Liver and Bile Disorders Quiz

Fatty Liver Disease and Bile Summary

• Fatty Liver Disease (FLD) can be caused by increased fatty acid synthesis, decreased oxidation of fatty acids, or impaired release of lipids from carrier proteins, common in heavy drinkers and alcoholics, and can lead to liver injury, cirrhosis, cancer, and liver failure.
• FLD is diagnosed through liver enzymes (AST/ALT), ultrasound, CT/MRI, and biopsy, and is commonly associated with alcoholic liver disease (ALD) and non-alcoholic fatty liver disease (NAFLD) in type II diabetes patients or metabolic syndrome.
• Alcoholic Liver Disease (ALD) refers to structural and functional changes in the liver resulting from excessive alcohol consumption, with three progressive stages: alcoholic fatty liver, alcoholic hepatitis, and alcoholic cirrhosis.
• Cirrhosis can be caused by alcoholic liver disease, chronic hepatitis, severe liver necrosis, drugs, chemicals, bile duct obstruction, genetic/autoimmune diseases, and leads to liver failure, portal hypertension, ascites, and clotting disorders.
• Cirrhosis interruptions in blood circulation through the liver results in portal hypertension and reduced blood flow, leading to the formation of circulatory bypass routes and increased risk of fatal hemorrhage from esophageal varices.
• The treatment of cirrhosis and portal hypertension includes endoscopic ligation/ablation of varices, drugs to reduce portal hypertension, and liver transplant with a 75% 5-year survival rate.
• Surgical procedures for the treatment of cirrhosis include portal-systemic anastomoses, splenorenal shunt, portacaval shunt, intrahepatic portosystemic shunt, and transjugular intrahepatic portosystemic shunt (TIPS).
• Reye Syndrome affects infants and children, causing fatty liver with liver dysfunction, cerebral edema with neurologic dysfunction, and has no specific treatment with a mortality rate of 25%.
• Bile is an aqueous solution with various dissolved substances, including conjugated bilirubin, bile salts, lecithin, cholesterol, water, and minerals, and is secreted continually, concentrated, and stored in the gallbladder.
• Bile acts as a biological detergent, aiding in the digestion of fats, and bilirubin is eliminated in feces and urine after being removed by conjugation in the liver.
• Evidence suggests that Reye Syndrome's pathogenesis is due to the combined effect of viral illness and the use of acetylsalicylic acid (aspirin), which may increase injurious effects on the liver and brain.
• Bile contains various dissolved substances and acts as a biological detergent, aiding in the digestion of fats, and bilirubin is eliminated in feces and urine after being removed by conjugation in the liver.

Liver Anatomy and Hepatitis Overview

• The liver is the largest organ in the body, located in the right upper quadrant of the abdominal area, beneath the diaphragm.
• It receives a double blood supply, with 70% of blood coming from the portal vein and the rest from the hepatic artery.
• Liver lobule is the functional unit of the liver.
• Common types of liver injury include viral infection, fatty liver, and toxins/alcoholic liver disease, which can lead to cirrhosis and potential cancer development.
• Various viruses are associated with hepatitis, including Hepatitis A, B, C, D, and E.
• Hepatitis A is an RNA virus with an incubation period of 2 to 6 weeks, transmitted through direct person-to-person contact or fecal contamination of food or water. It is self-limiting and can be prevented and treated with a vaccine or immune globulin.
• Hepatitis B is a dsDNA virus with an incubation period of 6 weeks to 4 months, primarily transmitted through blood or body fluids. It can lead to chronic liver disease and liver cancer, and prevention/treatment involves vaccination, immune globulin, and antiviral drugs.
• Hepatitis C is an ssRNA virus with an incubation period of 3 to 12 weeks, primarily transmitted through blood and body fluids. It can lead to chronic liver disease and cancer, and is treated with antiviral drugs, with no immunization available.
• Hepatitis D, or Delta Hepatitis, only infects individuals with acute or chronic hepatitis B virus (HBV) infection, and most U.S. cases are from sharing needles.
• Hepatitis E is transmitted through oral-fecal route and contaminated water, tends to be acute and self-limiting, and no immunization is available.
• Diagnosis of hepatitis involves blood tests to detect specific antigens, antibodies, and viral load.
• Different types of hepatitis have varying incubation periods, modes of transmission, prevention/treatment methods, and potential long-term effects on the liver.