Pathogenesis of Acute and Chronic Liver Failure Flashcards

1
Q

Most common cause of acute liver failure

  1. Worldwide
  2. North America
A
  1. Viral

2. Drug

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2
Q

Pathogenesis of viral hepatitis

A

Secondary to immune response to infection

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3
Q

Pathogenesis of drug and toxin injury to ive

A

Acetaminophen makes toxic metabolites when oversaturated enzymes
Other reactions are idiosyncratic

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4
Q

What is one symptom when someone has acute liver failure from acetaminophen that points to need for transplant?

A

Encephalopathy (grade 3 or 4)

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5
Q

Symptoms of chronic liver disease decompensation

A
Encephalopathy (confusion)
Spare body hair
Spider angioma
Muscle wasting
Dilated vessels
Red palms
Ascites
Jaundice
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6
Q

What cells cause liver fibrosis?

A

Stellate cells

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7
Q

Pathophys of portal hypertension

A

Splanchnic vasodilation causes a decrease in effective circulating volume
RAAS increases causing renal vasoconstriction
Cardiac output increases and systemic vascular resistance decreases

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8
Q

4 MELD criteria used for transplant listing

A

INR
Bilirubin
Creatinine
Na

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9
Q

Signs of encephalopathy

A

Decreased LOC
Slurred speech all the way to coma
Asterixis

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10
Q

Mechanism of hepatic encephalopathy

A

Increased GABA activity

Hyperammonemia from gut, false gut NTs (mechanisms unknown)

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11
Q

How to treat encephalopathy

A

Correct precipitating events
Lactulose (trap ammonia)
Intra-lumenal antibiotics

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