Flashcards in Chronic liver disease Deck (9):
What is chronic liver disease?
When it lasts for more than 6 months and can still present acutely.
End stage is almost always cirrhosis
How is the progression of Chronic liver disease?
Recurrent Inflammation -> fibrosis -> repair and regeneration
When does a patient with CLD present with symptoms of liver failure?
When the cirrhosis becomes decompensated
How are stellate cells activated in hepatic fibrosis?
Stimulation neighboring cell types - sinusoidal endothelium, Kupffer cells, hepatocytes, platelets, and leukocytes
Kupffer cell - releases cytokines (TGF, RoS, MMP-9) which stimulate collagen synthesis
What are the cytokines released by KUpffer cells which stimulate collagen synthesis in hepatic stellate cells?
TGF, MMP-9, RoS
How is simple steatosis in NAFLD diagnosed and managed?
Diagnosis - Ultra sound
Management - Weight loss and exercise
Risks - increased cardio-vascular risks
What is the pathogenesis of NAFLD?
1st hit - Excess fat accumulation
2nd hit - Intrahepatic oxidative stress
TNF-alpha, cytokine cascade (pro-inflammatory)
What is the histopathology of NAFLD?
Maladaptive response to oxygen stress