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HANA Part 4 – PM4B > (SYNOPTIC) Liver Disease & Management > Flashcards

(SYNOPTIC) Liver Disease & Management Flashcards

1
Q

What percentage of the liver is comprised of hepatocytes?

A

60%

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2
Q

How many blood supplies does the liver have?

A

2

~~~
Hepatic artery (from heart) OXYGEN RICH BLOOD
Portal vein (blood from the bowel)
NUTRIENT REACH BLOOD

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3
Q

What are the functions of the liver?

A

(1) Metabolism
(2) Synthesis
(3) Immunological
(4) Storage
(5) Secretion
(6) Homeostasis

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4
Q

What are some examples of substances metabolised in the liver?

A
  • Products of digestion
  • Bilirubin (yellowish substance made during your body’s normal process of breaking down old red blood cells.)
  • Steroid hormone
  • Insulin
  • Aldosterone
  • Vitamin D
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5
Q

What is synthesised in the liver?

A
  • bile and bile salts?
    Plasma proteins
  • Clotting factors
  • Cholesterol
  • Urea (from amino acids)
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6
Q

What is stored in the liver?

A
  • Fat soluble vitamins
  • Glycogen
  • Blood reservoir
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7
Q

What is secreted in the liver?

A

Bile + bile salts

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8
Q

What is the function of the liver in homeostasis?

A

Glucose regulation

Conversion of glucose to glycogen

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9
Q

What are some potential causes for chronic liver disease?

A
  • alcohol
  • NAFLD/ NASH
    ø Non-alcoholic fatty liver disease
  • immune/ autoimmune
  • drugs
  • malignancy
  • HCV/ HBV
    ø Hep C + Hep V
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10
Q

What are some potential causes for acute liver disease?

A

~~~
- HAV/ HBV/ HEV
ø 3rd trimester of pregnancy
- Drugs
- TPN: a method of feeding that bypasses the gastrointestinal tract. A special formula given through a vein provides most of the nutrients the body needs
- Infection, e.g. malaria
- Ischaemia: condition in which blood flow (and thus oxygen) is restricted or reduced in a part of the body.
- Alcoholic hepatitis
- Acute fatty liver of pregnancy
( is a rare but serious condition that can occur in pregnant women, especially during the third trimester. It is characterized by the accumulation of fat in the liver, which can lead to liver dysfunction and failure if left untreated)

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11
Q

What increases risk of non-alcoholic fatty liver disease?

A
  • T2DM
  • Obesity
  • Dyslipidaemia
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12
Q

What may be the first presentation of NAFLD?

A

Cirrhosis

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13
Q

What is the non-pharmacological management of NAFLD?

A
  • Weight loss
  • Healthy diet
  • Exercise
  • Smoking/ alcohol cessation
  • 2-3 cups of black coffee daily
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14
Q

What is the pharmacological management of NAFLD?

A
  • Statins

- Treat HTN/ T2DM

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15
Q

What co-morbidities can make a HepC (HCV) infection worse?

A

(1) HIV
(2) Underlying cirrhosis
(3) Liver transplant
(4) Lifestyle

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16
Q

What is the process of chronic liver disease development?

A

(1) Insult
- e.g. toxin/ virus
(2) Hepatitis or steatohepatitis (more severe form of nonalcoholic fatty liver disease)

(3) Reversible
- if cause is stopped, e.g. alcohol cessation
(4) If insult is not removed
(5) Fibrosis
- scarring + thickening of smooth muscle
(6) Cirrhosis

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17
Q

What is the general classification of liver disease?

A

(1) Compensated
- Asymptomatic due to medication/ sufficient healthy liver tissue for normal function
(2) Decompensated
- Symptomatic

In short, “compensated” indicates that the body is able to maintain its normal functioning despite a health condition, while “decompensated” indicates that the body is struggling to maintain that normal functioning and may require more intensive medical intervention.

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18
Q

What is a liver function test?

A

Used to identify patients struggling with liver/ biliary tract disease

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19
Q

What is a downside of liver function tests when checking for liver disease?

A

Some LFTs reflect liver DAMAGE rather than function

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20
Q

What results from a liver function test are considered a cause for concern?

A

3 times the upper limit of normal

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21
Q

How should a liver function test be used?

A

(1) Look for trends

(2) Do not use in isolation

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22
Q

What would a liver function test (LFT) show in acute hepatocellular damage?

A 
HIGH - plasma ALT
HIGH - plasma AST
HIGH - bilirubin (unconjugated)
PROLONGED - prothrombin time: a test to evaluate blood clotting
NORMAL -

Acute hepatocellular damage refers to injury or damage to the liver cells (hepatocytes) that occurs over a short period of time, usually within a few days or weeks

Elevated levels of liver enzymes: Alanine transaminase (ALT) and aspartate transaminase (AST) are enzymes that are found predominantly in liver cells. In acute hepatocellular damage, the levels of these enzymes in the blood can be significantly elevated, indicating that liver cells are being damaged or destroyed.

Elevated bilirubin levels: Bilirubin is a waste product that is produced when red blood cells break down. It is normally processed by the liver and excreted in the bile. In acute hepatocellular damage, the liver may not be able to process bilirubin properly, leading to an increase in the level of bilirubin in the blood. This can cause jaundice, a yellowing of the skin and eyes.

Abnormal clotting function: The liver produces several proteins that are involved in blood clotting. In acute hepatocellular damage, the liver may not be able to produce these proteins properly, leading to abnormal clotting function and an increased risk of bleeding.

Decreased albumin levels: Albumin is a protein that is produced by the liver and helps to maintain the osmotic pressure of blood. In acute hepatocellular damage, the liver may not be able to produce enough albumin, leading to a decrease in its level in the blood.

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23
Q

What would a liver function test (LFT) show in chronic hepatocellular damage?

A

NORMAL - ALT
NORMAL - AST
LOW - albumin
PROLONGED - prothrombin time

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24
Q

What would a liver function test (LFT) show in cholestasis (blockage of bile duct)?

A

HIGH - plasma ALP

Cholestasis is a condition in which the flow of bile from the liver to the small intestine is disrupted, leading to the accumulation of bile in the liver and an increase in the levels of bilirubin and alkaline phosphatase (ALP) in the blood.

Bile contains many substances, including bile salts, cholesterol, and bilirubin, and is released into the small intestine to aid in the digestion and absorption of fats.

HIGH - bilirubin (conjugated)

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25
Q

What other investigations can be done alongside a liver function test (LFT)?

A

(1) Ethanol
(2) Drug history
(3) FBC
(4) Clotting
(5) U+Es (urea and electrolytes?)
(6) Liver ultrasound
(7) Biopsy
(8) Liver screen
- if obstruction ruled out
- check for viral causes

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26
Q

How is acute liver failure graded?

A

(1) Hyperacute
- 6-7 days
(2) Acute
- 8-28 days
(3) Subacute
- 29-84 days

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27
Q

In which liver failure grade(s) is cerebral oedema rare?

A

Subacute

swelling of the brain

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28
Q

In which liver failure grade(s) is cerebral oedema common?

Hyperacute/ acute/ subacute

A

(1) Hyperacute

(2) Acute

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29
Q

What is the prognosis for each liver failure grade?

A

Hyperacute - moderate
Acute - Poor
Subacute - Poor

prognosis: chance of recovery

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30
Q

What is used to grade chronic liver disease?

A

(1) Child’s Pugh Score

(2) MELD
- Model for end-stage liver disease
- OR UKELD

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31
Q

What are the grades for chronic liver disease using the Child’s Pugh Score?

A

(1) A 5-6 points COMPENSATED
(2) B 7-9 MODERATE
(3) C 10-15 ADVANCED

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32
Q

What is the MELD score used for?

A

Determining the mortality of end-stage liver disease

MELD score is a scoring system used to assess the severity of liver disease and the risk of mortality in patients with chronic liver disease, as well as those with acute liver injury or failure

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33
Q

What are some common symptoms of liver disease?

A

(1) Jaundice - yellowing of eye
(2) Spider nevi in upper chest (small, reddish or bluish spider-like blood vessels that appear on the skin)
(3) Ascites - accumulation of fluid in peritoneal cavity
(4) Clubbing of nails
(5) Dilated abdominal veins
(6) Ankle oedema
(7) Bleeding tendency due to decreased prothrombin time

Normally, the liver produces a protein called albumin that helps to maintain the balance of fluids in the body. When the liver is damaged or diseased, it may not produce enough albumin, leading to fluid accumulation in the legs and ankles.

Liver disease can cause changes to blood vessels of skin. s. One of the primary mechanisms is the buildup of toxins in the blood that are normally cleared by the liver.

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34
Q

Which blood vessel brings blood to the liver from the heart?

A

Hepatic artery

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35
Q

Which blood vessel brings blood to the liver from the bowel?

A

Portal vein

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36
Q

How many general functions of the liver are there?

A

6

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37
Q

What are the general functions of the liver?

A

(1) Homeostasis
(2) Storage
(3) Metabolism
(4) Immunological
(5) Secretion
(6) Synthesis

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38
Q

Name some causes of chronic liver disease.

A
  • Alcohol
  • NASH/ NAFLD
  • Drugs
  • Malignancy
  • Autoimmune
  • HCV/ HBV
  • Metabolic, e.g. haemochromatosis
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39
Q

Name some causes of acute liver disease.

A
  • Drugs
  • TPN
  • Ischaemia
  • Infection
  • Alcoholic hepatitis
  • Acute fatty liver of pregnancy
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40
Q

What is non-alcoholic fatty liver disease?

A

A range of liver diseases

From simple fatty liver -> Non-alcoholic seato-hepatitis -> Fibrosis/ cirrhosis

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41
Q

What are some risk factors for NAFLD?

A
  • Diabetes
  • Obesity
  • Dyslipidaemia (metabolic syndrome)
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42
Q

What is the non-pharmacological management for NAFLD?

A
  • Weightloss
  • Healthy diet
  • Exercise
  • Stop smoking/ alcohol
  • 2-3 cups of black coffee daily
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43
Q

What is the pharmacological management for NAFLD?

A
  • Treat BP
  • Treat diabetes
  • Statins
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44
Q

What patient groups are at higher risk of Hepatitis B?

A
  • IV drug users
  • Casual sex
  • Close family members
  • Babies born to infected mothers
  • HCPs
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45
Q

What are the stages of progression of chronic liver disease?

A

(1) Insult
- e.g. toxin/ virus

(2) Hepatitis/ steatohepatitis

(3) Reversible
- liver is regenerating

(4) Insult not removed

(5) Fibrosis
- thickening + scarring

(6) Cirrhosis
- chronic liver disease

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46
Q

What is compensated chronic liver disease?

A

Asymptomatic

Sufficient meds/ tissue to continue normal function

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47
Q

What is decompensated chronic liver disease?

A

Symptomatic

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48
Q

What result of a LFT is considered to be cause for concern?

A

3x upper limit of normal

49
Q

What LFT results would be expected in acute hepatocellular damage?

A
  • Large rise in ALT + AST
  • 2y rise in unconjugated bilirubin
  • Prolonged PT
  • Normal albumin
50
Q

What LFT results would be expected in chronic hepatocellular damage?

A
  • Fairly normal ALT + AST
  • Prolonged PT
  • Low albumin
51
Q

What LFT results would be expected in cholestasis?

A
  • Rise in ALP

- Rise in conjugated bilirubin

52
Q

What is cholestasis?

A

Blockage of the bile duct

53
Q

Name some other investigations that can be carried out to determine liver damage/ function, alongside LFTs.

A
  • Ultrasound of liver
  • Biopsy
  • Liver screen (if known no obstruction)
54
Q

What are the grades of acute liver failure?

A

(1) Hyperacute
(2) Acute
(3) Subacute

55
Q

How many grades of acute liver failure are there?

A

3

56
Q

What is the time from jaundice to encephalopathy in hyperacute liver failure?

A

6-7 days

Encephalopathy is a broad term that refers to a group of disorders that affect the functioning of the brain

57
Q

What is the time from jaundice to encephalopathy in acute liver failure?

A

8-28 days

58
Q

What is the time from jaundice to encephalopathy in subacute liver failure?

A

29-84 days

59
Q

In which grades of acute liver failure is cerebral oedema common?

A
  • Hyperacute

- Acute

60
Q

When does renal failure occur in hyperacute liver failure?

A

Early

61
Q

When does renal failure occur in acute liver failure?

A

Late

62
Q

When does renal failure occur in subacute liver failure?

A

Late

63
Q

What is ascites?

A

Abnormal fluid buildup in the abdomen.

64
Q

In which acute liver failure types is coagulation disorder considered marked?

A

Hyperacute and acute

Coagulation disorders, also known as bleeding disorders, occur when the blood’s ability to clot is impaired

These conditions can cause a significant decrease in the production of clotting factors by the liver, leading to an increased risk of bleeding and coagulopathy.

65
Q

What is the prognosis of hyperacute liver failure?

A

Moderate

66
Q

What is the prognosis of acute liver failure?

A

Poor

67
Q

What is the prognosis of subacute liver failure?

A

Poor

68
Q

What is the Child’s Pugh Score used for?

A

Grading of chronic liver disease (cirrhosis)

69
Q

How is cirrhosis graded?

A

(1) Child’s Pugh Score

(2) MELD/ UKELD

70
Q

Name some symptoms of liver cell failure.

A
  • Coma
  • Spider nevi
  • Gynecomastia
    ø enlargement of male breasts
  • Jaundice
  • Ascites
  • Loss of sexual hair
  • Testicular atrophy
  • Bleeding tendency
    ø decreased prothrombin
  • Anaemia
  • Ankle oedema
71
Q

Name some symptoms of portal hypertension.

A
  • Oesophageal varices
  • Gastropathy
    ø melaena
  • Splenomegaly
  • Dilated abdominal veins
  • Ascites
  • Haemorrhoids (rectal varices)

The most common cause of portal hypertension is liver cirrhosis, which is a chronic liver disease that causes scarring and damage to the liver tissue

Portal hypertension is a medical condition that occurs when there is increased pressure within the portal venous system, which is responsible for carrying blood from the digestive organs (such as the stomach, intestine, spleen, and pancreas) to the liver.

The most common cause of portal hypertension is liver cirrhosis, which is a chronic liver disease that causes scarring and damage to the liver tissue. Other causes of portal hypertension include blood clots in the portal vein, parasitic infections, and tumors.

The increased pressure in the portal vein can cause blood to back up into other blood vessels, leading to a variety of complications, such as:

Varices: swollen veins in the esophagus, stomach, or rectum that can rupture and cause life-threatening bleeding.

Ascites: accumulation of fluid in the abdomen, which can cause discomfort, difficulty breathing, and an increased risk of infection.

Splenomegaly: enlargement of the spleen due to increased blood flow, which can cause low platelet counts and anemia.

Hepatic encephalopathy: a condition in which toxins that are normally removed by the liver build up in the bloodstream and affect brain function, causing confusion, forgetfulness, and other symptoms.

Treatment of portal hypertension depends on the underlying cause and may include medications to reduce blood pressure, procedures to remove or treat varices, and liver transplantation in severe cases.

Cirrhosis is considered a chronic disease because it develops gradually over time and is usually not diagnosed until significant damage has occurred. The liver has the ability to regenerate damaged tissue, but when the damage is severe and ongoing, the liver cannot keep up with the repair process, leading to the accumulation of scar tissue

Varices: swollen veins in the esophagus, stomach, or rectum that can rupture and cause life-threatening bleeding.

Ascites: accumulation of fluid in the abdomen, which can cause discomfort, difficulty breathing, and an increased risk of infection.

Splenomegaly: enlargement of the spleen due to increased blood flow, which can cause low platelet counts and anemia.

Hepatic encephalopathy: a condition in which toxins that are normally removed by the liver build up in the bloodstream and affect brain function, causing confusion, forgetfulness, and other symptoms.

72
Q

What are some causes of ascites?

A
  • Impaired aldosterone metabolism
  • Low albumin
  • Reduced renal blood flow
  • Portal hypertension
  • Increased hepatic lymph production
73
Q

Which drugs, generally, can exacerbate ascites and peripheral oedema?

A
  • NSAIDs
  • Salt
  • Saline
74
Q

What is the treatment for ascites?

A

(1) Fluid + salt restriction

(2) Spironolactone
- aldosterone antagonist

(3) Furosemide
- for peripheral oedema

(4) Paracentesis
- Removal of peritoneal fluid

(5) TIPSS
- connect portal vein to hepatic vein in the liver

(6) Peritoneo-venous shunt
- peritoneal fluid from peritoneum into veins

75
Q

What is hepatic encephalopathy?

A

Reversible changes in mental state

2y to failure of liver, due to inability to metabolise toxins

76
Q

What are the stages of hepatic encephalopathy?

A

(1) Forgetfulness/ confusion/ agitation
- >
(4) Coma + unresponsive to painful stimulus

77
Q

How many stages of hepatic encephalopathy are there?

A

4

78
Q

What is the treatment of hepatic encephalopathy?

A
  • Remove/ avoid precipitants
  • Reduce protein intake
  • Decrease bacterial ammonia production
  • Increase elimination of bacteria ammonia production

Hepatic encephalopathy (HE) is a condition that occurs when the liver is unable to remove toxins, such as ammonia, from the blood. Elevated levels of ammonia in the blood can lead to neurological symptoms, including confusion, disorientation, and personality changes.

in patients with liver dysfunction, such as those with cirrhosis or hepatitis, the liver is not able to efficiently process these toxins, leading to an accumulation of ammonia in the bloodstream.

In patients with hepatic encephalopathy, the role of colonic bacteria in ammonia production is particularly important. This is because these patients often have a higher abundance of ammonia-producing bacteria in their gut microbiome compared to healthy individuals.

79
Q

What is the pharmacological treatment for hepatic encephalopathy?

A

(1) Lactulose
- prevents constipation, inhibits colonic bacteria

(2) Phosphate enemas

(3) Rifaximin
- poorly absorbed Abx, eliminates colonic bacteria

80
Q

What is pruritus?

A

Severe itching of the skin

81
Q

How does chronic liver failure cause pruritus?

A
  • Bile acid build up in the skin
82
Q

What is the pharmacological treatment for pruritus, secondary to liver failure?

A

(1) Chlorphenamine, be careful due to masking hepatic encephalopathy
(2) Menthol in aqueous cream

83
Q

How is VTE risk evaluated in liver failure?

A

PT

Prothrombin time

84
Q

Which administration route should be avoided in VTE, secondary to liver failure?

A

IM

Can lead to haematoma

85
Q

What is a variceal haemorrhage?

A

A variceal hemorrhage is a medical emergency that occurs when a swollen vein (varix) in the esophagus, stomach, or rectum ruptures and bleeds profusely.

86
Q

What causes a variceal haemorrhage?

A

(1) Decrease blood flow through liver
(2) Portal HTN (>12mmHg)
(3) Collateral vessels: network of small blood vessels?
(4) GIT varices

Variceal hemorrhage is caused by the rupture of enlarged, weakened blood vessels called varices. Varices are most commonly found in the esophagus and stomach, and are usually caused by portal hypertension

87
Q

What is DILI?

A

Drug induced liver injury

88
Q

What are the types of DILI?

A

(1) Type A - intrinsic

(2) Type B - idiosyncratic

89
Q

Describe Type A (intrinsic) DILI (drug induced liver injury)

A

-Type A (intrinsic) drug-induced liver injury (DILI) is a type of liver injury that occurs as a result of a direct toxic effect of a medication on liver cells.

Predictable
- Dose related
- Occurs rapidly
- Causes necrosis/ acute liver
- Can occur at lower doses if LD already
- Direct toxicity of drug/ metabolite
- Often identified in clinical trials
- Reproducible in animal models

90
Q

Describe Type B (idiosyncratic) DILI.

A

Type B (idiosyncratic) drug-induced liver injury (DILI) is a type of liver injury that occurs as a rare, unpredictable reaction to a medication, even when taken at recommended doses. This type of liver injury is not related to the dose or duration of the medication, but rather to the individual’s unique genetic, immune, or metabolic factors that make them susceptible to liver injury.

  • Unpredictable
  • May/ may not be dose related
  • Tends to take longer to occur (weeks->months)
  • Often more frequent if pre-existing LD
  • Accounts for >90% of cases
91
Q

What website/ source can be used to identify causative agent(s) of drug-induced liver injury (DILI)?

A

LiverTox

92
Q

What drug class has the highest incidence for causing DILI?

A

Antimicrobials

93
Q

What drug class has the second highest incidence for causing DILI?

A

Herbal and dietary supplements

94
Q

Which metabolite of paracetamol is toxic?

A

NAPQI

95
Q

What is the antidote for paracetamol?

A

N-acetylcysteine

96
Q

What are inducers of P450 enzymes in the liver?

A
  • Carbamazepine
  • St John’s Wort
  • Phenytoin
  • Rifampicin
  • Ethanol

Enzyme induction can lead to an increase in the metabolism of drugs and other substances by the liver. This can result in a decrease in the effectiveness of medications that are metabolized by the P450 system, as they may be cleared from the body more quickly. In some cases, enzyme induction can also result in the production of toxic metabolites that can damage liver cells.

Enzyme induction can also lead to drug interactions, as drugs that are metabolized by the same P450 enzymes may compete for the enzymes, leading to changes in drug levels in the body.

97
Q

What are inhibitors of P450 enzyme in the liver?

A
  • Erythromycin
  • Amiodarone
  • Protease inhibitors
  • Ciprofloxacin
98
Q

What are some prescribing tips for drugs and the liver?

A
  • Most drugs are safe in stable liver disease
  • Use older + more established drugs
  • Avoid drugs
  • Start with small dose and increase slowly
  • Choose best option and monitor clinical response
99
Q

Which analgesics should be actively avoided in hepatic impairment?

A

NSAIDs + COX2 inhibitors

When the liver is impaired, it may not be able to metabolize NSAIDs effectively, leading to the accumulation of these drugs in the body. This can cause liver toxicity and further liver damage.

100
Q

For which analgesics should there be caution when used in hepatic impairment?

A

Opioids

e.g. codeine is metabolised to active form in the liver

101
Q

Are tricyclic antidepressants suitable in hepatic impairment?

A

Yes, at low doses

102
Q

How should neuropathic pain be treated in hepatic impairment?

A

Gabapentin is suitable

103
Q

What should be the antidepressant choice in hepatic impairment?

A
  • Sertraline/ citalopram
  • TCAs should be avoided due to sedating effect
  • Mirtazepine is also suitable, due to low bleeding risk but has a sedating effect
104
Q

When should statins be avoided in hepatic impairment?

A

(1) Acute liver disease

(2) Decompensated chronic liver disease

105
Q

How can seizures from alcohol withdrawal be prevented?

A

Benzodiazepine

  • Chlordiazepoxide
  • Diazepam
  • Lorazepam
106
Q

What is chlordiazepoxide?

A

Anxiolytic + anticonvulsant

107
Q

When should a chlordiazepoxide dose be reassessed, when used in alcohol withdrawal?

A

If >3 PRN doses are required in 24hrs

108
Q

On a flexible chlordiazepoxide regimen, for alcohol withdrawal, what should the review criteria be?

A

Calculate every 2-4hrs depending on severity

109
Q

Is this drug long, intermediate, or short-acting? Diazepam

A

Long-acting

110
Q

Is this drug long, intermediate, or short-acting? Lorazepam

A

Short/ intermediate-acting

111
Q

Is this drug long, intermediate, or short-acting? Oxazepam

A

Short/ intermediate-acting

112
Q

Is this drug long, intermediate, or short-acting? Chlordiazepoxide

A

Long-acting

113
Q

What is the first organ to recieve nutrients and distribute it to organs

A

LIVER

nutrients and other substances are transported to liver via hepatic portal vein

114
Q

do kidneys recieve nutrients directly from food we eat

A

NO thats liver job

Job of kidney: filter waste product from blood
regulate fluid and electroltye balance

115
Q

How does liver maintain blood glucose

A

The liver plays a key role in regulating blood sugar levels through a process called gluconeogenesis, which is the production of glucose from non-carbohydrate sources. This process is important because it allows the body to maintain a stable blood sugar level even when carbohydrate intake is low.

When blood sugar levels are high, insulin levels increase, and the liver responds by storing excess glucose as glycogen.

On the other hand, glucagon is a hormone produced by the pancreas that signals the liver to break down glycogen and release glucose into the bloodstream when blood sugar levels are low.

116
Q

what does it mean when a drug is said to be ‘renally excreted’

A

Drugs that are renally excreted are typically metabolized by the liver and then excreted in the urine.

it means that a significant portion of the drug is eliminated through the kidneys, which can impact its dosing and potential toxicity. In patients with impaired kidney function, the drug may be eliminated more slowly, leading to a buildup of the drug in the body and an increased risk of side effects

117
Q

how can cirrhosis be detected

A

Cirrhosis can be detected through a variety of methods, including:

Blood tests: Blood tests can help detect liver damage and dysfunction by measuring liver enzyme levels and other markers of liver function.

Imaging tests: Imaging tests, such as ultrasound, CT scans, or MRI, can be used to detect changes in the liver, such as scarring or nodules.

Biopsy: A liver biopsy involves taking a small sample of liver tissue for analysis under a microscope. This can help confirm the presence of cirrhosis and determine the severity of the disease.

Physical examination: A doctor may perform a physical examination to check for signs of liver disease, such as an enlarged liver or spleen, or visible veins on the abdomen.

Medical history: A patient’s medical history can provide important clues about the development of cirrhosis, such as a history of heavy alcohol use or viral hepatitis.

118
Q

what are the common causes of cirhossis

A

The most common cause of cirrhosis is chronic alcohol consumption, which damages liver cells over time and leads to the accumulation of scar tissue. Other common causes of cirrhosis include viral hepatitis (B and C), non-alcoholic fatty liver disease, autoimmune hepatitis, and genetic disorders such as hemochromatosis and Wilson’s disease.

HANA Part 4 – PM4B (28 decks)

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