Liver Function and Cirrhosis Overview

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Questions and Answers

What is a potential cause of post necrotic cirrhosis?

Chronic biliary obstruction

Heart failure

Alcohol consumption

Viral hepatitis (correct)

What does portal hypertension result from?

Increased albumin production

Decreased blood volume in the abdomen

Increased blood flow through the liver

Increased resistance due to fibrosis (correct)

What is the primary substance that decreases due to liver cirrhosis, leading to ascites?

Albumin (correct)

Glucose

Bilirubin

Electrolytes

Which type of cirrhosis is associated with gallbladder disease?

Biliary cirrhosis Signup and view all the answers

What is a complication of cirrhosis characterized by yellow discoloration of the skin?

Jaundice Signup and view all the answers

Which condition results from an increase in venous pressure due to portal hypertension?

Hemorrhoids Signup and view all the answers

What is the primary cause of cirrhosis of the liver in the United States?

Chronic alcoholism Signup and view all the answers

What is a typical antidote given for a Tylenol overdose, which can help prevent liver damage?

Activated charcoal Signup and view all the answers

What are esophageal varices primarily caused by in cirrhosis patients?

Congestion due to blood backup Signup and view all the answers

What physiological change occurs in the liver during the progression of cirrhosis?

Liver enlarges and becomes firm in the early stage Signup and view all the answers

What impact does decreased albumin levels have on the body?

Decrease in oncotic pressure leading to fluid leakage Signup and view all the answers

Which symptom is most likely to develop as a result of ascites due to cirrhosis?

Difficulty breathing Signup and view all the answers

Which of the following correctly describes a key characteristic of cirrhosis?

It involves extensive scarring and fibrosis of the liver. Signup and view all the answers

What is the function of bilirubin in the body, particularly in relation to liver health?

It indicates the breakdown of waste products in the liver. Signup and view all the answers

Which of the following conditions does NOT contribute to liver disease?

Physical inactivity Signup and view all the answers

In which state is the liver described as shrinking and decreasing in function?

Progressive cirrhosis Signup and view all the answers

What is a common consequence of hypovolemic shock due to bleeding from esophageal varices?

Loss of consciousness Signup and view all the answers

Which vitamin deficiency due to decreased bile production poses a significant risk for bleeding disorders?

Vitamin K Signup and view all the answers

What is the mortality rate for patients who experience hemorrhage from esophageal varices?

50% Signup and view all the answers

What is the total normal platelet count range?

150,000-450,000 Signup and view all the answers

What symptoms might suggest the presence of bilirubin due to liver dysfunction?

Clay-colored stool and dark urine Signup and view all the answers

What is a necessary component for the replication of Hepatitis D virus (HDV)?

Hepatitis B virus Signup and view all the answers

What is a common management strategy for patients with active bleeding from esophageal varices?

Fluid resuscitation through IV Signup and view all the answers

Which factor contributes to the risk of bone fractures in patients with liver disease?

Decreased bile production Signup and view all the answers

What is the primary method for preventing the transmission of Hepatitis D virus?

Avoiding IV drug use Signup and view all the answers

Which of the following symptoms is NOT commonly associated with liver cancer in its later stages?

Nausea Signup and view all the answers

What is the prognosis for patients diagnosed with liver cancer?

Often negative with a recommendation for hospice care Signup and view all the answers

Which intervention is likely to be ineffective for treating liver cancer?

Chemotherapy Signup and view all the answers

Which preventive measure should be taken to avoid Hepatitis E virus infection?

Avoiding undercooked pork Signup and view all the answers

What is the main reason for the severity of the clinical course associated with Hepatitis D virus?

Its persistence depends on the duration of Hepatitis B. Signup and view all the answers

What is a noted characteristic of the primary source of cancer in the liver?

It rarely originates in the liver. Signup and view all the answers

Which of the following statements about liver transplantation is correct?

Patients can be live donors donating a portion of healthy liver. Signup and view all the answers

Study Notes

Liver Function and Disease

The liver has over 500 functions, affecting every body system.
It is the largest organ in the body, and crucial for digestion, nutrition, and metabolism.
Liver disease can severely impact these functions.
Without a healthy liver, survival is impossible.

Cirrhosis

Cirrhosis is a chronic, long-term liver disease characterized by scarring of the liver.
The scarring is extensive and irreversible.
This chronic inflammation often leads to hepatic necrosis (tissue death).
Cirrhosis commonly develops over years, not weeks.
In the US, the major causes of cirrhosis are chronic alcoholism and hepatitis C.
Other common global causes include hepatitis B and D.

Pathophysiology of Cirrhosis

Fibrotic bands of connective tissue form.
This scarring is termed fibrosis.
Hepatic (liver) inflammation also plays a role.
Toxins and cell destruction within the liver are additional contributors.

Liver Function Tests and Implications

Liver enzymes (AST, ALT, alkaline phosphatase) elevated.
Bilirubin levels can be high.
Albumin levels are usually low in cirrhosis and liver disease (typically in the range of 3.5-5.0 mg/dL). Low levels indicate problems with the liver’s ability to produce this protein. Albumin is essential for maintaining blood pressure.
Liver function decreases with progression, potentially causing shrinkage.
In early stages, many patients are asymptomatic, but as the disease progresses, symptoms may be more severe.
Up to 40% of patients remain asymptomatic even in later stages.

Complications of Cirrhosis

Portal hypertension: Reduced blood flow through the liver.
Ascites: Fluid build-up in the abdomen.
Esophageal varices: Enlarged veins in the esophagus. These can easily bleed.
Gastric varices: Enlarged veins in the stomach.
Hemorrhoids: Enlarged veins in the rectum.
Splenomegaly: Enlarged spleen.

Additional Complications

Encephalopathy: High ammonia levels affect the brain, causing confusion, disorientation, personality changes, and slurred speech.
Nutritional deficiency: Liver plays a critical role in nutrient processing and storage.
Jaundice: Yellowing of the skin and eyes, due to bilirubin buildup.
Hepato-cellular disease: Liver cells are unable to effectively process bilirubin.
Esophageal Varices: Bleeding from enlarged vessels in the esophagus.
Liver Cancer (Cirrhosis as possible cause): This condition is marked by a high fatality rate due to internal bleeding. Symptoms include loss of appetite, weight loss, upper right quadrant pain, jaundice, and bleeding.

Treatment and Management

Treatment for Esophageal Varices: Fluid resuscitation, blood transfusions may be necessary, and Sengstaken-Blakemore tube may be employed.
Additional Treatment (Cirrhosis): Beta-blockers, such as propranolol and nadolol, may be prescribed to manage blood pressure. Also, Fresh Frozen Plasma is beneficial for enhancing blood clotting.
Endoscopic Procedures: Variceal ligation (banding) and sclerotherapy to stop bleeding.
Endoscopic Variceal Ligation: Ligation of the enlarged veins to reduce bleeding.
Endoscopic Sclerotherapy: Injection of a chemical into enlarged veins to shrink them, reducing bleeding.
Nutritional Therapy: Diet modification to reduce ammonia levels.
Medication: Neomycin and lactulose (commonly not used together), metronidazole.
Treatment for Encephalopathy: Lactulose to reduce ammonia levels.
If infections occur after surgery, antibiotics may be given.
Transplantation: May be an option for end-stage liver disease. The need for a successful transplantation often requires prior treatment to ensure liver function is optimal.

Types of Hepatitis

Viral hepatitis is an inflammation of the liver.
Five different types (A, B, C, D, and E) cause liver injury.
Transmission can occur via numerous pathways, including contaminated food, water, or direct contact.
Different hepatitis types have different incubation periods, and symptoms can vary.

Hepatitis A

Easily transmitted via fecal-oral route, contaminated food and water.
Self-limiting with symptomatic treatment.

Hepatitis B

Primarily through contact with blood or bodily fluids.
May or may not present with symptoms.
Vaccination is recommended for prevention.

Hepatitis C

Primarily through contact with blood or bodily fluids.
Chronic infection is a major cause of cirrhosis.
Antiviral treatment is often effective at suppressing the virus.

Portal Systemic Encephalopathy

Complication of cirrhosis, affecting the brain.
Ammonia buildup leads to neurological problems.

Liver Cancer

Often metastasizes from other organs.
Early diagnosis is crucial for improved outcomes.
Surgical options, radiation, and chemotherapy are possible treatments.

Liver Transplantation

Considered for end-stage liver disease.
Factors like active alcoholism and substance abuse may exclude a patient from consideration.
Requires immunosuppressant medications to prevent rejection.

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Description

Explore the vital functions of the liver and the implications of liver diseases such as cirrhosis. Understand how liver health is crucial for overall body function, and learn about the common causes and pathophysiology of cirrhosis. This quiz will test your knowledge on liver function tests and their significance in disease management.