Liver Functions and Conditions Quiz
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Questions and Answers

What is the name of the vein that carries blood from the digestive system to the liver?

Portal vein

What happens to the blood flow when the liver is failing?

The blood flow is slowed and blocked

What is the name of the condition when the liver enlarges?

Hepatomegaly

What is the main function of the liver?

<p>Filtering the blood</p> Signup and view all the answers

What happens to the liver cells when they get damaged?

<p>They lay down fibrotic scar tissue</p> Signup and view all the answers

What type of cells are being regenerated in the liver after being damaged?

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

What are the three main complications of cirrhosis?

<p>Portal hypertension, decreased liver function, and hepatocellular carcinoma</p> Signup and view all the answers

What is the name of the condition that can cause an increase in pressure in the veins that drain the digestive system?

<p>Portal hypertension</p> Signup and view all the answers

What is the name of the condition that causes fluid buildup in the abdomen?

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

What is the name of the condition that causes swelling in the legs and ankles?

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

What is the name of the condition that causes the liver to enlarge and become yellow?

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

What is the name of the condition that causes inflammation of the liver?

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

What is the name of the condition that causes the liver to become scarred and hardened?

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

What are the three stages of alcoholic liver disease?

<p>Fatty liver, alcoholic hepatitis, and cirrhosis</p> Signup and view all the answers

What type of virus causes hepatitis B?

<p>Double-stranded DNA virus</p> Signup and view all the answers

What are the five main categories of liver function?

<p>Synthesis, storage, metabolic, elimination, and excretion</p> Signup and view all the answers

What is the primary cause of fibrotic scarring in the liver?

<p>Excessive alcohol consumption</p> Signup and view all the answers

Which statement correctly describes portal hypertension?

<p>It results from the constriction of blood flow due to nodules in the liver.</p> Signup and view all the answers

What is the primary clinical manifestation when a patient with cirrhosis is decompensating?

<p>Manifestations of liver failure</p> Signup and view all the answers

Which condition is least common among the causes of liver damage?

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

What occurs when hepatocytes regenerate into nodules?

<p>Constriction of blood flow in the liver</p> Signup and view all the answers

What complication arises from decreased liver function in cirrhosis?

<p>Portal hypertension</p> Signup and view all the answers

Which factor is NOT associated with parenchymal damage in the liver?

<p>Excessive physical exercise</p> Signup and view all the answers

What results from hepatic congestion due to right heart failure?

<p>Portal hypertension</p> Signup and view all the answers

What condition is often characterized by increased resistance to blood flow in the portal venous system?

<p>Portal Hypertension</p> Signup and view all the answers

Which complication is associated with the backflow of blood in mesenteric veins due to portal hypertension?

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

What is a consequence of the formation of portosystemic shunts in cirrhosis?

<p>Increased ammonia buildup</p> Signup and view all the answers

Which of the following is a potential serious complication of esophageal varices?

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

How does liver function decline affect albumin levels in the body?

<p>Hypoalbuminemia occurs</p> Signup and view all the answers

What is often stimulated by a decrease in vascular volume due to liver complications?

<p>Renin-angiotensin system activation</p> Signup and view all the answers

Which of the following vascular changes result from portal hypertension in cirrhosis?

<p>Formation of new shunts to reduce resistance</p> Signup and view all the answers

What condition may lead to caput medusae in patients with advanced liver disease?

<p>Pressure in the internal iliac veins</p> Signup and view all the answers

What is one of the main complications of liver cirrhosis related to blood clotting?

<p>Decreased clotting factors</p> Signup and view all the answers

Which of the following conditions is associated with the impaired metabolism of estrogens in cirrhosis?

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

What effect does hypoalbuminemia have in the context of cirrhosis?

<p>Increased ascites and edema</p> Signup and view all the answers

What is a consequence of the liver's reduced ability to clear ammonia in cirrhosis?

<p>Increased blood ammonia levels</p> Signup and view all the answers

In cirrhosis, which condition is NOT a result of impaired liver function?

<p>Increased production of bile acids</p> Signup and view all the answers

What is the role of alcohol dehydrogenase (alDH) in alcohol metabolism?

<p>Catalyzes the conversion of ethanol into acetaldehyde</p> Signup and view all the answers

What characterizes the treatment approach for liver failure due to cirrhosis?

<p>Managing ammonia production</p> Signup and view all the answers

What happens to NAD+ during alcohol metabolism?

<p>It gets consumed and reduced to NADH</p> Signup and view all the answers

Which metabolic process is inhibited due to increased NADH levels from alcohol consumption?

<p>β-oxidation</p> Signup and view all the answers

What is a primary physiological change in males due to hyperestrogenism associated with cirrhosis?

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

Which of the following best describes thrombocytopenia in cirrhosis?

<p>Decreased thrombopoietin production</p> Signup and view all the answers

What can be a consequence of elevated acetaldehyde levels in the liver?

<p>Formation of free oxygen species (ROS)</p> Signup and view all the answers

How does the production of NADH affect lactic acid metabolism?

<p>It increases the conversion of pyruvate to lactate</p> Signup and view all the answers

What is the daily alcohol intake estimate associated with the development of liver disease?

<p>80 g/day</p> Signup and view all the answers

What progressive change is NOT part of alcoholic liver disease?

<p>Acute pancreatitis</p> Signup and view all the answers

Which of the following factors can influence individual susceptibility to alcohol-induced liver damage?

<p>Biological sex and genetics</p> Signup and view all the answers

What characterizes alcoholic hepatitis?

<p>Inflammation and necrosis of liver cells</p> Signup and view all the answers

Which symptom is NOT typically associated with alcoholic hepatitis?

<p>Dry skin</p> Signup and view all the answers

What is indicated by the presence of nodules on the liver?

<p>Irreversible damage and cirrhosis</p> Signup and view all the answers

Which condition is a potential complication of alcoholic cirrhosis?

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

What triggers acute liver inflammation in hepatotropic viruses?

<p>Direct hepatocellular injury</p> Signup and view all the answers

What is a common consequence of persistent alcoholic hepatitis?

<p>Potential progression to cirrhosis in 1 to 2 years</p> Signup and view all the answers

What change occurs to the liver as it progresses to alcoholic cirrhosis?

<p>Formation of large, uniform nodules</p> Signup and view all the answers

Which factor does NOT typically influence the progression of fatty liver?

<p>Presence of viral infections</p> Signup and view all the answers

What is the primary virus associated with the development of chronic hepatitis and cirrhosis?

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

What is a key characteristic of Hepatitis C compared to Hepatitis B?

<p>It is more genetically unstable.</p> Signup and view all the answers

What treatment is effective for chronic hepatitis infection after immunization?

<p>Interferons and antiviral agents</p> Signup and view all the answers

Which hepatitis viruses do NOT progress to chronic liver disease?

<p>Hepatitis A, D, and E</p> Signup and view all the answers

What is the term for the state where hepatitis infection does not show symptoms but can still be contagious?

<p>Asymptomatic infection</p> Signup and view all the answers

Which of the following is a manifestation associated with cirrhosis?

<p>Portal hypertension</p> Signup and view all the answers

What factor contributes to the slower progression of the disease after liver transplantation for Hepatitis C patients?

<p>Reinfection of the graft with Hepatitis C</p> Signup and view all the answers

Why does Hepatitis C pose a challenge in developing a vaccine?

<p>Its RNA structure is much less stable.</p> Signup and view all the answers

Study Notes

Hepatic Failure

  • Portal vein blood circulation: Blood enters one organ, travels through a vein, then enters another organ, and returns to circulatory circulation. All blood flowing to the liver is slowed.
  • Hemorrhoids and splenomegaly can be symptoms of liver failure.

Table of Contents

  • Assessing liver function (covered in introduction)
  • Cirrhosis
  • Alcoholic liver disease
  • Hepatitis-induced cirrhosis

Cirrhosis

  • Overview: Injury causes cells to produce fibrotic scar tissue and the regeneration of hepatocytes is inhibited. Fibrotic scar tissue and growing nodules restrict blood flow through the vessels and bile ducts.
  • Main causes: parenchymal damage, vascular disease, and biliary tract disease.

Etiologies of Liver Damage

  • Parenchymal damage: Alcohol (most common), autoimmune hepatitis, viral (hepatitis B and C), and nonalcoholic fatty liver disease (obesity, hypertension, hyperlipidemia).
  • Vascular disease: Right heart failure (causing hepatic congestion) and clots in hepatic veins.
  • Biliary tract disease: inflammation of intrahepatic and/or extrahepatic bile passageways (cholangitis), causing bile backflow.

Clinical Manifestations

  • Compensated cirrhosis is initially asymptomatic.
  • Decompensated cirrhosis presents symptoms due to complications of:
    • Portal hypertension
    • Decreased liver function
    • Hepatocellular carcinoma
  • Portal hypertension: hepatic encephalopathy, esophageal varices, ascites, splenomegaly, and acute kidney injury.
  • Decreased liver function: hypoalbuminemia, coagulopathies, ammonia buildup, hyperestrogenism, and hyperbilirubinemia (jaundice).

Portal Hypertension

  • Increased pressure in the peritoneal capillaries causes collateral channels, shunting blood flow.
  • Causes: Splenomegaly, anemia, leukopenia, thrombocytopenia, bleeding, and hepatic encephalopathy.
  • Backflow of blood from the mesenteric veins leads to ascites and splenomegaly.
  • Portosystemic shunts: cause esophageal varices and ammonia buildup. Complications include: hemorrhoids, caput medusae, esophageal varices (hematemesis and melena), and elevated ammonia levels leading to hepatic encephalopathy.

Portal Hypertension: Ascites

  • Blood backs up into the mesenteric veins, increasing hydrostatic pressure.
  • This causes fluid buildup in tissues and the peritoneal cavity, causing abdominal distension.
  • Danger of bacterial translocation: microbes travel to the peritoneum and cause peritonitis.

Ascites Treatment

  • Dietary restrictions and diuretics.
  • Diuretics inhibit aldosterone, affecting the nephron.
  • Loop diuretics (furosemide).
  • Bed rest prevents activating the renin system.
  • Paracentesis: removing large volumes of fluid.
  • Volume expanders (albumin) are sometimes needed to maintain circulating volume.

Portal Hypertension: Splenomegaly

  • Blood shunting back along the splenic vein enlarges the spleen.
  • Sequestration of formed elements (RBCs, platelets, leukocytes) is called hypersplenism.
  • Increased transit time through the spleen removes more formed elements from the blood, causing anemia, thrombocytopenia, and leukopenia.

Decreased Liver Function

  • 80-90% of the liver's functional capacity is lost.
  • Manifestations result from the loss of synthesis, storage, metabolic, and elimination functions.
  • Main complications: decreased clotting factors, decreased thrombopoietin production, hypoalbuminemia, decreased ammonia clearance, hyperestrogenism, and decreased bilirubin processing.

Liver Failure: Endocrine Disorders

  • Liver metabolizes estrogens; they remain in circulation longer (hyperestrogenism).
  • In males: testicular atrophy, gynecomastia, impotence.
  • In females: menstrual irregularities, sterility, loss of libido, palmar erythema, and spider angioma.
  • Impaired bilirubin conjugation impairs bile acid production and malabsorption of fats and fat-soluble vitamins (cholestasis). Bilirubin accumulates in the sclera and skin (jaundice)

Liver Failure: Treatment

  • Eliminating alcohol is a priority.
  • Provide sufficient carbohydrates to prevent protein breakdown.
  • Manage ammonia production in the GI tract by controlling protein intake.
  • Prevent infections.
  • Liver transplantations can treat end-stage liver disease.

Alcoholic Liver Disease

Alcohol Metabolism

  • Most alcohol is metabolized by alcohol dehydrogenase (ADH) in hepatocytes.
  • ADH converts ethanol → acetaldehyde → acetate.
  • Excess NADH is problematic.

Fatty Liver

  • Increased lipogenesis → fat deposition in hepatocytes (steatosis).
  • The liver enlarges and becomes yellow. Progression is not fully understood; depends on alcohol consumption, diet hormones.
  • Reversible with controlled alcohol consumption

Alcoholic Hepatitis

  • Inflammation, necrosis of liver cells, and fibrotic tissue.
  • Develops acutely with increased alcohol intake. Increased risk if persistent alcohol intake.
  • Symptoms include hepatic tenderness, pain, anorexia, nausea, fever, jaundice, ascites, and hepatic encephalopathy.
  • Mortality rate ≈ 10% for acute phase; chronic hepatitis may progress to cirrhosis in 1-2 years.

Alcoholic Cirrhosis

  • End-stage alcoholic liver disease, extensive uniform nodules.
  • Nodules grow and compress hepatic veins/bile ducts, producing Cholestasis (accumulation of bile components in the blood) and portal hypertension(causing portosystemic shunts).

Hepatitis-induced cirrhosis

  • Hepatitis refers to inflammation of the liver. Many viruses (Epstein-Barr, herpesviruses, enteroviruses, hepatitis A, B, C, D, E) can cause systemic liver inflammation and injury.
  • Hepatitis often develops due to direct hepatocellular injury or the body's response to viral antigens.
  • An inability to remove the virus early can lead to chronic hepatitis and the ability to transmit the virus.
  • Hepatitis A, D, and E typically do not progress to chronic liver disease.
  • Hepatitis B and C are associated with cirrhosis.

Disease Progression

  • Viral hepatitis can present as asymptomatic infection, acute hepatitis, liver failure, carrier state, or chronic hepatitis. Some types may progress to cirrhosis.

Hepatitis B

  • Double-stranded DNA virus, blood-borne (through infected serum/blood).
  • Clinical course: Acute or chronic hepatitis, cirrhosis, fulminant hepatitis, and carrier state.
  • Immunization provides long-term protection

Hepatitis C

  • Single-stranded RNA virus, blood-borne (through infected serum/blood).
  • Common cause of chronic hepatitis, cirrhosis, and hepatocellular cancer.
  • No effective vaccine
  • Treatment includes interferons and nucleoside agents; transplants more successful than in Hepatitis B, but graft infection may occur.

Review Questions (from slide 30)

  • Describe the unique characteristics of blood circulation in the liver compared to other organs.
  • How is a liver lobule organized?
  • List and explain the main categories of liver function, and describe what manifestations arise when each function is impaired.
  • What are the functions of the hepatocytes?
  • What are nodules in cirrhosis? Explain their formation and impact on liver function.
  • Describe portal hypertension, its cause, and the associated manifestations.
  • List the common manifestations of cirrhosis.

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Lecture 21.2 Hepatic Failure PDF

Description

Test your knowledge on the liver's roles and the conditions affecting it. This quiz covers topics such as blood flow related to liver health, common liver diseases, and the main functions of the liver. Perfect for students studying anatomy or health sciences.

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