18-1: Liver Failure Flashcards
Why is the liver so susceptible to a wide variety of metabolic, toxic, microbial, circulatory, and neoplastic insults?
It is the body’s great filter so all that we come into contact with will pass through the liver.
What is jaundice of the eyes called?
scleral icterus
What are the normal levels of conjugated and unconjugated bilirubin?
direct: .1 - .3 mg/dL
indirect .2 - .9 mg/dL
What serum measurements can be taken to evaluate hepatocyte integrity?
AST
ALT
LDH
What does an AST:ALT > 1 indicate?
Cirrhosis
also if it is 2:1 could indicate alcoholic hepatitis
What disease process are elevated ALP and GGT consistent with?
Cholestatic liver disease
What are the reversible degenerative changes that can be seen in the liver
steatosis
cholestasis
ballooning
Clumping of intermediate filaments
What is the predominant pattern of necrosis you will see in the liver death?
coagulative necrosis
What the predominant cell type involved in the extensive repair capabilities of the liver?
hepatic stellate cells
Usually vit A storage cells but when activated become fibrogenic
What is the most severe form of liver disease?
liver failure due to acute or chronic injury
What percent of liver functional capacity can be lost before injury becomes apparent
80-90%
Encephalopathy and coagulopathy are associated with what kind of liver failure and what is the majority cause in the US
acute liver failure and acetaminophen
What are signs and symptoms of acute liver failure?
Nausea, vomiting, icterus, jaundice, itching,
COAGULOPATHY and ENCEPHALOPATHY
Cirrhosis is associated with what kind of liver failure?
Chronic
*Note cirrhosis is response to an injury not specific dx itself
What are the leading causes of chronic liver failure world wide?
HBV, HCV, NAFLD, Alcoholic Liver Disease
