Flashcards in Liver Deck (40)
How much is taken in a liver biopsy?
1/50000th of the total liver volume
Why would you biopsy the liver?
Confirm presence/nature of neoplasm
Exclude underlying liver disease
Exclude secondary process
Name 5 diseases of the liver
Chronic hepatitis (viral/autoimmune/drugs)
Iron overload (haematochromatosis)
What cells activate fibrosis?
Stellate cells (they contain vitamin A)
What does chronic hepatitis involve architecturally?
Portal tract inflammation
Fibrosis and cirrhosis
What does biliary disease involve architecturally?
Portal tract inflammation and expansion
Bile duct damage and loss
How do you treat genetic haemoatochromatosis?
What does paracetamol do to the liver?
What do steroids, flucloxicillin and erythromycin do to the liver?
Cause cholestasis (bland w/steroids)
Cause cholangiolytic cholestasis (w/fluclox and eryth)
What do contraceptive steroids do to the liver?
Hepatic vein thrombosis
Nitrofurantoin and etretinate do to the liver?
Cause chronic hepatits
What does allopurinol do to the liver?
What do antineoplastic agents do to the liver?
What would decompensation in liver disease look like?
(due to sepsis, GI bleed, volume depletion)
What causes ascites in liver disease?
-> hyperspelnism and varices
-> less blood in circulation
Fluid imbalance = ascites
Also, hypoalbuminaemia due to liver failure= ascites
Why is jaundice seen in liver disease?
Lack of functioning hepatocytes
Conjugated and unconjugated bilirubin increases
ALT and AST and ALP raised
What clotting factors aren't able to be made in liver failure?
1, 2, 5, 7, 9, 10, 12, 13
Why do people with liver failure get more infections?
Unable to produce acute phase proteins
Why do people with liver failure experience hypoglycaemia?
Liver unable to store glycogen and fat
Pathogenesis of encephalopathy
Liver fails to detoxify and excrete
Brain converts ammonia to glutamine
Osmotic imbalance and cerebral oedema
= dorwsiness, confusion, coma
What is involved a liver screen?
Viral hepatitis serology
Cholesterol, TGs, ferritin, Alpha-1 antitripsin
Management of ascites?
Na and water restriction
Modify microbiota (lactulose, rifaxamin, probiotics)
What marker is raised in fatty liver disease?
What is seen in the architecture of steatohepatitis?
Pericellular and perisinusoidal fibrosis
What causes oxidative stress in alcoholic hepatitis?
CCl4-> free radicals
Ethanol-> Cytp450 and diet -> oxidant stress
What are the major cytokines involved in alcoholic hepatitis?
IL-8 (attracts neutrophils)
NFKB (attracts IL-8)
What causes fatty liver to turn into alcoholic hepatitis?
A Babson event-> activated macrophage-> TNF
What could a Babson event be?
Massive boozing spree