Liver diseases Flashcards
What are the different types of liver disease?
1.Alcoholic Liver Disease- 2.5 million deaths
2.NAFLD-1 in10
3.Viral hepatitis- B=290 million c= 200 million 900k deaths due to B
4.Drug-induced toxicity- Paracetamol overdose
5.Hepatic Carcinoma- 5th common cancer
What are the causes of Pre-hepatic, Hepatic and Post-Hepatic?
1.Pre-hepatic-Haemolytic, Newborn &Genetic
2.Hepatic-Alcohol, viruses , diets & drugs
3.Post-Hepatic- Gallstones & tumours
What happens in alcohol liver disease (ALD) and what is the treatment?
1.Alcohol is sent to the liver for processing
Excess can cause liver disease
2.Alcohol enters the liver cells or hepatocytes it takes on of the three pathways
a. Use of ADH
b. CATALYSE- PERSXISOME
c. Cytochrome p450 2e1
These all lead to the conversion of alcohol to acetaldehyde
3.When ADH coverts the alcohol to acetaldehyde it needs another compound NAD which is converted to NADH. NADH levels increase and the NAD levels decrease it has an effect
4.The increase in NADH tells cells make fatty acid and the decrease in NAD tells cells produce less fatty acid oxidation leading to more fat production in the liver = fatty liver so it becomes large in size , making it heavy greasy and tender the liver becomes yellow and there are other symptoms that are not present
Treatment- decrease alcohol intake
What are the happens of acute Alcohol Poisoning/intoxication and what can cause it ?
- Coma
2.Low respiration
3.Vomiting- choke
4.Low body temp, Cold
5.Low BP/low heart rate
Binge drinking can lead to acute alcohol poisoning
How does chronic ALD happen?
Through excess alcohol intake over the years
What parts of the body does liver damage effect ?
1.Heart(Dilated cardiomyopathy
2.Pancreas(acute/chronic
3.Brain(damage, poor memory)
4.Skeletal muscle – type I & II fibres
5.Bone(osteoporosis
6.Foetus
What are the cofactors of ALD?
1Nutrition(dietary fat/iron)
2. Genotype for alcohol dehydrogenase, CYP2E1
3. Viral hepatitis
4. Gender
These co-factors increase the risk of ALD
What are the ALD stages?
1.More drinking leads to AH then Fibrosis and cirrhosis which is where the liver is failing
Cirrhosis- caused my alcohol abuse
Ah- is inflammation to the liver
What happens in alcoholic hepatitis and what is the treatment?
1.Acetaldehyde from ethanol it starts to generate reactive oxygen species which are reactive and have o2 e,g hydrogen peroxide
2.These reactive oygen species react with proteins and dna causong damage to the cells
- Acetaldehyde can bind to macromolecules and cell membrane inhibiting the molecule forming Acetaldehyde adduct
4.The immune system recognises the new compounds as foreign so the neutrophils to clean it up it destroys the hepatocytes and the liver inflammated and damaged which is AH
Treatment;
Stop alcohol and supress immune system tablets
More damage leads to cirrhosis and liver failure
What is NADH role in the electron chain?
Nadh fuels electron flows in the electron transport chain in the mitochondria- electrons are leaking out of the chain
How does the liver get nutrients?
Nutrients from gut goes through the portal vein and transports it to the liver
What are the two stage in alcohol cirrhosis and what do they do?
- Compensated- the liver is still function 70% loss of the function but can still work
2.Decompensated- not stability patient needs liver transplant - loss of function
What is NAFLD/MAFLD and what are the stages?
NAFLD/MAFLD is a liver disease caused by diet
Health -> non-alcoholic fatty liver (Benign tumour but no liver damage) –> non-alcoholic steatohepatitis (Liver inflammation leading to fibrosis) –> cirrhosis
What causes NASH non-alcoholic steatohepatitis, what it lead to and how is it diagnosed?
Caused by excess dietary energy intake
Leads to lobular necroinflammatory hepatitis decreasing the function
it is diagnosed be Liver biopsy there are non biochemical markers
Who has the highest level of billirubin and how can it be broken down?
New borns- if it is way to high it can lead to brain damage
It is broken down by UV light/ blue light
