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31 Cards in this Set
- Front
- Back
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Liver Function: Metabolic |
Glucose homeostasis: glycogenolysis and gluconeogenesis |
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Liver Function: Synthetic |
Albumin, blood coagulation factors, binding proteins for iron, copper, vit. a |
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Liver Function: Storage Capacity |
Glycogen, tryglycerides, iron, copper, lipid soluble vitamins |
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Liver Function: Catabolic Processes |
Hormones and serum proteins |
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Liver Function: Excretory Functions |
Bile- resipotory product of heme catabolism and vital for absorboption of fat |
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Liver Tests: Not Function |
AST ALT Alkaline phosphatase yGT |
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Liver Function |
Bilirubin
INR Albumin MELD Score |
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MELD Score |
Bilirubin, INR, Creatinine |
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Hepatocellular Liver Disease |
viral hepatitis, NASH, Autoimmune, Alcoholic, Genetic liver diseases |
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Cholestatic Liver Disease |
PBC, PSC |
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Acute Liver Failure Causes |
Drug Toxicity Viral hepatitis (A,B,E) Mushroom (Amanita phalloides) Alcohol (hepatitis) |
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Cholestatic Liver Disease: Causes |
Lack of fat soluable vitamins: ADEK Osteoporosis Malnutrition |
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Hepatocelluar carcinoma: Basics |
HCC Most common malignancy deaths Asia/Africa |
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HCC Etiology |
Hepatitis C: most common in japan, combo w/ HBV increases risk Hemochromatosis: (cirrhosis) 30% risk NASH, alpha1-AT deficiency |
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HCC Treatment |
Resection Liver Transplant Palliation: RFA, TACE, PEI, Chemo |
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Gallbladder Function |
1. Reservoir for bile 2. Release of cholecystokinin causes it to contract and secrete bile into small intestine thought the common bile duct 3. Emulsification of fats and neutralizing acids in partly digested foods 4. Absorption of fat soluble vitamins |
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Bile Functions |
Bile emulsifies fat for digestion/absorption Eliminates cholesterol, insoluble liver catabolites 95% biles salts reabsorbed and recirculated Liver synthesizes up to 1L bile/d. |
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Cholelithiasis |
Gallstones |
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Types of gallstones |
cholesterol, pigment, mixed |
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Choledocholithiasis |
Small stones, sludge can get stuck in the bile duct: Cholecystitis (inflammation of the GB) Pancreatitis cholangitis ERCP Cholecystectomy |
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Nutritional Implications of Choledocholithiasis |
Indigestion, decreased ability to digest andabsorb fat, increased abdominal gas Diarrhea post surgery |
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Nutrition Therapy for Cholelithiasis |
Nutrition Intervention: Low fat, modest protein Small frequent meals During acute attacks- nothing by mouth for 12hours; bowel rest as long as symptomspersist, parenteral nutrition therapy as needed Post surgery – high fiber |
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Pancreas Function: Exocrine |
Acinar cells: help break down carbs, fats, proteins, and acids in the duodenum |
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Pancreas Function: Endocrine |
Inlet cells: insulin, glucagon, somatostatin, pancreatic polypeptide |
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Pancreatitis |
Acute: alcohol, gallstones, medications, triglyceride Chronic: alcoholic, hereditary, malabsorption |
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Pathophysiology of the ExocrinePancreas: Acute Pancreatitis |
Upper abdominal pain radiating to the backworsening with ingestion of food, nausea, vomiting Autodigestion of pancreatic cells due to prematureactivation of trypsin Diagnosis based on clinical symptoms and elevatedlipase and/or serum amylase 30-60% of cases are due to gallstones 15-30% of cases are due to excessive alcohol |
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Pathophysiology of the Exocrine Pancreas: Chronic Pancreatitis |
Chronic, irreversible inflammation leadingto fibrosis with tissue calcification Chronic abdominal pain Diabetes, steatorrhea |
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Pancreatic malabsorption leads to: |
Steatorrhea (fat in stool) Weight Loss Low levels of vitamins Bacterial Overgrowth |
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Nutritional Implications ofPancreatitis |
Malnutrition, inadequate digestionand absorption Steatorrhea
Decreased Vitamin B12 absorptionand fat soluble vitamins |
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Pancreatic Cancer: Symptoms and treatment |
4th LCD: 95% increase Symptoms: anorexia, weight loss abdominal pain, new onset DM, jaundice. Treatment: surgery, but many patients are inoperable at presentation |
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Nutritional Aspects of Pancreatic Cancer |
Steatorrhea Diarrhea (following Whipple resection) Early satiety, anorexia: frequent smaller meals • Replace vitamins (A, D, E, K, if low B12) |
