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Alimentory System > Main functions of the liver > Flashcards

Main functions of the liver Flashcards

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1
Q

what are the role of the liver

A

production of the clooting factors
bile acids
carohyrades production, gluconugesi
protein synstes
lipdis
hormones

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2
Q

how does the liver detodxy

A

removal of urea
detoxifciation of drugs
bilirubin metabolism
breakdown of insulin and hormones

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3
Q

what is the immune function of liver

A

clearning blood of particel and infectiosn including bacteria
nutrilsing and destroying all drugs and toxins

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4
Q

what does hte liver store

A

vid d, a, b12 and k

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5
Q

what type of bilirubin is bond to albumin

A

unconjugated

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6
Q

is unconfugae soluble in water

A

no

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7
Q

can unconjuaged bilirubi pass through brain barrier

A

yes

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8
Q

what are amniotransferases

A

enzymes present in the hepatocytes

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9
Q

which is mroe speici, alt or ast

A

alt

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10
Q

what chemical sratin piotns toward ald

A

ast, alt

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11
Q

what is alkaline phosphatas

A

enzyme presnet in bile duct with is elvetated in liver obstion or infaiton,

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12
Q

where can alkaline phosphatise be found

A

bile ducts, obstuaiotn and livver infaltion, bones, placent and intestines

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13
Q

what does radiwd gamma gt mean

A

alchol use or drug suc as nsaids

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14
Q

what does low levels of albumin mena

A

kidney disoroer or chronci liver diseaes

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15
Q

what is a low prothorbin time indicitiv off

A

liver dysfuctoin

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16
Q

what does creatine mean

A

determes surfial from liver deia nad need for transplant

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17
Q

what can a low platelte count indicate

A

hyperslenism

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18
Q

what is the platlet count an indirect mraker of

A

portal hypertension

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19
Q

symptoms of liver failure

A

jaundice
ascites
variceal bleed
hepatic encephalopathy

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20
Q

causes of preheaptic jandice

A

increased quantity of bilirubin
imparied transprot

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21
Q

hepatic causes of jaundice

A

defectvie uptake of bilirubin
defective conjugation
defective excretion

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22
Q

post hepatic jaundice cause

A

defective tranport of bilirubin by th biliary ducts

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23
Q

what are the cues on hisrotyr for pre hepatic jaundice

A

anemica
acholuri jaundice

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24
Q

clues on history for hepatic jaundice

A

risk foactr for liver diesea e.g. ivdu
decompresation - acidtes, varicela bleed, encephalopahty

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25
clues on history for post hepatic jaundice
abdomial pain cholestatis - pale stool, high colured urine, prutitus
26
what is seen on clical examination for pre hepatic jaundice
pallor, splenomegaly
27
what is seen on clincial examion for hepatic jaundice
stigmata of cld, ascites asterixis
28
what is seen on clinal examintion for post hepatic jaundice
palpable gall bladder
29
what blood investigation can be done for jandice
hep b and c serology auto antibody porife caerulopasmin and copper ferritin and transferrin saturation alph 1 antitrypsin fasting glucose adn lipid profile
30
what can be seen for ultra sound in jaundice patins
see where the obstion is and wherther it is extraphatic or intra hepatic delinetas site of obstuciotn cause of obstruction portal hypertension see cancer spread
31
main benift of ct/mri over sultrat
higher senityite, betteer for pancrease
32
what is ercp
uses endoscpoe and x ray to diagnose paites
33
what is mrcp
a scan using mri and contrast maerks, no die is added
34
what is endoscopic retrograde cholangiopancreatography
placing an endocpy in paitent and using radiation to highlight areas of issues uses markers
35
how can ercp be usedd therpatuily
dilate bialry tree acute gaoll stones stenting of ulary tract obsiton
36
complicaton of ercp
sedation pancratis, cholangistis sphincteromeoty
37
what is choleecocholithiaiss
gall sotnses in common bile duct
38
what is the role of the percutaneous transhepathic cholangiogarm
when ercp not possible due to duodeal obstuoi fo previous serve hilar stengin injects die into skin tgehn use ct to look at it
39
what is main differece in ercp and ptc
ercp more invaise, it uses a dye injected into liver through skin, does not require endosocpty
40
does mrcp use contrast
no
41
what is endoscopic ultrasound
a tiney proe is enter into the skin and used for biypys
42
what can endoscopic biopsy be used for
characterin pancreatic masses, stadging of tumours, fine needle aspiarto of tumor and cysts, excluding biliar mcirocalculi
43
what can be found with a liver biopsy
certain conditions sucha s autoimmune hepatitis confirm diagnos e.g. pbc, drug induced liver injury important for staing of severity e.g. alcholich hepatis, nafld
44
what is chornic liver diese
liver diase that lasts more than 6 months
45
what are the causes of cirrhosis
alchol autoimmune - primary biliary cholangitis, primary schlerosis cholangitis haemochromatosi chronci viral hepatisis b,c non alcholic fatty liver disease drugs - amiodarne cysitic fibrosis, a1 antipyin difice, wilsons disese vascualr probls - portal hypertion cyrpotgenic sacodois amyloid schistomiasis
46
what pathological change is seen in liver as a result of cirrhosis
infilataiton of lymphocytes apotopic heapcyts (enlagemnet and change in nucli) kupffer cel acited suinoi lumne with increased resistance to blood flow
47
what are the presentaion of componseaeted chronic liver diseae
screening tests abnomal liver funcion tests
48
what are the presenation of decompansted liver disese
hepatorenal syndome ascites varicela bleeding hepatic encephalopahty
49
what are acites
fluid in the free space in abdomen
50
how to confirm ascites
ultrasound
51
what are the periphal signs of ascites
spiders neivie, palmar erythema, abdomial veins, fetor hepaticus, umilical nodule jvp flank haematoma
52
what tests are needed for new onset asciteis
proetin and albumin concentation cell count and differentials sagg - serum cell count
53
what does 1.1g /dl cut of mean
if hte serum asice graide is great than 1.1g/ dl it is proal hyptension related if less than 1.1. it is non portla hyperaion related
54
causes of ascities
portal hypertension Low serum albumin causing reduced plasma oncotic pressure Hypoperfusion of the kidneys leading to activation of the renin-angiotensin system leading to salt and water retention
55
what extra tests could be done for asciti fludi
tb culture cytolgy triglueride bilirubuin
56
cause of sagg above 1.1.
portal hypertoisn chf constrictive pericarditis budd chiarri myxedema massive liver metates
57
what cause sagg below 1.1
malignancy, tb, chylous asciteis, pancretic, biliary ascietes, nephrotic syndrome, serositis
58
what are the treatment options for ascites
diuretics large volume paracenties tips aquareetics liver transplations
59
what is heptarenoal sydrome
artiers in kidney deteriorate due to increase in rass, and the heart increase contagion due to tachycardia
60
what cuawes heptaroenal syndoem
sever liver cirrhosis
61
what is the treamte for heptaorenla syneom
vasosuppersi, liver transoalt , voluem exspantoin of albium
62
what cuase viceral heamorages
portal hyperension
63
where are portaoysmpysci astomsie
skin - caput medusa oesophagel and gastric rectal posterial abdomal wall stomal
64
what are the varices with portal hyptension
caput medusae, rectal varices, oesophagel varcies
65
whis the treatmen for varcies hemoargese
recussitiaon, iv treatnem, endocopy band ligation, teripressin for contoal, sengestilblakemore tube , tipss for rebleed after banding
66
what is hepatic encephalopathy
confusion due to liver disease, due to toxin buildup
67
what is seen with hepatic encoepy symptions
gi bleed, infection, constipation, dehydration, Asterixis - flapping tremor foetoer hepatics - choronci bad breath
68
what is the terament for hepatic encephaly
underliing cause traament antiboitix including neopycin and broad spectrino laxatives - phsphe enemas nd lactulse
69
what is the most common liver cancer
hepatoceluar carcinoma
70
presenationof hepatcelluar carcinoma
abdmoial mass abdomial pain weight loss bleeding form tumouur
71
what ar the radiolical tests for hepatocellular carcinoma
ultrasound, ct, mri
72
what are the turmor markers for heptacolluar carcinoma
afp
73
treatment for hepaceluar carcinoma
hepatic rection liver transpland chemotharpy - local or systematic alcohol injection radioterhfatoin ablation tki inhitoar hormonal therapy
74
ways to deliver local chaimrey
trasncatherter arterlial chemoa embolization
75
tki infoar for hepacelluar carciaons
sorafenib
76
hormone therapy for hepacelluar cancer
tamoxifen
77
what is used to stop bleeding of oepsygal vercies
terrepressin

Alimentory System (32 decks)

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