Treating Liver Disease

Question 1

Describe the major metabolic functions of the liver and causes of liver dysfunction

Answer 1

Synthetic function
-Plasma proteins (albumin, globulins) cholesterol, triglycerides and lipoproteins

Detoxification and excretion
Ammonia to urea (urea cycle), bilirubin, cholesterol, drug metabolites

Storage function
Vitamins A,D,E,K and B12

Production of bile salts
Helps in digestion

What happens when it goes wrong?

• Hepatocellular disease
• Chokestasis (obstruction of bile flow)
• cirrhosis (scaring)
• hepatitis (inflammation)
• jaundice
• liver cancer
• steatosis (fatty liver)
• genetic disorders
  
  • hemochromatosis (iron storage)

Question 2

Describe markers of liver function tests such as:

Liver enzymes, Bilirubin

Answer 2

CLASSIFICATION OF LFT

GROUP 1: Markers of liver dysfunction

• Serum bilirubin: total and conjugated
• Urine: bile salts and urobilinogen
• Total protein, serum albumin and albumin/globulin ratio
• Prothrombin time

GROUP 2: Markers of hepatocellular injury

• Alanine aminotransferase (ALT)
• Aspartate aminotransferase (AST)
• Often reported as a ratio - of balance is changed it shows there is damage to the liver

GROUP 3: Markers of cholestasis

• Alkaline phosphate (ALP)
• g-glutamytransferase (GGT)
• Normal Liver function test (LFT) do not always indicate absence of liver disease
• liver has a very large reserve capacity
• asymptomatic people may haves abnormal LFT results
• Diagnosis should be based on clinical examination

Question 3

Describe markers of liver function tests such as:

Albumin and prothrombin time that can diagnose hepatic injury and assess hepatic function

Answer 3

a

Question 4

Common complications: portal hypertension

Answer 4

This means that there is too much pressure in the portal veins. Contributes to ascites and encephalopathy

Question 5

Common complications: ascites

Answer 5

This means a swollen abdomen due to fluid accumulation, serum albumin is reduced

Question 6

Common complications:encephalopathy

Answer 6

The blood/brain barrier changes due to the presence of ammonia in the body

Question 7

Common complications:bleeding varies

Answer 7

The Upper gl tract bleeds

Question 8

Common complications: bacterial peritonitis

Answer 8

Bacterial infection of the ascitic fluid

-high chance of death

Question 9

Common complications: pruritus

Answer 9

The deposition of bile slats within the skin

Question 10

Causes of liver disease

Answer 10

What causes liver disease?

1. Alcohol
2. Viral infection (hepatitis A-E)
3. Fatty liver
4. Cancer
5. Autoimmune disease
6. Drug and toxin abuse
7. Inherited metabolic disease