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.
What is liver cirrhosis?
Chemicals or disease damage the liver→ liver cells replaced by scar tissue leading to fibrosis → scar tissue disrupts blood flow
Name the different types of liver cirrhosis
1. Laennec's (alcoholic)
2. Postnecrotic
3. Primary biliary
4. Cardiac
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)
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
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)
•Normal blood flow in liver
Portal vein and hepatic artery -> sinusoids -> hepatic vein
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
What are some clinical manifestations of hepatic encephalopathy?
•Changes in personality, Memory, Confusion, Asterixis (Hand flapping), Stupor, Coma
What is the treatment of hepatic encephalopathy?
Low protein diet, Monitor fluid and electrolytes, Decrease in use of drugs metabolized in liver, Lactulose,Neomycin
Why is lactulose given to patients with liver cirrhosis?