Week 11 Flashcards

(80 cards)

1
Q

liver function

A
  • bile production
  • clearing meds
  • metabolism
  • protein production
  • breakdown toxins
  • clotting factors
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2
Q

loss of bile production leads to

A

jaundice

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3
Q

loss of med clearance leads to

A

drug toxicity

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4
Q

loss of clotting factors leads to

A

coagulopathy

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5
Q

loss of toxin breakdown leads to

A

encephalopathy

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6
Q

loss of protein production leads to

A

low albumin > edema / ascites

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7
Q

loss of metabolism leads to

A

hypoglycemia, lethargy, cachexia

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8
Q

hepatitis

A

liver injury due to inflammation

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9
Q

what are acute hepatitis

A

hepatitis A / E

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10
Q

what are chronic hepatitis

A

hepatitis B / C

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11
Q

what leads to increased risk of liver cirrhosis / cancer

A

hepatitis B / C

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12
Q

what are the sources of hepatitis A / E

A

contaminated food & water, acute illness

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13
Q

what are the sources of hepatitis B / C

A

blood products / bodily fluids

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14
Q

those infected with acute hepatitis B present with __

A

lethargy, body-aches, fever, jaundice and dark tea-
colored urine

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15
Q

what is a rare complication of hepatitis A / E

A

liver failure; transplant is the only life saving option

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16
Q

risk of liver cancer increased in

A
  • males > 40 yrs, females > 50 yrs
  • liver cirrhosis
  • family history
  • high level of hep B
  • alcohol, smoking, obesity
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17
Q

what does lipogenesis result in

A
  • dyslipidemia
  • insulin resistance
  • obesity
  • metabolic syndrome
  • Type 2 diabetes
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18
Q

what does inflammation result in

A
  • lipid peroxidation
  • mitochondrial dysfunction
  • oxidative stress
  • apoptosis
  • pro-inflammatory cytokine activation
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19
Q

what does fibrosis result in

A
  • advanced cell damage
  • scarring
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20
Q

what are the 3 stages involved in fatty liver disease

A

lipogenesis, inflammation, fibrosis

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21
Q

what gene is associated with autoimmune hepatitis

A

human leukocyte antigen

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22
Q

gallbladder diseases

A

cholelithiasis, cholecystitis, biliary colic, choledocholithiasis, cholangitis

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23
Q

cholelithiasis

A

gallstones in gallbladder

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24
Q

cholecystitis

A

GB & cystic duct inflammation

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25
biliary colic
abdominal pain due to gallstone in gallbladder neck
26
choledocholithiasis
gallstones in CBD
27
cholangitis
infected bile ducts
28
causes of cholelithiasis
bile saturated due to high cholesterol, obesity, estrogen
29
causes of biliary colic
Gallstone lodged in the neck of the gallbladder or cystic duct
30
causes of Cholecystitis
infected GB leading to inflammation
31
causes of choledocholithiasis
Obstruction of biliary flow into the duodenum due to gallstone stuck in CBD
32
causes of Cholangitis
biliary tract infected causing obstructed bile flow
33
cirrhosis
hardening of liver
34
causes of cirrhosis
hepatitis B / C excessive alcohol autoimmune liver disease fatty liver iron build up copper accumulation repeated heart failure with liver congestion
35
most common causes of liver cirrhosis in SG
chronic hepatitis B & alcoholic liver disease
36
symptoms of compensated cirrhosis of the liver
- abnormal function tests - low platelet count - spider like blood vessels - fatigue and weight loss
37
symptoms of decompensated cirrhosis of the liver
- abdominal swelling - leg swelling - jaundice - vomit blood - confusion
38
how is cirrhosis diagnosed
US, MRI, CT
39
complications of portal hypertension
dilated vessels > splenomegaly > fluid accumulation in abdomen
40
complications of liver failure
low protein > easy bruising > jaundice
41
complications of cirrhosis
ascites, varices, encephalopathy, jaundice, liver cancer
42
ascites
fluid accumulation in abdomen due to low protein levels in body
43
leg swelling
fluid accumulation in feet
44
spider naevi
dilated blood vessels on upper chest wall
45
palmar erythema
reddish discoloration of palms due to dilated blood vessels
46
jaundice
yellowing of sclera of eyes due to bilirubin accumulation
47
varices
swollen veins in esophagus & stomach leading to rupture and bleeding
48
hematemesis
vomit blood
49
malena
dark stool
50
encephalopathy
confusion & drowsiness due to toxins in brain
51
liver cirrhosis severity determined by
- cirrhosis / child's score A, B, C - MELD score - liver siffness / fibroscan
52
liver cirrhosis treatment
- treat hepatitis B / C - stop alcohol - treat autoimmune hepatitis - exercise / weight loss
53
varices treatment
reduce variceal bleeding via - non selective beta blockers for portal hypertension - endoscopic banding / ligation
54
mild ascites treatment
avoid development of ascites & leg swelling via - low salt diet - diuretics to increase water clearance
55
severe ascites treatment
remove excess fluid to reduce abdominal swelling & breathlessness - abdominal paracentesis - TIPS shunt - liver transplant
56
hepatic encephalopathy treatment
- clear bowels regularly to reduce toxins - lactulose to prevent constipation - fleet enema to clear retained stools
57
types of liver transplant
cadaveric & living donor
58
how is cirrhosis diagnosed
biopsy & fibroscan (measures stiffness)
59
how should one survey for liver cancer
Ultrasound & AFP every 6 months; confirm using CT/MRI
60
arterial phase characteristic is __
hypervascular
61
delayed venous phase characteristic is __
washout
62
what test is used for liver function
child pugh class & portal hypertension
63
what test is used for physical status
ECOG, co-morbidities, symptoms
64
what is the material used for selective internal radiation therapy
Yttrium-90
65
TACE
transarterial chemoembolization
66
systemic chemotherapy used for HCC is __
sorafenib
67
when is RFA suitable for HCC
single nodules < 3cm & outcome similar to surgery for nodules < 2cm
68
RFA
radiofrequency ablation
69
TACE is recommended for __
BCLC B; multifocal HCC w/o PV invasion or metastasis
70
SIRT w/ Y90 is suitable for __
multifocal HCC w/ PV invasion
71
what hormones are inactivated in liver
aldosterone & estrogen
72
gluconeogenesis
protein & fat > glucose
73
glycogenolysis
glycogen > glucose
74
hepatic artery function
supplies oxygenated blood from general circulation
75
hepatic portal vein function
supplies nutrients
76
what neutralizes HCl
bicarbonate ions
77
endocrine hormones produced by islet of langerhans
insulin, glucagon
78
where is vitamin K synthesized
resident normal flora
79
what does congested spleen & varices lead to
hemolysis
80
what is the most common primary tumor
hepatocellular carcinoma