Flashcards in Acute Liver Disease Deck (32):
WWhat is acute liver disease?
Rapid development of hepatic dysfunction without prior liver disease
What are the functions of the liver?
Bile acid metabolism
Hormone and drug metabolism
What is the blood supply of the liver?
Oxygen from the hepatic artery (10%-20% of blood supply)
The hepatic portal vein is will bring nutrients from the bowel to the liver
Blood flows out of the liver via the 3 hepatic veins and into the IVC
What are Liver function tests?
Name of blood tests that test for:
GGT (least useful test, ever.)
What is a true liver function test?
Prothrombin time -time taken for blood to clot in the lab
What else produces alkaline phosphatase?
What is the best test for the liver ?
What is acute liver disease ?
Insult to the liver causing damage in a previously normal liver
Less than 6 months of duration
What does acute liver disease defined as causing?
Encephalopathy - clouding of consciousness
What is Wilson's disease?
What are the clinical features of acute liver disease ?
Pain - RUQ
What are the viral causes of acute liver disease ?
Hepatitis A, B,C,D,E
Epistein Barr Virus
Who gets Hepatitis A?
People who had traveled who eat shell fish
What are the other causes of acute liver disease?
Cholangitis - acute liver infection
Chronic liver disease
What are the rare causes of acute liver disease?
Budd Chiari - occlusion of the hepatic veins that drain the liver
AFLP - acute fatty liver pregnancy
Cholestatsis of pregnancy
What is colangitis?
An acute liver infection
What are the factors that cause liver damage?
What is the classic presentation of wilson's syndrome?
What are the causes of nutrition that causes liver disease ?
Non alcoholic steatohepatitis (NASH)
What are the investigations for acute liver disease?
LFT’S (including Albumin & Bilirubin)
HISTORY & EXAMINATION
Ultra-sound inc. vascular
Investigations of chronic liver disease
RARELY liver biopsy
What is the treatment for acute liver disease?
Increase calories (35-40 kcal/kg/day)
No fatty food
For itch- sodium bicarbonate bath, cholestryamine or Uresodeoxycholic acid
What are the metabolic considerations for acute liver disease?
Hypoglycaemia - very serious clinical sign
What antibiotics can induce live disease ?
What is more important, gains or liver?
Gain > liver
What are the acute effects of alcohol?
What are the effects of chronic heavy drinking?
What is foetal alcohol syndrome?
Foetus exposed to alcohol during pregnancy.
Results in: growth deficiency, mental retardation/intellectual impairment, attentional learning disabilities, & behavioral problems
How is alcohol metabolised?
There are 3 pathways of alcohol metabolism. Alcohol Dehydrogenase
What is the mechanisms of alcoholic liver damage?
Chronic cytotoxic lymphocyte damages hepatocytes via acetaldehyde protein adducts
IL8 production causes neutrophil activation and damage of hepatocytes
Kupffer cells cause damage to hepatocytes
What are the features of alcoholic hepatitis?
What is used determine prognosis of alcoholic hepatic?