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23 Cards in this Set
- Front
- Back
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Liver Failure
:Most common Cx :Clinical Features |
80-90% Loss of functional capacity
Cx: Chronic progressive disease with cirrhosis Clinical Features: -Hypoalbuminemia -HYPERbilirubinemia (Jaundice) -HYPERammonemia -HYPERestrogenemia -Increased portal blood shunting Increased risk for organ failures -Encephalopathy -Hepatorenal syndrome -Hepatopulmonary syndrome |
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Cirrhosis
:Endstage chronic liver disease :Common causes :Pathology |
Most common causes:
-Alcohol abuse -Viral hepatitis -Non-alcoholic fatty liver disease Pathology :Bridging fibrosis (scarring) :Parenchymal nodules (regeneration) :Architectural/Vascular reorganization (Collagen in Space of Disse) |
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Portal Hypertension
:Consequence of Cirrhosis :Cx :Complications |
Cx: Increased resistance to blood flow through the portal vein
Intra-hepatic cirrhosis Complications: -Ascites -Creations of portosystemic shunts -Congestive Splenomegaly -Hepatic encephalopathy |
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Cholestasis
:consequence of cirrhosis :impaired bile secretion/flow |
Bile -> hepatocyte damage
Elevated Alk P HYPERbilirubinemia (blood) Jaundice, Pruritis (skin) Yellow sclera (eye) Xanthomas (skin) Fat absorption (GI) |
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Infectious Hepatitis
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:CMV
:Viral Hepatitis -Acute inf. w/ recovery -Fulminant acute hepatitis -Chronic hepatitis :Acute Fulminant Hepatitis |
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Autoimmune Hepatitis
:CD4,8 T-cells attack hepatocytes |
Usually Pt. has other autoimmune diseases
Elevated gammaglobulins US: Type 1 (more common) Europe: Type 2 (more common) |
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Alcoholic Liver Disease
:3 features |
3 features
:Steatosis :Hepatitis :Cirrhosis Larger Liver Size |
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Non-alcoholic Fatty Liver Disease
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empty
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NAFLD
:Non-alcoholic fatty liver disease |
Steatosis with minor inflammation
Most common cause of chronic liver disease 2 hit hypothesis :1 Fat accumulation :2 Oxidative stress |
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NASH
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Empty
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Hemochromatosis
:Cause :HFE gene C282Y |
Cause: Genetic defect of Fe absorption (heritable)
Unrestricted Fe release into blood Hepcidin: Prevents Fe release into blood HFE gene 282Y mutation (70% pop) |
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Alpha-1-antitrypsin deficiency
:autosomal recessive |
Empty
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Wilson's Disease
:WND gene mutation (ATP7B) :autosomal recessive |
Accumulation of copper
:Liver, brain, eyes Kasier-Fleisher rings (eyes) |
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Primary Sclerosing Cholangitis
:Clinical Presentation |
Clinical Presentation
:Ulcerative colitis :High Alk P. :Pruritis, fatigue, jaundice, cirrhosis :Liver transplantation :Risk for cholangiocarcinoma |
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Chronic Passive Congestion
(Hepatic circulatory disorders) |
Right sided heart failure)
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Centrilobular Necrosis
(Hepatic Circulatory Disorders) |
Left sided heart failure, Shock
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Liver Laboratory Tests
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AST
ALT Total & Direct Bilirubin Decreased serum albumin Increased Prothrombin time |
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Liver Histology
:Periportal area :Pericentral area :Mid-zonal area :Space of Disse |
Periportal area: Around portal triad. Resistant to ischemia b/c recieves most highly oxygenated blood
Pericentral area: Around hepatic vein. Prone to ischemia b/c gets least oxygenated blood Mid-zonal area: Rich in 02 and nutrients Space of Disse: Garbage dump for hepatocyte trash. Affected in Cirrhosis |
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Fulminant Acute Hepatitis
(Viral Infectious Hepatitis) |
Massive to submassive necrosis
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Hepatic Steatosis (Fatty Liver)
:Cause :Diagnosis |
Cause: Chronic alcoholic use
Vesicular lipids accumulate in cells Increased weight |
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Alcoholic hepatitis
:4 findings (diagnostic) |
4 findings
:Hepatocyte damage :Mallory bodies :Neutrophils :Fibrosis Steatosis (extra clue) |
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Alcoholic cirrhosis
:3 changes |
3 changes
:Bridging fibrosis :Regenerative nodules :Vascular reorganization Mallory Bodies (end stage) |
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Primary Biliary Cirrhosis
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Intrahepatic medium-size bile ducts are destroyed by inflammation
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