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GI Extra > 6.1 Liver pathology > Flashcards

6.1 Liver pathology Flashcards

1
Q

3 functions of the liver, with examples

A
  1. storage
    -glycogen
    -vitamins
    -iron, copper
  2. synthetic
    -glucose
    -albumin
    -clotting factors
    -bile
    -lipids/cholesterol
  3. metabolic
    -bilirubin
    -ammonia
    -drugs/alcohol
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2
Q

4 specific symptoms of liver pathology and what’s gone wrong to cause them

A
  1. jaundice: bilirubin metabolsim
  2. oedema/ascites: albumin
  3. bleeding/easy bruising: clotting factors
  4. confusion: ammonia
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3
Q

causes of acute liver failure

A

-alcohol
-paracetamol
-EBV/CMV/viral hepatitis
-meds e.g. aspirin

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4
Q

decompensated liver disease

A

all specific symptoms of liver disease all at once

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5
Q

acute liver failure

A

acute onset of all specific symtpoms of liver disease, with no previous history

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6
Q

define cirrhosis

A

permanent irreversible liver damage which impairs function of liver architecture in response to chronic inflammation. can cause scarring and hepatocyte necrosis

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7
Q

how do nodules form from cirrhosis

A

liver pops out between fibrous bands

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8
Q

5 ‘umbrella’ causes of cirrhosis

A

drugs
infection
deposition
autoimmune
other

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9
Q

explain how cirrhosis can be caused by drugs

A

iatrogenic: meds
alcoholic liver disease: Progression:
fatty change(weeks), excess sugar converts to TAG, deposits
alcoholic hepatitis (years) RUQ pain, ascites, jaundice

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10
Q

explain how cirrhosis can be caused by infection

A

hep B
hep C
malignancy: hepatocellular carcinoma from chronic inflammation

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11
Q

cause of non alcoholic fatty liver disease

A

insulin resistance

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12
Q

result of NAFLD

A

TAG depostis

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13
Q

cause and result of hereditary haemacrhomatosis

A

ferritin
hepatocellular carcinoma

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14
Q

Wilsons disease
-aetiology
-whos affected
-management

A

decrease copper secretion from biliary system to circulation for removal so deposits in tissues

affects CNS: tremors, memory problems
affects children/young adults

liver transplant, lifestyle modification

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15
Q

3 autoimmune causes of cirrhosis

A

autoimmune heoatitis
primary biliary cirrhosis
primary sclerosis cholangitis

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16
Q

other causes of cirrhosis

A

alpha 1 antitrypsin deficiency
glycogen storage

17
Q

what is the portal circulation?

A

network of veins, drain via liver into IVC

18
Q

what veins drains descending colon?

A

inferior mesenteric

19
Q

which 2 veins join to form portal vein?

A

SMV, splenic

20
Q

explain how portal hypertension arises, and how it causes problems

A

fibrosis tissue less expansive so compresses portal venouss veins entering liver so increases hydrostatic pressure of portal venous system (PORTAL HYPERTENSION)

causes
ascites: leakage of fluid to peritoneal cavity
splenomegaly: increased pressure in splenic circulation
varices: blood shunt from portal to venous circulation

21
Q

what is hepatorenal syndrome?

A

rapid deteriorating kidney function due to liver failure from portal hypertension

22
Q

explain how portal hypertension can lead to hepatorenal syndrome

A

backlog of blood so also affects afferent blood
arterial vasodilation
perceived decreased circulating vol
RAAS
renal artery vasoconstriction decreases perfusion

23
Q

how to treat hepatorenal syndrome

A

correct underlying liver pathology

24
Q

where specifically does the CBD enter the duodenum?

A

ampulla of vater

25
Q

function of sphincter of oddi

A

controls rate of substance release from CBD into second part of duodenum

26
Q

how to image gallstones, why not xray?

A

USS
no ca2+

27
Q

contents of gallstones

A

cholesterol
bile pigments

28
Q

risk factors for gallstones

A

fair fat female forty
pregnancy
cholesterol diet

29
Q

4 complications of gallstones

A
  1. biliary cholic
  2. acute cholecystitis
  3. ascending cholangitis
  4. acute pancreatitis
30
Q

explain how biliary colic occurs

A

RUQ pain few hours after fatty meal, CCK released so gallbladder contracts, pushes gallstone against neck of gallbladder, temporary obstruction of cystic duct

no inflammation, last hours then eases and cycles

31
Q

treatment of biliary colic

A

pain relief, gallbladder removal

32
Q

treatment of acute cholecystitis

A

pain relief, ABx if infected, gallbladder removal

33
Q

explain how acute cholecystis occurs

A

RUQ pain, gallstones impacted in cystic duct, nothing can go through

inflammation

positive Murphy’s sign

34
Q

positive Murphy’s sign

A

hand on R abdo, breath in pushes liver and gallbladder down, sharp pain as liver hits hand

35
Q

what’s ascending cholangitis

A

infection of biliary tree

36
Q

charcots triad

A

In ascending cholangitis
1. RUQ pain
2. inflammation (fever, blood test)
3. jaundice (infection behind stone)

37
Q

treatment of ascending cholangitis

A

ABx, fluids, relieve obstruction surgically

GI Extra (16 decks)

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