
Hepatocyte injury can be caused by………
viral infection, drugs or toxins, hypoxia, immunologic and structural disorders, or inborn errors of metabolism
Cholestasis is defined ………..
An alternative or concomitant response to injury caused by extrahepatic or intrahepatic obstruction to bile flow.
Substances that are normally excreted in bile, such as bile acids, conjugated bilirubin, cholesterol, and trace elements, accumulate in serum
In extrahepatic obstruction …..characteristics
Bile pigment may be visible in the intralobular bile ducts or throughout the parenchyma as bile lakes or infarcts
Definition of Cirrhosis……
Cirrhosis, defined histologically by the presence of bands of fibrous tissue that link central and portal areas and form parenchymal nodules, is an end stage of any acute or chronic liver disease
Type of cirrhosis ,……..?
Cirrhosis can be macronodular, with nodules of various sizes (up to 5 cm) separated by broad septa, or
micronodular, with nodules of uniform size (<1 cm) separated by fine septa;
mixed forms occur.
When do u say henpatomegaly in neonate……
In a newborn infant, extension of the liver edge more than 3.5 cm below the costal margin in the right midclavicular line suggests hepatic enlargement
jaundice in children and adults occurs when the serum concentration of bilirubin reaches….
2-3 mg/dL
Pathogenicity of spider angiomas…..
They presumably reflect altered estrogen metabolism in the presence of hepatic dysfunction
Palmar Erythema……..?
Abnormal serum estradiol levels and regional alterations in peripheral circulation have been identified as possible causes.
Portal Hypertension…….? Definition
Normal portal pressure is between 1 and 5 mm Hg.
Portal hypertension is defined as a portal pressure greater than or equal to 6 mm Hg.
Clinically significant portal hypertension exists when pressure exceeds a threshold of 10-12 mm Hg
Hepatorenal syndrome definition…….?
Hepatorenal syndrome is defined as functional renal failure in patients with end-stage liver disease.
Pathophysiology of hepatorenal syndrome…..?
It is related to splanchnic vasodilation, mesenteric angiogenesis, and decreased effective blood volume with resulting decreased renal perfusion.
The diagnosis is supported by the findings of….. in hepatorenal syndrome….?
oliguria (<1 mL/kg/day), a characteristic pattern of urine electrolyte abnormalities (urine sodium <10 mEq/L, fractional excretion of sodium of <1%, urine: plasma creatinine ratio <10, and normal urinary sediment), absence of hypovolemia, and exclusion of other kidney pathology
The best treatment of hepatorenal syndrome…..?
Liver transplantation, with complete renal recovery expected.
Hepatopulmonary syndrome (HPS) is characterized ……?
Triad of
hypoxemia,
intrapulmonary vascular dilations, and
liver disease
Reason for HPS syndrome ……..?
Shunting of vasodilatory mediators from the mesentery away from the liver is thought to contribute
Treatment for HPS……..?
Liver transplant
Recurrent Cholangitis the most common cause…….?
Gram-negative enteric organisms such as Escherichia coli, Klebsiella, Pseudomonas, and Enterococcus
Sensitive indicators of obstruction or inflammation of the biliary tract……..?
Elevations in serum AP, 5′ nucleotidase, and GGT levels
Which is liver specific enzyme….?
Alanine aminotransferase (ALT, serum glutamate pyruvate transaminase)SGPT
A several thousand–fold elevation of liver enzymes etiology……can result from
acute viral hepatitis,
toxic injury (e.g., acetaminophen),
hypoxia, or
hypoperfusion
AST >ALT…….causes!
alcohol-induced liver injury,
fulminant echovirus infection, and
various metabolic diseases
ALT>AST……causes. .?
Acute hepatitis
AST and ALT elevations may be less marked in which conditions…….?
In chronic liver disease or
in intrahepatic and extra-hepatic biliary obstruction
vitamin K–dependent factors …….
II, VII, IX, and X
Persistently low levels of which factor are evidence of a poor prognosis in patients with fulminant liver disease
factor VII
