Flashcards in Symptoms of liver disease Deck (22):
What are the symptoms in early stages
Non-specific: Weakness, fatigue, general malaise (unwell)
As the disease progresses, a poor nutrition status would result in:
Chronic: weight loss and anorexia,
Advanced: loss of muscle bulk
Other symptoms of a progressed disease status:
Abdominal discomfort, pain, tenderness over the liver, jaundice
There are also Cutaneous signs on the skin:
Hyperpigmentation (darker pathces), scratch marks, Spider naevus(surface vessels), and also non-specific symptoms like nail changes, finger clubbing, palmar erythema, and Dupuytren's contracture which is involuntary contration of the fingers towards the palm.
What are the abdominal signs of Liver disease?
Distension, Hepatomegaly, Splenomegaly, Umbilical and Paraumbilical Veins
An obvious sign of Liver disease:
Jaundice where the breakdown of RBCs is impaired, and there is an increased level of Birilium circulating the blood
What are the symptoms of Jaundice?
Yellowing of the sclerae in the eye, and the skin.
Pruritis - itchiness due to deposition of bile salts in the skin
(The concnetraion of bile salts in the skin does not correlate with severity of the Pruritis i.e. colud have little bile salts but lot of itchiness)
What are the different causes of Jaundice?
Hepatocellular: drugsm hepatitis, Tumours
Cholestatic: Obstruction of bile release
Prehepatic: Increased blood breakdown
If the jaundice is caused by Cholestatic conditions, what are the treatment optins?
Get the obstruction removed by endoscopy, radiology, or surgery.
What are the treament options for Jaundice caused by conditions other than Cholestasis?
Another symptom of Liver disease is Portal Hypertension which can lead to:
Chollateral vein formation (alternative route for the blood to flow to bypass the Portal Venous system) and the shunting of blood to the systemic circulation
What does Portal Hypertension contribute to?
Formation of Ascites (fluid accumulation in the abdominal cavity), and the development of encephalopathy
Complications of Portal hypertension will lead to
A variceal bleed - the veins in the oesophagus, stomach, rectum enlarge to accomodate the blocked blood flow.
What other conditions apart from Portal hypertension can lead to Ascites?
Central hypovolaemia (decreased blood vlow), reduced serum albumin, Splanchnic artery vasodilation (relating to visceral organs)
Other issues that occur are CLOTTING ABNORMALITIES which means:
The synthesis of defective clotting factors, with an increased tendancy to bleed.
Hepatocyte failure will directly cause the defective synthesis of factors
I and V, increased risk of bleeding
Hepatocyte Failure will also cause defective bile excretion leading to:
Malabsorption of Vitamin K, Defective synthesis of factors II, VII, IX, X, increased risk of bleeding
Hypersplenism which is an overactive spleen will cause
Low platelets and increased tendancy to bleed.
There are some endocrine changes due to liver disease most common in:
Alcoholic Liver disease
Endocrine changes is thought to be due to
Poor metabolism of oeastrogen
In males, the symptoms of Endocrine changes due to liver disease is
Testicular atrophy (diminish in size), female body hair, gynaecomastia (enlargment of breasts)