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Flashcards in Liver disease (pathology) Deck (12)
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1

Why learn about liver disease?

Bleeding risk
-reduced synthesis of clotting factors
Infection risk
-pts may have hep B and C

2

About liver

Lots of blood goes through liver
Big organ
From blood liver does lots of things e.g. produces bile
-bile goes down bile ducts into duodenum
Gall bladder stuck on side
-cul de sac
-bile can be produced here and squirted out when needed

3

Too much work in

Prehepatic jaundice
Too many breakdown products for liver to deal with
E.g. haemolytic anaemia
-genetic variant --> RBCs fragile
-break down much more quickly than normal
-can cause jaundice
-breaking down goes on in spleen --> splenomegaly (if you remove spleen they won't get jaundice)
-LOOK AT PICTURES OF BLOOD CELLS

4

Too little liver tissue to process normal amounts

Hepatic jaundice
People end up with jaundice and liver failure
E.g. cirrhosis
-end stage of liver disease
-knobbly liver, lots of fibrosis and regenerative nodules

5

Jaundice is indicated of

Too much bilirubin?

6

General mechanism of cirrhosis

Damage to liver cells --> inflammation around liver cells --> regeneration of liver cells
If it goes on for long enough
Inflammation around liver cells leads to some healing by fibrosis --> cirrhosis

7

Incidence of cirrhosis

Hepatitis viruses can cause cirrhosis
-high levels where Hep B and C are high
Old soviet union - alcohol consumption

8

Causes of cirrhosis

Hepatitis viruses
Alcohol - damages liver

9

Consequences of cirrhosis

Liver failure
-can't clear toxic products out of body including bilirubin --> jaundice
Portal hypertension
Ascites
Hepatocellular carcinoma
-rare but occurs in cirrhosis

10

Ascites

Low albumin production
Increased blood pressure due to portal hypertension

11

Portal hypertension

> in BP in the portal vein, which carries blood from bowel and spleen to liver
-p in portal vein may rise because the resistance in liver is > because of scarring (fibrosis) or cirrhosis
-> in p in the portal vein as a result
Big dilated veins in oesophagus can rupture --> people bleed to death
Rectal varices

12

Blockage to flow of bile out of liver

Post hepatic jaundice
Toxins --> bile --> duodenum
Gall stones can block bile duct
-if they get out of gall bladder they can cause trouble
-causes jaundice
Tumours of duodenum or pancreas
-duct is dilated
-people don't know about it until they get jaundiced
-painless progressive jaundice - very bad sign