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GI system > Hepatitis, cirrhosis, liver metastases > Flashcards

Hepatitis, cirrhosis, liver metastases Flashcards

1
Q

What is meant by hepatitis?

A

Inflammation of hepatocytes of liver

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2
Q

How does hepatitis affect the liver itself?

A

Damaged hepatocytes

reduced liver function

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3
Q

What are the consequences of reduced liver function?

A

Increases susceptibility to infections

Increased susceptibility to drugs and toxins

Increased blood ammonia

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4
Q

What type of infections is a patient with reduced liver function more susceptible to?

A

Bacterial

Fungal

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5
Q

Why does a patient with reduced liver function have increased susceptibility to drugs and toxins?

A

Reduced metabolism of drugs and toxins by liver

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6
Q

Why does a patient with reduced liver function have increased blood ammonia?

A

Disturbed urea cycle

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7
Q

What is a consequence of increased blood ammonia?

A

Hepatic encephalopathy

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8
Q

What is hepatic encephalopathy?

A

Reduced consciousness due to high levels of ammonia in the blood which is due to reduced liver function

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9
Q

What normally produces ammonia in the body?

A

Colonic bacteria deaminating amino acids

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10
Q

What are the signs and symptoms of hepatitis?

A

Fever

RUQ pain

Moderate jaundice

Dark urine

Anorexia

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11
Q

What are the abnormal LFT results with hepatitis?

A

High conjugated bilirubin in the blood
high unconjugated bilirubin in the blood

High ALT

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12
Q

What is cirrhosis?

A

Fibrosis of the liver

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13
Q

What does a cirrhotic liver look like?

A

Shrunken

Nodular

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14
Q

What are the causes of cirrhosis?

A

Viral hepatitis

Chronic excessive alcohol consumption

Fatty liver disease

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15
Q

What are the causes of hepatitis?

A

Viral

Acute excessive alcohol consumption

Fatty liver

Drugs, toxins

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16
Q

How does cirrhosis affect the liver itself?

A

Reduced hepatocytes

Compression of hepatic sinusoids, portal veins

Compression of bile canaliculi, hepatic ducts

17
Q

What are the consequences of compression of the hepatic sinusoids and portal veins?

A

Portal hypertension

18
Q

What are the signs and symptoms of cirrhosis?

A

Ascites

Swollen legs

Easy bleeding and bruising

Jaundice

Hepatic encephalopathy

Oeosphageal varices, haemorrhoids, caput
medusa

Weight loss

19
Q

What is ascites?

A

More than 25ml of fluid in peritoneal cavity

20
Q

Why does a patient with cirrhosis get ascites?

A

Portal hypertension
increased capillary hydrostatic pressure before portal vein
transudation of fluid into peritoneal cavity

21
Q

Why does a patient with cirrhosis get swollen legs?

A

Reduced hepatocytes
reduced albumin production
reduced oncotic pressure in the blood
transudation of fluid

22
Q

Why does a patient with cirrhosis get easy bleeding and bruising?

A

Reduced hepatocytes
reduced production of clotting factors
reduced coagulation

23
Q

Why does a patient with cirrhosis get oesophageal varices, haemorrhoids and captus medusa?

A

Portosystemic shunting

24
Q

What is portosystemic shunting?

A

Blood shunts from the portal venous circulation to the systemic venous circulation

25
Q

What causes portosystemic shunting?

A

Portal hypertension

26
Q

How are the portal and systemic circulations related to each other?

A

Anastamoses between them

27
Q

Where are the portosystemic anastamoses located?

A

Oesophago-gastric junction

Ligamentum teres

Ano-rectal junction

28
Q

Why does a patient with cirrhosis get weight loss?

A

Reduced blood containing nutrients from the gut reaching the liver due to portal hypertension, portosystemic shunting
reduced hepatocytes, so reduced storage and metabolism of nutrients from gut

29
Q

What are the abnormal LFTs with cirrhosis?

A

Low albumin

Prolonged protrombin time/INR

Raised conjugated bilirubin in the blood
raised unconjugated bilirubin in the blood

Raised ALT if ongoing inflammation

Raised Alk Phos

Raised Gamma GT if excessive alcohol consumption

30
Q

How often do metastases spread to the liver?

A

Commonly spread to the liver

31
Q

Why do metastases commonly spread to the liver?

A

Rich blood supply, portal and systemic

Hepatic sinusoids filter blood, metastases lodge here

32
Q

What organs do liver metastases come from?

A

GI tract organs via the portal circulation

Breast, lung via the systemic circulation

33
Q

What are the abnormal LFTs with liver metastases?

A

Raised conjugated bilirubin in the blood
Raised ALT

Raised unconjugated bilirubin in the blood

Raised Alk Phos

Raised Gamma GT

GI system (21 decks)

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