Session 6- Liver Function and Patholgy

Question 1

what can cause acute liver failure

Answer 1

alcohol
paracetamol
viral
medications

Question 2

what is cirrohosis

Answer 2

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

Question 3

symptoms of liver failure

Answer 3

jaundice
oedema
ascites
bleeding
confusion

Question 4

what is wilsons disease

Answer 4

reduced copper secretion

increased deposition

Question 5

portal circulation

Answer 5

network of veins that drain via the liver into the IVC

Question 6

what drains the descending colon

Answer 6

inferior mesenteric vein

Question 7

what drains the ascending colon and midgut structures

Answer 7

superior mesenteric vein

Question 8

pathophysiology behind ascites

Answer 8

when liver tissue becomes fibrotic it compresses the veins entering the liver from portal veins system.

This increases hydrostatic pressure therefore causing ascites

Question 9

what does portal hypertension cause

Answer 9

oesophageal varices

splenomegaly

ascites- increased hydrostatic pressure

Question 10

where do ano-rectal varices develop

Answer 10

between superior and middle and inferior rectal veins

Question 11

what does the superior rectal vein drain into

Answer 11

inferior mesenteric vein which drains into portal vein

Question 12

what do the middle and inferior rectal veins drain

Answer 12

drain into internal iliac vein into the IVC

Question 13

what does the umbilical vein become

Answer 13

ligamentum teres

Question 14

what is caput medsae

Answer 14

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.‌

Question 15

what is hepato renal syndrome

Answer 15

portal hypertension

arterial vasodilatation to decrease pressure

percieved reduced circulating blood volume

RAAS

renal artery vasoconstriction- reduced perfusion- reduced function

Question 16

how do oesophageal varices develop

Answer 16

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

Question 17

where do the upper 2/3 of the oesophagus drain

Answer 17

azygous vein into the SVC

Question 18

where do teh distal portions of the oesophagus drain

Answer 18

left gastric vein -> portal vein

Question 19

murpheys sign

Answer 19

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.

Question 20

what do gallstones consist of

Answer 20

cholesterol
bile pigments
mixed

Question 21

risk factor for gall stones

Answer 21

diet
female
pregnancy

Question 22

biliary colic

Answer 22

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

Question 23

acute cholecystitis

Answer 23

fully impacted cystic duct

positive murphys sign

inflammation

Question 24

ascending cholangitis

Answer 24

Charcots triad

• RUQ pain
• Inflammation
• Jaundice

Question 25

acute pancreatitis

Answer 25

stone in the bile duct either after/ at the point at which the pancreatic duct joins with the bile duct

in distant bilary tree

Question 26

symptoms of acute pancreatitis

Answer 26

autodigestion
epigastric pain which radiates to the back ( retroperitoneal structure)
vomiting

Question 27

stages of acute liver disease

Answer 27

fatty change
alcohol hepatitis
jaundice
tender hepatomegaly

Question 28

what is NAFLD

Answer 28

Non alcoholic fatty liver disease

stimulated by obesity, diabetes, metabolic syndrome rather than alcohol

Question 29

common cause of portal hypertension

Answer 29

cirrhosis

Question 30

why do gall stones develop

Answer 30

certain components of bile coming out of solution to form a solid

Question 31

what causes cholangitis

Answer 31

if a gallstone moves into the CBD and becomes impacted