LIVER Flashcards
(42 cards)
What are the 3 commonest causes of HEPATOMEGALY?
- Cirrhosis
- Malignancy
- RHF
What are the palpation findings of hepatomegaly caused by liver cirrhosis?
- initially enlarged then decreases in size as cirrhosis progresses
- non tender firm liver
What are the palpation findings of hepatomegaly caused by malignancy?
Hard irregular liver edge
What are the palpation findings of hepatomegaly caused by right heart failure?
Firm, smooth, tender liver edge
May be pulsatile
3 branches of the coeliac trunk?
- left gastric artery
- splenic artery
- common hepatic
2 branches of the common hepatic artery
proper hepatic
& gastro duodenal artery
what artery supplies the liver
hepatic artery proper
what 2 veins drain into the hepatic portal vein
- splenic vein
- superior mesenteric vein
what is the portal triad
- hepatic artery
- portal vein
- common bile duct
list the liver function tests
- Liver enzymes: ALT & AST
- ALP
- GGT
- Bilirubin
- Albumin
- PT/INR
cause of low albumin & high protein
multiple myeloma
cause of low albumin & normal protein
infection
when is jaundice usually detected
when serous bilirubin is above 50 umol/L
what is Haem in RBC broken down into
Biliverdin and then bilirubin
where does conjugation of bilirubin occur?
liver, hepatocytes
where does urobilinogen go?
- oxidised by bacteria in intestine to stercobilin which gives stool its pigmentation
- transported by the blood to the kidney converted to urobilin giving urine its characteristic colour
what type of jaundice goes haemolysis cause?
pre hepatic jaundice; high levels of serum bilirubin
5 causes of haemolysis?
1) mechanical - metallic valve prostheses
2) Autoimmune haemolytic anaemia
3) Malaria infection
4) Transfusion reactions
5) Congenital red cell problems - sickle cell anaemia/hereditary spherocytosis
what does high levels of conjugated hyperbilirubin mean?
there is an obstruction to the outflow tract of bile
causes of post hepatic jaundice?
- pancreatic cancer
- gall stones
- pancreatitis
ALT > AST indicates?
hepatocyte damage - chronic liver disease
what could low albumin & protein indicate (3)
- decreased intake: malnutrition
- decreased synthesis: cirrhosis, alcoholism, chronic inflammation
- increased excretion: nephrotic syndrome
AST:ALT < 0.8
indicates that ALT is greater than AST therefore non- alcoholic liver disease
bone pathologies that cause raised ALP
- ostomalacia
- Pagets disease
- fractures
- multiple myeloma
