Acute Liver Injury I Flashcards
What do transaminases and bilirubin levels do with shockliver?
transaminases peak 25 to 250 times normal and decline to normal in 7-10 days. Bilirubin rises only as transaminases re falling and rarely go abot 4x uln.
what are kupffer cells
intercalated cells between the endothelial cells and forming part of the sinusoidal linig they have phagocytic capactiesia nd defend us by nabbing intestinal bacteria. However, they stim il1 tnf il6 il8 il12 tgf b ifn pgd2 pge2 txa and complement
what are ito cells?
also called stellate ells, they are underneath sinusoidal lining cells, with random distribution. they are mesenchymal cells with ability to differentitate into fibroblasts or myfibroblasts with chronic liver injury.
what is the space of disse
it’s the space between the sinusoidal lining cellsa nd hepatocyte cell membranes. contains ecm, glycoproteins collagen fibrils
what is white bile?
actually mucus
what are the three pregnancy induced liver dzs
hellp
acute fatty liver of pregnancy
intrahepatic cholestasis of pregnancy (most common of these)
what is intrahepatic cholestasiss of pregnancy?
due to epiallopregnanolone sulfate inh of farnesoid x receptor mediate bile acid efflux. causes mild elevation of bilirubin, sometimes slight elevation of alk phos, pruritis, modest risk of fetal distress and premature birth and stillbirth, and responds to ursodeoxycholic acid tx
cholestastic drug induced liver dz does what?
severely elevated bilirubin and alk phosp with mod elevated transaminases
what hepatocytes are best supplied with blood rich in oxygen nutrients.
periportal hepatocytes
what is the toxic metabolite of tylenol
napqi, which is conjugated with glutathione to become non toxic
when the tylenol overdose symptoms reappear, what other symptoms are added
jaundice and confusion or encephalopathy and bleeding
what hurts the central zone?
midzone?
periportal zone?
acetominophen
yellow fever, mushrooms
phosphorous
