Flashcards in Chronic Liver Failure II Deck (10)
What are several proposed mechanisms of hepatic encephalopathy?
ammonia, nitrogenous wastes, increased intracellular glutamine, astrocyte swelling, cerebral edema, inflammatory cytokins alter bbb
what is chronic hepatic encephalopathy?
often slow and subtle on onset, family notices, coworkers wont
what are physical signs of encephalopathy
hyperextended the wrists and reprititive movement, inability to perform sustained grip of hand, hyperextension of he ankles
what is a treatment of encephalopathy
lactulose, poorly absorbable sugar, cathartic, decreases intestinal pH, decreases glutamine absorpption, reduces syntehsis and absorption of nh3
zinc, cofactor in nh3 metabolism
antibiotics - alter intestinal flora, decrease nh3
do people with encephalopathy need to cut down protein
what are alzhemier type ii astrocytes?
seen in metabolic encephalopathy, large round vasicular nuceei with scanty chromatin and prominent nucleolus
what is hepatorenal syndrome?
a syndrome where the kidneys are not damaged yet shut down from signs from the liver. liver failure causes renal arterial vasoconstriction and renal failure
what do you see on labs and eval with hepatorenal syndrome?
cirrhosis and ascites
serum creat over 1.5
what are teh two types of hepatorenal syndrome?
i - rapid worsening
ii - slow progression