Wk 4 Cirrhosis

Question 1

What is cirrhosis?

Answer 1

Irreversible, inflammatory, fibrotic liver disease

Question 2

What causes cirrhosis?

Answer 2

Structural changes from injury, such as alcohol or viruses, and fibrosis

Question 3

What is the mortality rate of cirrhosis?

Answer 3

26%

Question 4

The pathological mechanisms of cirrhosis are..

Answer 4

not well understood

Question 5

What is fibrosis of the liver a result of?

Answer 5

Infiltration of leukocytes that release inflammatory mediators in activation of this fibrotic process

Question 6

What does chaotic fibrosis throughout the liver lead to?

Answer 6

Obstructive biliary changes and blood flow

Question 7

What does obstructive biliary changes and blood flow cause?

Answer 7

Jaundice

Portal hypertension

Question 8

Why does the liver not just regenerate?

Answer 8

Regeneration is disrupted by hypoxia, necrosis, atrophy, and liver failure

Question 9

If the damage is related to toxins such as alcohol metabolites, the progression of cirrhosis depends on…

Answer 9

the amount of toxins present

Question 10

Can removal of the toxin slow progression of cirrhosis?

Answer 10

Yes but the damage that has already occurred can’t be reversed

Question 11

What are 4 common causes of cirrhosis?

Answer 11

Hep B&C
Alcohol
Idiopathic
Non-alcoholic fatty liver disease

Question 12

When we intake alcohol it is transformed into…

Answer 12

Acetaldehyde

Question 13

Significant amounts of acetaldehyde activate what type of cells?

Answer 13

hepatic stellate cells

Question 14

What is the primary cell involved in liver fibrosis?

Answer 14

hepatic stellate cells

Question 15

What does acetaldehyde inhibit?

Answer 15

Exports and proteins from the liver

Question 16

In turn, acetaldehyde alters metabolism of…

Answer 16

Vitamins and minerals and induces malnutrition

Question 17

What also activates during alcohol consumption?

Answer 17

Kupffer cells

Question 18

Kupffer cells attract __ which promote more inflammation

Answer 18

Neutrophils

Question 19

What else do kupffer cells cause?

Answer 19

Toxins to accumulate from translocation of gut bacteria and causes cellular mediated immunity to be suppressed

Question 20

What is the most common type of cirrhosis?

Answer 20

Alcoholic cirrhosis

Question 21

Alcoholic cirrhosis accounts for __% of all types of cirrhosis

Answer 21

25%

Question 22

Alcoholic fatty liver is the…

Answer 22

Mildest/asymptomatic stage of alcoholic cirrhosis development

Question 23

Which alcoholic liver stage is a precursor to cirrhosis?

Answer 23

Alcoholic steatohepatitis

Question 24

What is alcoholic steatohepatitis?

Answer 24

Inflammation, degeneration of hepatocytes

Question 25

What is alcoholic fibrosis and scarring of the liver?

Answer 25

Alcoholic cirrhosis

Question 26

If a patient stops drinking in the alcoholic fatty liver phase...

Answer 26

their liver can go back to normal once they stop drinking and don't have other liver toxins

Question 27

Fat deposition in the liver is caused by an increase in...

Answer 27

lipogenesis and other pathological changes within the hepatocytes themselves which is caused by the acetaldehyde

Question 28

At the point of alcoholic steatohepatitis, it is stimulating

Answer 28

Irreversible fibrosis

Question 29

What are the symptoms of alcoholic steatohepatitis?

Answer 29

Anorexia nausea jaundice edema

Question 30

Alcoholic cirrhosis is characterized by...

Answer 30

``` Oxidative stress Inflammation Cellular damage Cellular necrosis Fibrosis ```

Question 31

List 7 steps to liver failure

Answer 31

``` Liver cells destroyed Cells try to regenerate Disorganized process and abnormal growth Poor BF and hypoxia scar tissue formation Liver failure ```

Question 32

What are the GI disturbances of EARLY liver cirrhosis

Answer 32

N/V Anorexia Flatulence Change in bowel habits

Question 33

What other 3 symptoms are early manifestations of liver cirrhosis?

Answer 33

Fever Weight loss Palpable liver

Question 34

Cirrhosis is often diagnosed in the...

Answer 34

Late stages