Liver Disease Quiz (BMS Learning Outcomes)

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Questions and Answers

What is one of the essential functions of the liver in relation to carbohydrates?

  • Filters toxins from the blood
  • Breaks down proteins
  • Produces vitamins A and D
  • Converts glucose into glycogen (correct)

Which condition is characterized by reversible liver damage with lifestyle changes?

  • Primary biliary cirrhosis
  • Cirrhosis
  • Haemochromatosis
  • Alcoholic hepatitis (correct)

Which of the following symptoms indicates advanced liver disease?

  • Dark urine (correct)
  • Nausea
  • Tiredness and weakness
  • Weight gain

What is one way Hepatitis B can be transmitted?

<p>Via blood through needle stick injuries (C)</p> Signup and view all the answers

What condition is primarily caused by the immune system attacking bile ducts?

<p>Primary biliary cirrhosis (D)</p> Signup and view all the answers

Which symptom is associated with increased blood pressure in the liver?

<p>Spider naevi (D)</p> Signup and view all the answers

What is a major consequence of untreated cirrhosis?

<p>Liver failure (A)</p> Signup and view all the answers

Which vitamin is stored by the liver and is essential for vision?

<p>Vitamin A (B)</p> Signup and view all the answers

Which of the following is NOT a role of the liver?

<p>Producing insulin for digestion (A)</p> Signup and view all the answers

What is one of the consequences of excessive alcohol consumption on the liver?

<p>Cirrhosis leading to irreversible damage (C)</p> Signup and view all the answers

What precaution must be taken when treating a patient with hepatitis C?

<p>Wear personal protective equipment (PPE) (D)</p> Signup and view all the answers

What post-transplant consideration is crucial in dental treatment planning?

<p>Avoid dental treatment until at least 6 months after transplant (C)</p> Signup and view all the answers

Which of the following is a common modification in anesthetic usage for patients with liver disease?

<p>Switch to articaine instead of lidocaine (B)</p> Signup and view all the answers

What is a possible oral consequence for children who need liver transplants?

<p>Delayed eruption of teeth or dental hypoplasia (C)</p> Signup and view all the answers

What is an important dietary consideration for patients with liver disease?

<p>Diet analysis and advice are essential (B)</p> Signup and view all the answers

What is a consequence of poor oral hygiene (OH) linked to alcoholic cirrhosis?

<p>Sialosis or parotid enlargement (A)</p> Signup and view all the answers

Which of the following statements about treating patients with liver disease is FALSE?

<p>High doses of tetracycline can be safely used. (D)</p> Signup and view all the answers

What might be necessary for a patient with liver disease after invasive dental procedures?

<p>Antibiotic prophylaxis due to immune suppression (C)</p> Signup and view all the answers

Which of the following is NOT recommended for patients with liver disease?

<p>Waiting until after transplant for dental care (C)</p> Signup and view all the answers

What should be prioritized in the oral health care of patients with liver conditions?

<p>Good oral hygiene practices (C)</p> Signup and view all the answers

Flashcards

Hepatitis C

Hepatitis C is a viral infection spread through blood contact, impacting liver health. It requires strict infection control measures.

Increased Bleeding Risk (Hepatitis C)

A patient with Hepatitis C has a higher risk of bleeding during dental procedures due to compromised liver function.

Delayed Wound Healing (Hepatitis C)

Patients with Hepatitis C may experience delayed wound healing after dental procedures due to impaired liver function.

Antibiotic Prophylaxis (Hepatitis C)

Dental treatment for Hepatitis C patients often requires antibiotic prophylaxis due to potential immunosuppression.

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Alcoholic Cirrhosis

Alcoholic cirrhosis is a severe liver condition linked to excessive alcohol consumption and can lead to dental problems.

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Oral Manifestations of Alcoholic Cirrhosis

Patients with alcoholic cirrhosis often experience dental neglect, erosion caused by gastric reflux, and salivary gland enlargement.

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Gingival Enlargement (Ciclosporin)

Ciclosporin, a medication sometimes used after liver transplant, can cause gingival overgrowth.

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Dental Development Issues (Liver Transplant)

Children needing liver transplants may experience delayed tooth eruption or hypoplasia, discoloration, and other developmental issues.

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Post-Transplant Dental Delay

Dental treatment for liver transplant patients should be delayed for at least 6 months after the procedure to allow for recovery.

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Dental Modifications for Liver Disease

Dental practitioners should be aware of specific modifications required for patients with liver disease.

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Liver as a filter

The liver filters and cleanses blood, removing toxins and metabolic waste products. It also plays a crucial role in breaking down and eliminating harmful substances from the body.

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Bile production

The liver produces bile, a digestive fluid that helps break down fats and absorb fat-soluble vitamins. Bile is stored in the gallbladder and released into the small intestine.

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Glucose regulation

The liver is responsible for making and storing glucose, a type of sugar that provides energy to the body. It converts excess glucose into glycogen for storage and releases stored glycogen when needed.

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Liver's role in clotting

The liver manufactures blood clotting factors, which are essential for stopping bleeding. It also produces albumin, a protein that helps maintain blood volume and pressure.

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Alcohol's effect on the liver

Alcohol consumption can lead to damage to the liver, progressing from reversible stages like alcoholic fatty liver disease and alcoholic hepatitis, to irreversible cirrhosis, which can lead to liver failure.

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NAFLD

Nonalcoholic fatty liver disease (NAFLD) is a build-up of fat in the liver, unrelated to alcohol consumption. It is often linked to obesity, diabetes, and high blood pressure.

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Primary Biliary Cirrhosis

Primary biliary cirrhosis is an autoimmune disease where the immune system attacks the bile ducts in the liver, leading to inflammation and scarring.

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Viral Hepatitis

Hepatitis A, B, and C are viral infections that can cause liver damage. Hepatitis A is spread through contaminated food or water. Hepatitis B and C spread through contact with infected blood.

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Symptoms of liver disease

Symptoms of liver disease often present as fatigue, loss of appetite, and weight loss, but more severe symptoms like jaundice, itching, and swelling may indicate advanced liver damage.

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Hepatitis B and dental care

Dental professionals can advise on the prevention of Hepatitis B through vaccinations and the importance of safe practices like using sterile needles and proper hygiene to prevent transmission.

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Study Notes

Liver Function

  • Filters and cleans the blood
  • Processes carbohydrates, proteins, and fats
  • Stores vitamins (A, D, E, K, B12) and minerals (iron, copper)
  • Produces bile for fat digestion and absorption
  • Removes toxins and metabolic waste
  • Fends off infections, digesting bacteria, fungi, parasites, etc
  • Regulates blood glucose and cholesterol
  • Synthesizes essential proteins (clotting factors, albumin, hormones, etc)
  • Maintains normal blood clotting
  • Breaks down hemoglobin, cholesterol, proteins, hormones, and drugs

Liver Disease Causes

  • Alcohol: Alcohol must be processed by the liver, causing damage with consistent consumption. Different stages, from reversible fatty liver to irreversible cirrhosis.
  • Non-Alcoholic Fatty Liver Disease (NAFLD): Fat buildup due to obesity, hypertension, and diabetes.
  • Immune System Issues: Autoimmune attacks on bile ducts (primary biliary cirrhosis).
  • Tumors and Cysts: Abnormal growths within the liver.
  • Inherited Conditions: Examples include iron overload (hemochromatosis).
  • Viral Infections: (Hepatitis A, B, C, D, E): Spread through various routes, leading to inflammation and potential liver damage.

Liver Disease Symptoms

  • Often asymptomatic until significantly damaged
  • Symptoms may include fatigue, nausea, loss of appetite, weight loss, skin changes (palmar erythema, spider naevi, finger clubbing), enlarged salivary glands, jaundice, itching, easy bleeding/bruising, swollen extremities, and dark urine; and endocrine disturbance.

Liver Disease and Dentistry

  • Relevance: Hepatitis A & B may be spread through contaminated food/drinks and blood/body fluids, respectively. Both must be anticipated in a dental setting. Hep C also has implications in the dental setting.
  • Infection Control: PPE is essential. Vaccination schedules are crucial, along with strict infection control procedures.
  • Specific Considerations: Patients with liver disease may have impaired wound healing, increased bleeding risk, and immunosuppression requiring antibiotic coverage for invasive procedures. Liver transplant patients need specific treatment considerations.
  • Modified Treatment Plans:
    • Reduced local anaesthetic dosages may be necessary.
    • Alternative or modified treatment plans might be required.
    • Increased oral hygiene, nutritional guidance, and cessation of habits.

Liver Disease and Dental Hygiene/Therapy

  • Hepatitis Implications: Dental hygienists and therapists should be aware of possible transmission routes and must be vaccinated, with appropriate PPE. Avoiding needle stick injuries is crucial.
  • Symptoms Correlation: Recognizing symptoms (e.g., bleeding/bruising, jaundice, etc.) aids in patient care.
  • Patient Management Considerations: Modifying treatment plans based on specific needs (e.g., alcohol/drug usage). Maintaining excellent oral hygiene is important, particularly in relation to liver disease, as it is closely linked with poor oral health. Oral care can be complicated by other factors such as complications linked to liver disease.

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