Module 6: Hepatobilary system

Question 1

define alcohol liver disease

Answer 1

fatty deposition resulting from alcohol consumption contributes to alcoholic liver disease which can progress from fatty liver to alcoholic hepatitis and finally to alcoholic cirrhosis

Question 2

Alcoholic liver cirrhosis two most common causes

Answer 2

hepatitis C and alcoholism

Question 3

Alcohol liver cirrhosis

Answer 3

impairs the hepatocytes ability to metabolise and remove a range of potentially harmful substances from the bloodstream

Question 4

Clinical manifestations of alcohol liver cirrhosis

Answer 4

ascities
gastrointestinal haemorrhage
portal hypertension
hepatic encephalopathy
oesophageal varices

Question 5

hepatitis which is inflammation of the liver is caused by

Answer 5

viral infection (hence the term hepatitis can commonly be referring to viral hepatitis

Question 6

What is viral hepatitis

Answer 6

an infection of the liver caused by a strain of the hepatitis virus (A, B or C) are the most common in Australia and NZ

Question 7

How can hepatitis be acquired and what are the clinical manifestations

Answer 7

acquired from injesting contaminated food and manifestates with:
fever
abdomnal pain
jaundice

Question 8

Although they differ with respect to modes of transmission and severity of acute illness, all types of viral hepatitis can cause what and what do these changes cause

Answer 8

can cause hepatic cell necrosis, kupffer cell hyperplasia and inflitration of liver tissue by mononuclear phagocytes. These changes obstruct bile flow and impair hepatocyte function

Question 9

State the clinical manifestations of viral hepatitis according to the staging

Answer 9

pre-icteric phase (stage 1): fever, malaise, anorexia, liver enlargement and tenderness
Stage 2: Jaundice and hyperbilirubinaemia
recovery phase (stage 3): symptoms resolve. Recovery takes several weeks

Question 10

what is chronic hepatitis

Answer 10

it is a complication of hepatitis B or C virus. It causes widespread hepatic necrosis and is often fatal

Question 11

true or false: hepatitis predisposes patients to mestatic invasion of the liver and this is more common than prmary cancer of the liver

Answer 11

true

Question 12

what is portal pressure

Answer 12

elevation of portal venous pressure, cause by increased resistance to venous flow in the port vein, including the sinusoids and hepatic vein

Question 13

what is the most common cause of portal hypertension

Answer 13

liver cirrhosis

Question 14

what is the most serious complication of liver disease and why

Answer 14

portal hypertension because it can cause potentially fatal complications such as blledding varicose, ascities and hepatic encephalopathy

Question 15

Define ascities

Answer 15

the accumulation and seuestration of fluid in the peritoneal cavity, often as a result of portal hypertension and decreased concenctations of plasma proteins.

Question 16

What is hepatic encepalopathy

Answer 16

impaired cerebral function caused by blood-borne toxins (particulally ammonia) not being metabolised by the liver.
Toxin baring blood may bypass the liver in collateral vessels opened as a result of portal hypertension or diseased hepatocytes may be unable to carry out their metabolic fuctions

Question 17

Clinical manifestions of hepatic encephalopathy

Answer 17

confusion
memory loss
asterixis (flapping tremor of the hands), to
loss of consciousness 
coma 
death

Question 18

what is jaundice

Answer 18

(icterus) is a yellow or greenish pigmentation of the skin or sclera of the eyes caused by increases in plasma bilirubin concentration (hyperbilirubinaemia)

Question 19

Obstructive jaundice casued by

Answer 19

obstructed bile canaliculi (intrahepatic obstructive jaundice) or ostructed bile ducts outside the liver (etrahepatic obstructive jaundice) Bilirubin accumulates proximal to sites of obstruction, enters the bloodstream and is carried to the skin and deposited

Question 20

what is prehepatic jaundice

Answer 20

caused by destruction of red blood cells at a rate that exceeds the livers ability to metabolise bilirubin