Wk 4 Cirrhosis Flashcards
What is cirrhosis?
Irreversible, inflammatory, fibrotic liver disease
What causes cirrhosis?
Structural changes from injury, such as alcohol or viruses, and fibrosis
What is the mortality rate of cirrhosis?
26%
The pathological mechanisms of cirrhosis are..
not well understood
What is fibrosis of the liver a result of?
Infiltration of leukocytes that release inflammatory mediators in activation of this fibrotic process
What does chaotic fibrosis throughout the liver lead to?
Obstructive biliary changes and blood flow
What does obstructive biliary changes and blood flow cause?
Jaundice
Portal hypertension
Why does the liver not just regenerate?
Regeneration is disrupted by hypoxia, necrosis, atrophy, and liver failure
If the damage is related to toxins such as alcohol metabolites, the progression of cirrhosis depends on…
the amount of toxins present
Can removal of the toxin slow progression of cirrhosis?
Yes but the damage that has already occurred can’t be reversed
What are 4 common causes of cirrhosis?
Hep B&C
Alcohol
Idiopathic
Non-alcoholic fatty liver disease
When we intake alcohol it is transformed into…
Acetaldehyde
Significant amounts of acetaldehyde activate what type of cells?
hepatic stellate cells
What is the primary cell involved in liver fibrosis?
hepatic stellate cells
What does acetaldehyde inhibit?
Exports and proteins from the liver
In turn, acetaldehyde alters metabolism of…
Vitamins and minerals and induces malnutrition
What also activates during alcohol consumption?
Kupffer cells
Kupffer cells attract __ which promote more inflammation
Neutrophils
What else do kupffer cells cause?
Toxins to accumulate from translocation of gut bacteria and causes cellular mediated immunity to be suppressed
What is the most common type of cirrhosis?
Alcoholic cirrhosis
Alcoholic cirrhosis accounts for __% of all types of cirrhosis
25%
Alcoholic fatty liver is the…
Mildest/asymptomatic stage of alcoholic cirrhosis development
Which alcoholic liver stage is a precursor to cirrhosis?
Alcoholic steatohepatitis
What is alcoholic steatohepatitis?
Inflammation, degeneration of hepatocytes
What is alcoholic fibrosis and scarring of the liver?
Alcoholic cirrhosis
If a patient stops drinking in the alcoholic fatty liver phase…
their liver can go back to normal once they stop drinking and don’t have other liver toxins
Fat deposition in the liver is caused by an increase in…
lipogenesis and other pathological changes within the hepatocytes themselves which is caused by the acetaldehyde
At the point of alcoholic steatohepatitis, it is stimulating
Irreversible fibrosis
What are the symptoms of alcoholic steatohepatitis?
Anorexia
nausea
jaundice
edema
Alcoholic cirrhosis is characterized by…
Oxidative stress Inflammation Cellular damage Cellular necrosis Fibrosis
List 7 steps to liver failure
Liver cells destroyed Cells try to regenerate Disorganized process and abnormal growth Poor BF and hypoxia scar tissue formation Liver failure
What are the GI disturbances of EARLY liver cirrhosis
N/V
Anorexia
Flatulence
Change in bowel habits
What other 3 symptoms are early manifestations of liver cirrhosis?
Fever
Weight loss
Palpable liver
Cirrhosis is often diagnosed in the…
Late stages
