SS1. Liver failure

Question 1

Explain liver failure

Answer 1

Liver failure is diagnosed when there’s evidence of ascites, failure of blood clotting & marked physiological changes.

Question 2

What components does liver failure affect?

Answer 2

Inflammation
Vascular disorders
Metabolic disease
Toxic injury
Neoplasms

Question 3

What are the 3 consequences of liver failure?

Answer 3

digestive effects

Effects on the blood & those concerning the excretion of toxic substances

Question 4

What happens to gluconeogenesis? (3)

Answer 4

It stops. The galactose levels rise because it’s not converted to glucose.
Bile production slows or ceases which impairs digestion and fat absorption
Hypoglycaemia develops
Ammmonia levels rise

Question 5

What happens to plasma proteins during liver failure?

Answer 5

They’re impaired, leads to loss of albumin and certain globulins. If total plasma protein falls, reduction in oncotic pressure is seen, leading to generalised oedema or ascites

Question 6

What happens to enzymes during liver failure?

Answer 6

The enzymes within hepatocytes enter blood cells, such as transaminases, phosphatases, lactate dehydrogynase.

Question 7

What happens with the pathway of bilirubin excretion?

Answer 7

It’s blocked unbound unconjugated bilirubin accumulates in plasma causing jaundice development.
In neonates, it can accumulate in basal ganglia of the brain, resulting in kernicterus.

Question 8

What happens with clotting factor productions when there’s liver failure?

Answer 8

the production will fall, leads to impariment of blood clotting which can result in spontaneous bleeding from skin & membranes.

Question 9

What happens with chronic liver failure?

Answer 9

Normal tissue replaced by fat and fibrous tissue. Increases vascular resistance resulting in portal hypertension.
The venous anastomones linking portal & circulation dilates & form swollen veins/varices. May rupture.

Question 10

What happens with detoxification during liver failure?

Answer 10

It’s unable to perform, can result in drug actions to be prolonged, disturbances in gonadal function & gynaecomastia in males. Sometimes Cushing’s.

Question 11

How can liver failure be treated?

Answer 11

All physiological processes must be addressed.
Alcohol cirrhosis: stop alcohol intake, increase carbohydrate & calories, correct fluid and elecrtolyte imbalance, limited protein intake.