Session 6- Liver Function and Patholgy Flashcards
what can cause acute liver failure
alcohol
paracetamol
viral
medications
what is cirrohosis
Permanent irreversible damage of the liver that results in impairments of liver function and disortion of shape and structure. It is result of chronic inflammation.
Fibrous bands of liver and hepatocyte necrosis- nodules
symptoms of liver failure
jaundice oedema ascites bleeding confusion
what is wilsons disease
reduced copper secretion
increased deposition
portal circulation
network of veins that drain via the liver into the IVC
what drains the descending colon
inferior mesenteric vein
what drains the ascending colon and midgut structures
superior mesenteric vein
pathophysiology behind ascites
when liver tissue becomes fibrotic it compresses the veins entering the liver from portal veins system.
This increases hydrostatic pressure therefore causing ascites
what does portal hypertension cause
oesophageal varices
splenomegaly
ascites- increased hydrostatic pressure
where do ano-rectal varices develop
between superior and middle and inferior rectal veins
what does the superior rectal vein drain into
inferior mesenteric vein which drains into portal vein
what do the middle and inferior rectal veins drain
drain into internal iliac vein into the IVC
what does the umbilical vein become
ligamentum teres
what is caput medsae
Cluster of swollen veins in your abdomen. The swelling usually appears around the belly button, and the veins branch out from a central point. They are typically painless, but they are a symptom of circulatory problems that are often related to liver disease.
what is hepato renal syndrome
portal hypertension
arterial vasodilatation to decrease pressure
percieved reduced circulating blood volume
RAAS
renal artery vasoconstriction- reduced perfusion- reduced function
how do oesophageal varices develop
where the upper 2/3 of the oesophagus drain into the azygous vein into the SVC CROSS the junction with the left gastric vein pressure builds up and the veins dilate and vause varices.
They can rupture and cause Haemoptysis
where do the upper 2/3 of the oesophagus drain
azygous vein into the SVC
where do teh distal portions of the oesophagus drain
left gastric vein -> portal vein
murpheys sign
elicited in patients with acute cholecystitis by asking the patient to take in and hold a deep breath while palpating the right subcostal area. If pain occurs on inspiration, when the inflamed gallbladder comes into contact with the examiner’s hand, Murphy’s sign is positive.
what do gallstones consist of
cholesterol
bile pigments
mixed
risk factor for gall stones
diet
female
pregnancy
biliary colic
RUQ pain in abdomen due to stones obstructing the cystic duct or common bile duct
usually occurs after eating a meal as CCK is released which makes the gall bladder move and contract and pushes gall stone up against the neck of gall bladder- PAIN
no inflammation
acute cholecystitis
fully impacted cystic duct
positive murphys sign
inflammation
ascending cholangitis
Charcots triad
- RUQ pain
- Inflammation
- Jaundice
acute pancreatitis
stone in the bile duct either after/ at the point at which the pancreatic duct joins with the bile duct
in distant bilary tree
symptoms of acute pancreatitis
autodigestion
epigastric pain which radiates to the back ( retroperitoneal structure)
vomiting
stages of acute liver disease
fatty change
alcohol hepatitis
jaundice
tender hepatomegaly
what is NAFLD
Non alcoholic fatty liver disease
stimulated by obesity, diabetes, metabolic syndrome rather than alcohol
common cause of portal hypertension
cirrhosis
why do gall stones develop
certain components of bile coming out of solution to form a solid
what causes cholangitis
if a gallstone moves into the CBD and becomes impacted
