Liver - hepatitis Flashcards
What is cirrhosis?
Irreversible damage to liver
Microscopically - liver will be fibroses - area of nodular regeneration
Cause cirrhosis?
Alcohol, infection hep B or C
What is jaundice?
Yellow pigmentation skin, sclerae and mucosa causing excess plasma bilirubin
What is pre-hepatic jaundice?
Excess bilirubin production
Liver become rate limiting step - build up of uncojugated bilirubin in skin
Faeces still brown as still have conjugated bilirubin
How is bilirubin produced?
Product of harm degradation = liver normally conjugate and excrete bilirubin
Why is faeces brown?
Bacteria break down stercobillogen into stercobillin which is responsible for brown faeces
What is post-hepatic jaundice?
Blockage of bile duct - conjugated bilirubin produced but not release into intestine for excretion
Cause pale stools and dark urine
What is intra-hepatic jaundice?
Happen when liver function is reduced
Conversion into bilirubin becomes slower - still some conjugated therefore usually avoid pale stool
What is ascites?
Accumulation of protein-containing fluid within abdomen
common cause = portal hypertension
How investigate liver function?
FBC
LFT - when damaged releases enzymes into blood and liver produced proteins decrease
Coag screen - inc. platelet count and bleeding time
Why is problem w/ haemostats in liver disease?
- Thrombopoetin not produced
- Liver dependent clotting factors reduced
- Splenic sequestration of platelets (related portal shunt)
Administering LA in hepatic pt?
2-3 fold decrease in mod-severe impairment
LA - amides metabolised in liver - toxic reaction at lower expected dose
Why haematemesis in hepatic pt?
Arise from oesophageal varies due to hypertension
Function of liver
- Detoxification
2. Conjugation - change uncharged fat-soluble to charger water-soluble particles that can be exerted
How much bilirubin for jaundice?
> 5mg dl-1 in blood
