Pathophysiology

Question 1

Metabolic functions of the liver

Answer 1

Glucose metabolism
Ammonia conversion
Protein metabolism
Fat metabolism
Vitamin and iron storage
Bile formation
Bilirubin excretion
Drug metabolism

Also: cholesterol

Question 2

Considerations for older liver

Answer 2

Gallstones
Rapid disease progression and decreased response to tx
Decreased clearance, repair, flow, and size

Question 3

Portal HTN

Answer 3

Due to obstructed flow at liver
Leads to ascites and varices

Question 4

Ascites

Answer 4

Due to portal HTN from cirrhosis
Dilation of splanchnic circulation
Can’t properly metabolize aldosterone - leads to fluid retention
Decreased albumin leads to low osmotic pressure thus movement of fluid to peritoneum
Brain releases ADH but this only makes it worse

Question 5

Hepatic encephalopathy

Answer 5

Due to increased ammonia from hepatic insufficiency and portosystemic shunting

Question 6

Glaucoma

Answer 6

Damaged optic nerve due to high IOP
Aqueous production more than output
Irreversible

Question 7

Corneal dystrophy

Answer 7

Inherited, manifests at 20 yo
Deposits in cornea
Cone shaped astigmatism

Question 8

Ménière’s disease

Answer 8

Abnormal fluid balance in inner ear due to malabsorption of endolymphatic sac or blockage of duct