Liver Failure Flashcards
What is Liver Failure?
liver shuts down d/t loss of more than 80% functional capacity
True or False: Liver Failure does not increase mortality rate of 50%
false
Is liver failure acute or chronic? (reversible or irreversible)
It can be acute (reversible) or chronic (irreversible)
Etiology of Liver Failure (3)
- cirrhosis: decrease functional cells
- severe hepatotoxicity eg alcohol
- fulminant hepatitis eg Hepatitis C virus
What does Fulminant mean?
severe and acute
Patho: What is impacted/cause in LF? (4)
- Hematology
- Metabolism
- Hepatorenal Syndrome
- Hepatic Encephalopathy
Patho: Explain how LF affect hematology. Describe Manifestations (5)
- hemostasis is impaired –> anemia: the ability to clot is lost
- defective synthesis of clotting factors and fibrinogen: liver is unable to provide resources for clotting
- depressed marrow function leading to thrombocytopenia and leukopenia: liver is unable to supply building blocks (clotting factors, proteins, and GFH) for blood cells in the marrow
- inadequate clearance of activated clotting factors –> DIC = disseminated intravascular coagulation: widespread formation of blood clots in sm. vessels in body (thrombosis/embolus)
- GI bleeds and hemolysis: caused by ruptured varices leading to hemorrhage
Inadequate liver fxn causes _______ failure.
multiorgan
Liver is a vital organ that help supplies resources for other organs
What is Hemolysis? Why does it occur in LF?
Hemolysis = lyses of blood cells predominantly RBC
b/c membrane of erythrocytes has defective properties d/t LF
Patho: Explain how LF affect Metabolism. Describe Manifestations (4)
- inadeq. clearance of bilirubin: bilirubin cannot be broken down into excretable form in liver resulting in jaundice
- defective urea cycle: liver is unable to process ammonia to be converted to urea resulting in hyperammonemia = acumm. of ammonia
- hypoalbuminemia = deficiency of albumin: low albumin results in low osmotic pressure t/f fluid shift out of vessels resulting in edema and ascites
- decrease estrogen catabolism: liver is unable to break down estrogen resulting in hyperestrogenism
What is bilirubin combined with to be converted to an excretable form? Where is it excreted?
Glucuronic acid
in kidneys
What is the consequence of hyperammonemia?
ammonia is toxic to body and gets into the circulation which eventually impact the brain
How does edema and ascites occur?
D/t deficiency of albumin, there is a decrease in OP which cause fluid to remain in tissues/interstitial space = edema
Increase fluid in interstitial space causes fluid to move into body cavity =ascites
What results in men and women in excessive levels of estrogen in circulation? Is it life-threatening?
Results are not life-threatening but produce significant problems.
Women and Men:
- infertility
- decrease libido
- large breast
- menstration issues
- atrophy of testicles
Patho: Explain how LF cause hepatorenal syndrome. Describe Manifestations (3)
- severe renal ischemia: vessels in hepatic portal system is dilated and systemic vessels are constricted –> acumm. of blood in splanchnic vessels –> less blood circulating to kidneys
- renal failure: failure of liver is linked to kidney failure; reversed hepatic failure improves renal fxn (mechanism unknown)
- oliguria, azotemia, and increase creatinine
