liver diseases

Question 1

what is acute liver disease

Answer 1

• Usually self-limiting
• Results in hepatocyte inflammation/damage
• Occasionally results in liver failure
• Generally caused by drugs or viruses

Question 2

what is chronic liver disease

Answer 2

• Inflammation present for over 6 months
• Results in permanent damage with structural changes resulting in cirrhosis
• Most common cause is alcohol abuse (cirrhosis and occasionally cancer)

Question 3

what is the progression of liver damage

Answer 3

1. chronic injury
2. inflammation - damage starts
3. early fibrosis
4. late fibrosis and cirrhosis
5. transplant/cancer

Question 4

what is fatty liver

Answer 4

a reversible condition wherein large vacuoles of triglyceride fats accumulate in liver cells via the process of steatosis

Question 5

what are the stages of fatty liver disease

Answer 5

1. healthy
2. fatty liver - increased TGs, LFTs and liver fat
3. non-alcoholic fatty liver disease - inflammation, fibrosis
4. cirrhotic liver
5. cancer

Question 6

which viruses can cause liver damage

Answer 6

hep A, B, C, D, E, G

Question 7

how is hep A passed on and how does it cause liver damage

Answer 7

fecal-oral causing acute inflammation that generally resolves spontaneously

Question 8

how is hep B passed on and how does it cause liver damage

Answer 8

body fluids, acute infection progressing to chronic inflammation resulting in cirrhosis

Question 9

how is hep C passed on and how does it cause liver damage

Answer 9

bodily fluids, chronic inflammation resulting in cirrhosis

Question 10

how is hep D passed on and how does it cause liver damage

Answer 10

bodily fluids - requires concomitant infection with hep B for it to survive

Question 11

how is hep E passed on and how does it cause liver damage

Answer 11

contaminated food and water - usually self limiting

Question 12

how is hep G passed on and how does it cause liver damage

Answer 12

body fluids - chronic infection similar to HCV

Question 13

how can drugs cause liver damage

Answer 13

Hepatocytes become temporarily inflamed or permanently damaged by medicines

Question 14

what are some examples of drugs and natural products that can cause liver damage

Answer 14

statins, abx, mtx, vit A in high doses, some mushrooms

Question 15

how can alcohol cause liver damage

Answer 15

directly toxic to liver cells - causes inflammation which can progress to fatty liver and eventually fibrosis which alters structure and blood flow leading to portal hypertension and eventual failure

Question 16

what is cholestasis

Answer 16

a lack of bile due to hepatocyte damage or bile duct obstruction

Question 17

what are the symptoms of acute liver disease

Answer 17

general malaise
anorexia
fever
jaundice

Question 18

what are the symptoms of chronic liver disease

Answer 18

fatigue
weight loss
N&V
abdominal swelling
jaundice
gum/nose bleeding

Question 19

symptoms of cirrhosis

Answer 19

easy bruising
gynaecomastia
impotence
confusion
ascites
portal hypertension
oesophageal varicies

Question 20

what is jaundice

Answer 20

yellow discolouration of skin and eyes caused by cholestasis or hepatocellular damage

Question 21

what is ascites

Answer 21

Abnormal accumulation of fluid in the peritoneal cavity due to pressure imbalance between inside the circulation (high) and outside in the peritoneal cavity (low)

Question 22

what is portal hypertension

Answer 22

Blood flow reduced in liver when disease and therefore pressure builds up in portal vein

Question 23

what are oesophageal varices

Answer 23

Oesophageal varices are swollen veins in the oesophagus - If pressure too high, they can rupture and bleed – uncontrolled bleeding leads to shock and death

Question 24

what is hepatic encephalopathy

Answer 24

Neurological abnormality caused by build-up of substances (mainly ammonia) normally metabolised by liver in the blood and crosses blood brain barrier

Question 25

what is Wernicke encephalopathy

Answer 25

due to deficiency of thiamine, with decreased mental function

Question 26

how can kidney disease cause anaemia

Answer 26

Effects iron homeostasis
Reduction in clotting factor synthesis