Symptoms of liver disease

Question 1

What are the symptoms in early stages

Answer 1

Non-specific: Weakness, fatigue, general malaise (unwell)

Question 2

As the disease progresses, a poor nutrition status would result in:

Answer 2

Chronic: weight loss and anorexia,
Advanced: loss of muscle bulk

Question 3

Other symptoms of a progressed disease status:

Answer 3

Abdominal discomfort, pain, tenderness over the liver, jaundice

Question 4

There are also Cutaneous signs on the skin:

Answer 4

Hyperpigmentation (darker pathces), scratch marks, Spider naevus(surface vessels), and also non-specific symptoms like nail changes, finger clubbing, palmar erythema, and Dupuytren’s contracture which is involuntary contration of the fingers towards the palm.

Question 5

What are the abdominal signs of Liver disease?

Answer 5

Distension, Hepatomegaly, Splenomegaly, Umbilical and Paraumbilical Veins

*megaly: enlargment

Question 6

An obvious sign of Liver disease:

Answer 6

Jaundice where the breakdown of RBCs is impaired, and there is an increased level of Birilium circulating the blood

Question 7

What are the symptoms of Jaundice?

Answer 7

Yellowing of the sclerae in the eye, and the skin.
Pruritis - itchiness due to deposition of bile salts in the skin
(The concnetraion of bile salts in the skin does not correlate with severity of the Pruritis i.e. colud have little bile salts but lot of itchiness)

Question 8

What are the different causes of Jaundice?

Answer 8

Hepatocellular: drugsm hepatitis, Tumours
Cholestatic: Obstruction of bile release
Prehepatic: Increased blood breakdown

Question 9

If the jaundice is caused by Cholestatic conditions, what are the treatment optins?

Answer 9

Get the obstruction removed by endoscopy, radiology, or surgery.

Question 10

What are the treament options for Jaundice caused by conditions other than Cholestasis?

Answer 10

Pharmacological treatment

Question 11

Another symptom of Liver disease is Portal Hypertension which can lead to:

Answer 11

Chollateral vein formation (alternative route for the blood to flow to bypass the Portal Venous system) and the shunting of blood to the systemic circulation

Question 12

What does Portal Hypertension contribute to?

Answer 12

Formation of Ascites (fluid accumulation in the abdominal cavity), and the development of encephalopathy

Question 13

Complications of Portal hypertension will lead to

Answer 13

A variceal bleed - the veins in the oesophagus, stomach, rectum enlarge to accomodate the blocked blood flow.

Question 14

What other conditions apart from Portal hypertension can lead to Ascites?

Answer 14

Central hypovolaemia (decreased blood vlow), reduced serum albumin, Splanchnic artery vasodilation (relating to visceral organs)

Question 15

Other issues that occur are CLOTTING ABNORMALITIES which means:

Answer 15

The synthesis of defective clotting factors, with an increased tendancy to bleed.

Question 16

Hepatocyte failure will directly cause the defective synthesis of factors

Answer 16

I and V, increased risk of bleeding

Question 17

Hepatocyte Failure will also cause defective bile excretion leading to:

Answer 17

Malabsorption of Vitamin K, Defective synthesis of factors II, VII, IX, X, increased risk of bleeding

Question 18

Hypersplenism which is an overactive spleen will cause

Answer 18

Low platelets and increased tendancy to bleed.

Question 19

There are some endocrine changes due to liver disease most common in:

Answer 19

Alcoholic Liver disease

Question 20

Endocrine changes is thought to be due to

Answer 20

Poor metabolism of oeastrogen

Question 21

In males, the symptoms of Endocrine changes due to liver disease is

Answer 21

Testicular atrophy (diminish in size), female body hair, gynaecomastia (enlargment of breasts)

Question 22

In females the symptoms of Endocrine changes due to liver disease is

Answer 22

Menstrual irreguarity and reduced fertility.