Chronic liver disease Flashcards
State some causes of cirrhosis
non-alcoholic fatty liver, alcohol, drug-induced, viral hepatitis, biliary disease, hemochromatosis and Wilsons disease
state some autoimmune liver diseases
autoimmune hepatitis and primary biliary/sclerosing cholangitis
What are the symptoms of a decompensated cirrhosis patient
liver cell failure- jaundice, coagulopathy, encephalopathy
portal hypertension - splenomegaly, ascites, varices and encephalopathy (SAVE)
What are some effects on other organs due to portal hypertension
higher pressures in the splenic vein which causes the spleen to enlarge (hypersplenism) and causes splenomegaly which reduces platelet count
veins branching off from the stomach and oesophagus are at risk of rupturing due to the higher pressure.
formation of ascites.
What are some treatments for cirrhotic liver patients
terlipressin- powerful vasoconstrictor for splanchnic circulation which reduces pressure in the varicose veins and reduces bleeding,
antibiotics to kill translocated bacteria due to varicose bleeds.
detox regimen for any alcohol in the blood
What are some causes, symptoms of hepatic encephalopathy and some treatments
blood containing ammonia is bypassed via varices into the systemic circulation which goes to the brain
metabolic flap, drowsy and confused,
treatments: give lactulose ( laxative) remove melaena and ammonia creating bacteria and you also change pH and colonic flora
outline the breakdown of erythrocytes
erythrocytes—>heme&bilirubin—–>bilirubing (water-soluble, sent to the small intestine with bile where it travels to the large intestine and is converted to urobilinogen where some are absorbed back and the rest is then oxidised to stercobilin and is excreted. some of the reabsorbed urobilinogen is converted to urobilin in the kidney to give urine the yellow colour
what are the 3 types of jaundice
pre-hepatic: indicates there is an excess supply of erythrocytes to the liver e.g. haemolytic anaemia and the conjugated enzymes can’t keep up so unconjugated bilirubin builds up in the blood
hepatic: chronic liver disease e.g. cirrhosis, conjugated bilirubin cant be secreted into the canaliculi properly which leads to a build-up of conjugated bilirubin
post hepatic: extrahepatic biliary obstruction
What is an ERCP
endoscopic retrograde cholangiopancreatography
a procedure where you insert an endoscope from the mouth into the duodenum and then insert a catheter into the ampulla to fill the bile duct with a dye to then image and see if the duct is dilated and if there are any gall stones.
you can pull the stone out or you can dilate the duct and let it flow out.
