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Flashcards in Liver - hepatitis Deck (17)
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1

What is cirrhosis?

Irreversible damage to liver
Microscopically - liver will be fibroses - area of nodular regeneration

2

Cause cirrhosis?

Alcohol, infection hep B or C

3

What is jaundice?

Yellow pigmentation skin, sclerae and mucosa causing excess plasma bilirubin

4

What is pre-hepatic jaundice?

Excess bilirubin production
Liver become rate limiting step - build up of uncojugated bilirubin in skin
Faeces still brown as still have conjugated bilirubin

5

How is bilirubin produced?

Product of harm degradation = liver normally conjugate and excrete bilirubin

6

Why is faeces brown?

Bacteria break down stercobillogen into stercobillin which is responsible for brown faeces

7

What is post-hepatic jaundice?

Blockage of bile duct - conjugated bilirubin produced but not release into intestine for excretion
Cause pale stools and dark urine

8

What is intra-hepatic jaundice?

Happen when liver function is reduced
Conversion into bilirubin becomes slower - still some conjugated therefore usually avoid pale stool

9

What is ascites?

Accumulation of protein-containing fluid within abdomen
common cause = portal hypertension

10

How investigate liver function?

FBC
LFT - when damaged releases enzymes into blood and liver produced proteins decrease
Coag screen - inc. platelet count and bleeding time

11

Why is problem w/ haemostats in liver disease?

1. Thrombopoetin not produced
2. Liver dependent clotting factors reduced
3. Splenic sequestration of platelets (related portal shunt)

12

Administering LA in hepatic pt?

2-3 fold decrease in mod-severe impairment

LA - amides metabolised in liver - toxic reaction at lower expected dose

13

Why haematemesis in hepatic pt?

Arise from oesophageal varies due to hypertension

14

Function of liver

1. Detoxification
2. Conjugation - change uncharged fat-soluble to charger water-soluble particles that can be exerted

15

How much bilirubin for jaundice?

>5mg dl-1 in blood

16

What is problem caused by porto-systemic shunt?

-Haematemesis - rupture oesophageal varices
-Encephalopathy

17

3 routes of porto-systemic shunting?

1. Rectum = haemorrhoids
2. Abdomen = captures medusa
3. Oesophageal