Week 11 Flashcards
(34 cards)
What is cirrhosis characterized by?
Fibrosis (scar tissue) and coversion of normal liver architecture to abnormal nodules.
When does fibrosis occur?
Happens when liver cells attempt to regenerate after liver injuries but the process is disorganized. This results in irregular lobular size and shape and impeded blood flow.
What do irregular regeneration, poor cellular nutrition, hypoxia and scar tissue result in?
Decreased functioning of the liver, which ends in cirrhosis.
What are the causes of cirrhosis?
Any liver disease, like chronic viral hepatitis, NAFLD, autoimmune hep, excessive alcohol intake.
What does alcohol do to the body?
Has a direct hepatotoxic effect, causes cell necrosis and fatty infiltration.
Approximately ___% of people with Hep C and ___% of people with Hep B develop cirrhosis.
20 and 25.
What are the 2 classifications of cirrhosis?
Compensated and decompensated.
What is compensated cirrhosis?
Its when the liver is able to continue to function. Lab tests are normal.
What is decompensated cirrhosis?
Its when the liver is unable to continue to function with its damage.
What are some early symptoms of decompensated cirrhosis?
Abdo pain, lassitude, fatigue, weight loss, enlargement of liver and spleen.
What are some late symptoms of cirrhosis?
Jaundice, peripheral edema, ascites, skin lesions, hematological disorders, endocrine distrubances, peripheral neuropathies.
Why does jaundice occur?
Occurs as a result of the liver’s decreased ability to conjugate bilirubin.
Why do skin lesions occur?
Happen because of increased circulating estrogen as a result of liver damage.
Why do hematological problems happen?
Thrombo-cytopenia, leukopenia, anemia caused by splenomegaly. Overactivity of enlarged spleen results in increased removal of blood cells from the blood.
why do coagulation problems occur?
Result from the liver’s inability to produce prothombrin, which is essential for blood clotting.
Why do endocrine disturbances occur?
Liver damage stops metabolization of steroid hormones. Can affect reproductive hormones and aldosterone. When aldosterone builds up in the body sodium and water retention occur.
Why does peripheral neuropathy occur?
May be caused by dietary deficiency in thiamine, folic acid, and cobalamin.
Why are the portal and hepatic veins and sinusoids affected by cirrhosis?
Because of structural changes and the cirrhotic process changes to the portal and hepatic veins occur. These changes result in obstruction to the normal flow of blood through the system.
What are the characteristics of portal hypertension?
Increased venous pressure, splenomegaly, large collateral veins, ascites, systematic hypertension, esophageal varices.
What are esophageal varices?
Complexes of tortuous veins located at the end of the esophagus. Enlarged and swollen as a result of portal hypertension.
Why does peripheral edema occur?
Caused by decreased colloidal oncotic pressure, as a result of impaired liver synthesis of albumin and increased portacaval pressure from portal hypertension.
Why does ascites occur?
Accumulation of serous fluid in the peritoneal or abdominal cavity. When the portal pressure elevates, protein shifts from the blood vessels into the larger pores of sinusoids into the lymph space. The lymphatic system is unable to carry protein and water, so it leaks into the peritoneal cavity.
Why does hypoalbuminemia occur?
Happens because the liver is unable to synthesize albumin, which results in a decreased colloidal onctic pressure.
Why does hyperaldostronism occur?
Liver is unable to metabolize aldosterone, which increases sodium and water retention in the kidneys.
