liver and bilary system and disease Flashcards
(24 cards)
what causes jaundice?
an elevation of bilirubin
what is the normal level of bilirubin?
3-7mmol/L
what enzymes are raised when the liver is inflamed?
transglutamase enzymes
what enzymes are raised in alcohol toxicity in the liver?
cholestatic enzymes
what are the 4 types of jaundice?
neonatal, haemolytic, hepatocellular and obstructive
what causes neonatal jaundice?
babies are born with low levels of bilirubin transferase which helps to remove bilirubin from the body
what is the treatment for neonatal jaundice and why does it work?
exposing babies to UV light, this makes the bilirubin more water soluble so can leave the blood stream
what causes haemolytic jaundice?
red blood cells are destroyed which as a byproduct creates bilirubin which accumulates
what causes hepatocellular jaundice?
damage to the liver means that although bilirubin is still able to be conjugated, the liver is unable to secrete the conjugated bilirubin
what causes obstructive jaundice?
the bile duct is obstructed therefore conjugated bilirubin cannot be passed into the intestine to be secreted so is passed into the blood
give 5 common symptoms of jaundice?
yellow skin, yellow eyes, brown urine, pale stools, fever
bullet point explain bilirubin metabolism in circulation?
- red blood cells are broken down to release haemoglobin
- globin is metabolised
- haem is converted into bilirubin bound to albumin
bullet point explain bilirubin metabolism in the liver?
- bilirubin dissociates from albumin and enters hepatocytes
- bilirubin is conjugated with two glucoronic acids
- bilirubin is secreted into bile and enters the small intestine
- intestinal bacteria convert bilirubin into urobilinogen
- 80% is secreted in faeces and 20% is secreted In urine
what is hepatitis?
inflammation of the liver
hepatitis A:
- how is it spread?
- incubation period?
- acute or chronic?
- any worse progression?
- symptoms?
- does it give life long immunity?
- faeces and orally
- short incubation period
- acute and self limiting
- no progression
- asymptomatic
- gives life long immunity
hepatitis B:
- how is it spread?
- incubation period?
- acute or chronic?
- any worse progression?
- blood and sexual contact
- long incubation period
- chronic
- can progress but most make a full recovery
hepatitis C:
- how is it spread?
- acute or chronic?
- any worse progression?
- symptoms?
- blood and sexual contact
- chronic
- most will develop liver disease
- asymptomatic
hepatitis E:
- how is it spread?
- acute or chronic?
- any worse progression?
- does it give life long immunity?
- low person to person spread
- acute and self limiting
- no progression
- immunity is not lifelong
explain the process of alcohol induced hepatocellular steatosis?
- alcohol dehydrogenase causes an excess of NADH which increases lipid biosynthesis
- assembly and secretion of lipoproteins is impaired
- lipid droplets accumulate at hepatocytes
- the liver becomes large yellow soft and greasy
what is cirrhosis?
where hepatocytes are replaced by non functional connective tissue leading to reduced liver function
give 3 causes of cirrhosis?
- alcohol
- drugs
- hepatitis
give 5 symptoms of cirrhosis?
fluid retention
defects in anticoagulation
peripheral neuropathy
gastric bleeding
jaundice
what causes gall stones?
bile is supersaturated with cholesterol, pigments and other substances and there are not enough bile salts
give 4 symptoms of gall stones?
epigastric pain
pain that radiates to the back
poor digestion of fatty foods
elevated temperature
