Patho/Pharm II: Liver

  1. What organ is the biggest in the body?
  2. How many lobes does the liver have? 
    • 2: Right and left
    • Right lobe divded into Quadrate and caudate
  3. What are the normal functions of the liver?
    • - manufacture and secretes bile
    • - metabolizes bilirubin, nutrients and detoxifies
    • - stores blood, vitamins and minerals
    • - synthesis of clotting elements
  4. What are the two functional cells in the liver? 
    • 1. Hepatocytes- bile, metabolic func.
    • 2. Kupffer- phagocytic, remove foreign subs. 
  5. True or False
    Cirrhosis of the liver is reversible.
    • False. 
    • Liver cirrhosis is not reversible, in fact it is the 4th leading cause of death in the U.S.
  6. What is liver cirrhosis?
    Chemicals or disease damage the liver→  liver cells replaced by scar tissue leading to fibrosis → scar tissue disrupts blood flow
  7. Name the different types of liver cirrhosis
    • 1. Laennec's (alcoholic)
    • 2. Postnecrotic
    • 3. Primary biliary
    • 4. Cardiac
  8. Define the 3 stages of alcoholic liver failure (ALF)
    • 1. Fatty Liver- deposits of fat cause liver enlargement. (can have full recovery)
    • 2. Liver fibrosis- Scar tissue forms (recovery poss but not full)
    • 3. Cirrhosis- Growth of connective tissue destroys liver cells (irreversible)
  9. Why are Varices (varicose vein), Splenomegaly (enlarged spleen), Ascites, or Hepatorenal syndrome complications of portal HTN?
    Back pressure 

    SAME complications as cirrhosis. Other complications of cirrhosis include: • Portal HTN•Asterixis (liver flap)- jerky movements•Abnormal bleeding
  10. Define portal hypertension
    hypertension in the hepatic portal system caused by venous obstruction or occlusion which causes backpressure of blood into spleen and "collateral" channels (esoph., rectal, abdominal veins)
  11. •Normal blood flow in liver
    Portal vein and hepatic artery -> sinusoids -> hepatic vein
  12. Hepatic Encephalopathy
    • Hepatic encephalopathy is a worsening of brain function that occurs when the liver is no longer able to remove toxic substances in the blood.
    • ***Systemic ammonia intoxication leading to cerebral edema and astrocyte (nerve) damage
  13. What are some clinical manifestations of hepatic encephalopathy?
    •Changes in personality, Memory, Confusion, Asterixis (Hand flapping), Stupor, Coma
  14. What is the treatment of hepatic encephalopathy? 
    Low protein diet, Monitor fluid and electrolytes, Decrease in use of drugs metabolized in liver, Lactulose,Neomycin
  15. Why is lactulose given to patients with liver cirrhosis? 
    To reduce ammonia levels -- expels through colon. 
  16. Why is Neomycin given to patients with cirrhosis? 
    To kill ammonia-producing bacteria in the bowel. 
Card Set
Patho/Pharm II: Liver
Patho/Pharm II: Liver