Hepatic Encephalopathy and Ammonia
40 Questions
1 Views

Choose a study mode

Play Quiz
Study Flashcards
Spaced Repetition
Chat to lesson

Podcast

Play an AI-generated podcast conversation about this lesson

Questions and Answers

What is the primary outcome of chronic liver disease?

  • Liver cancer
  • Cirrhosis (correct)
  • Hepatitis
  • Liver failure

    • What is the characteristic appearance of the liver in cirrhosis?

  • Cobbly and firm (correct)
  • Swollen and tender
  • Palest and brittle
  • Smooth and soft

    • What is the primary cause of portal hypertension in cirrhosis?

  • Blood shunting through the liver
  • Obstruction of hepatic veins
  • Hypoxia and necrosis of hepatocytes
  • Increased resistance to flow in the portal venous system (correct)

    • What is the late-stage manifestation of cirrhosis and portal hypertension?

    <p>Ascites and edema</p> Signup and view all the answers

    What is the primary cause of alcoholic cirrhosis?

    <p>Alcohol abuse</p> Signup and view all the answers

    What is the primary site of damage and inflammation in biliary cirrhosis?

    <p>Bile canalculi and bile ducts</p> Signup and view all the answers

    What is the typical demographic affected by primary biliary cirrhosis?

    <p>Women over 30 years old</p> Signup and view all the answers

    What is the result of impaired synthesis of albumin by the liver in cirrhosis?

    <p>Decreased colloidal osmotic pressure</p> Signup and view all the answers

    What is the primary mode of transmission of Hepatitis A virus?

    <p>fecal-oral route through contaminated food or water</p> Signup and view all the answers

    What is the duration of the incubation period of Hepatitis A virus?

    <p>2-4 weeks</p> Signup and view all the answers

    What is the duration of contagiousness before the onset of symptoms in Hepatitis A virus infection?

    <p>2 weeks</p> Signup and view all the answers

    What is the primary site of replication of Hepatitis A virus?

    <p>liver</p> Signup and view all the answers

    What is the duration of Hepatitis A virus infection?

    <p>4 months</p> Signup and view all the answers

    What is the percentage of people in developed countries who have evidence of Hepatitis A virus infection by mid-adult life?

    <p>40-50%</p> Signup and view all the answers

    What is the characteristic of Hepatitis A virus infection in developing nations?

    <p>most children are infected by age 10</p> Signup and view all the answers

    What is the outcome of Hepatitis A virus infection?

    <p>it does not cause a carrier state or chronic hepatitis</p> Signup and view all the answers

    What is the primary function of the liver in regards to ammonia metabolism?

    <p>To convert ammonia to urea</p> Signup and view all the answers

    What is the usual cause of hypotension in hepatorenal syndrome?

    <p>GI bleeding or failing liver</p> Signup and view all the answers

    What is the effect of ammonia accumulation on the brain?

    <p>It alters cerebral metabolism and interferes with neurotransmitter function</p> Signup and view all the answers

    What is the outcome of hepatorenal syndrome if left untreated?

    <p>Fatal coma</p> Signup and view all the answers

    What is the primary cause of renal failure in hepatorenal syndrome?

    <p>Sudden decrease in blood volume</p> Signup and view all the answers

    What is the term for inflammation of the liver?

    <p>Hepatitis</p> Signup and view all the answers

    What is the effect of the liver's inability to remove vasoconstrictive substances in hepatorenal syndrome?

    <p>Renal vasoconstriction</p> Signup and view all the answers

    What is the outcome of ammonia accumulation in the brain?

    <p>Rigidity and hyperreflexia</p> Signup and view all the answers

    What is the predominant chronic liver disease in the US?

    <p>Hepatitis C</p> Signup and view all the answers

    What is the concern regarding transmission of Hepatitis C?

    <p>Even small amounts of blood during tattooing, acupuncture, and body piercing can facilitate transmission</p> Signup and view all the answers

    What percentage of Hepatitis C cases exhibit jaundice?

    <p>25%</p> Signup and view all the answers

    What is the role of antibodies in Hepatitis C?

    <p>They serve as markers of the disease</p> Signup and view all the answers

    What is unique about Hepatitis D?

    <p>It is a defective RNA virus that cannot infect the hepatocyte on its own</p> Signup and view all the answers

    What is the distinguishing feature of Hepatitis E?

    <p>It has a high mortality rate among pregnant women</p> Signup and view all the answers

    What is the primary location where Hepatitis E occurs?

    <p>Underdeveloped countries</p> Signup and view all the answers

    What is the relationship between Hepatitis D and Hepatitis B?

    <p>Hepatitis D co-infects with Hepatitis B and depends on it for replication</p> Signup and view all the answers

    What is the average life expectancy after the onset of symptoms in patients with cirrhosis?

    <p>8-10 years</p> Signup and view all the answers

    What is the primary cause of secondary biliary cirrhosis in children?

    <p>Biliary atresia</p> Signup and view all the answers

    What percentage of people with Hepatitis C develop post-necrotic cirrhosis?

    <p>25%</p> Signup and view all the answers

    Which of the following is NOT a common symptom of post-necrotic cirrhosis?

    <p>Diarrhea</p> Signup and view all the answers

    What is the primary method of diagnosis for post-necrotic cirrhosis?

    <p>Needle biopsy</p> Signup and view all the answers

    Which of the following is a complication of advanced alcoholic cirrhosis?

    <p>Post-necrotic cirrhosis</p> Signup and view all the answers

    What is the primary cause of death in patients with post-necrotic cirrhosis?

    <p>Bleeding varices</p> Signup and view all the answers

    Which of the following is a cause of secondary biliary cirrhosis?

    <p>All of the above</p> Signup and view all the answers

    Study Notes

    Cerebral Edema and Hepatic Encephalopathy

    • Ammonia, a by-product of protein metabolism and intestinal bacterial action, accumulates in the brain and alters cerebral metabolism, leading to hepatic encephalopathy.
    • The liver's inability to convert ammonia to urea in liver failure causes neurologic signs, including rigidity, hyperreflexia, and seizures.
    • Fatal coma may occur due to hepatic encephalopathy.

    Hepatorenal Syndrome

    • Hepatorenal syndrome is a complication of advanced liver disease, characterized by renal failure.
    • The pathophysiology of hepatorenal syndrome involves a sudden decrease in blood volume, leading to decreased GFR, tubular necrosis, and renal vasoconstriction.
    • The liver's inability to remove vasoconstrictive substances, such as angiotensin, vasopressin, and catecholamines, contributes to renal vasoconstriction.

    Hepatitis

    • Hepatitis refers to inflammation of the liver and can be caused by viral infections, drug reactions, infectious disorders, and other factors.
    • Hepatitis A is caused by a small RNA-containing virus and is transmitted through the fecal-oral route.
    • The incubation period for HAV is 2-4 weeks, and individuals may be contagious for up to 2 weeks before the onset of symptoms.

    Hepatitis A

    • Hepatitis A is a self-limiting disease that usually runs its course within 4 months after exposure.
    • HAV does not cause a carrier state or chronic hepatitis.
    • By mid-adult life, about half of people in developed countries have blood anti-HAV antibodies as evidence of infection.

    Hepatitis C

    • Hepatitis C is the most common blood-borne infection in the US, affecting approximately 3.9 million Americans.
    • Chronic hepatitis occurs in 50-80% of cases, and HCV is the most common cause of chronic liver disease, cirrhosis, and liver cancer worldwide.
    • There is no vaccine available for HCV due to the over 50 subtypes of the virus.

    Hepatitis D

    • Hepatitis D is a defective RNA virus that cannot infect hepatocytes on its own and requires co-infection with HBV.
    • The Delta agent often increases the severity of HBV infection and can convert mild HBV infection into severe, fulminant disease.

    Hepatitis E

    • Hepatitis E is common in developing countries and clinically resembles hepatitis A.
    • It does not cause chronic or carrier states and has a high mortality rate (20%) among pregnant women.

    Cirrhosis

    • Cirrhosis is a leading cause of death in the US and represents the end stage of chronic liver disease.
    • Normal liver architecture and function are disrupted with the development of diffuse fibrosis and nodular regeneration.
    • Obstruction can cause portal hypertension, leading to increased resistance to flow in the portal venous system and blood shunting.

    Causes of Cirrhosis

    • Alcoholic cirrhosis (Laennec's cirrhosis) occurs after years of alcohol abuse and begins with fatty infiltration of the liver.
    • Biliary cirrhosis can be primary (autoimmune disease) or secondary (develops with prolonged partial or complete obstruction of the common bile ducts or branches).
    • Post-necrotic cirrhosis can result from severe liver disease, drugs, or toxins.

    Studying That Suits You

    Use AI to generate personalized quizzes and flashcards to suit your learning preferences.

    Quiz Team

    Related Documents

    Liver Module 11 PDF

    Description

    This quiz covers the role of ammonia in hepatic encephalopathy, a complication of liver failure. Learn how ammonia accumulation affects the brain and leads to severe symptoms.

    More Like This

    Acute Liver Failure
    14 questions

    Acute Liver Failure

    HappyMeadow avatar
    HappyMeadow
    Acute Hepatitis and Liver Failure Quiz
    5 questions

    Acute Hepatitis and Liver Failure Quiz

    SustainableSplendor142 avatar
    SustainableSplendor142
    Liver Disease: Hepatic Encephalopathy (HE)
    10 questions

    Liver Disease: Hepatic Encephalopathy (HE)

    FashionableHaiku avatar
    FashionableHaiku
    Hepatic Encephalopathy (HE) & Liver Failure
    80 questions

    Hepatic Encephalopathy (HE) & Liver Failure

    ComfortableGalaxy avatar
    ComfortableGalaxy
    Use Quizgecko on...
    Browser
    Open
    Browser
    Browser