Patho 3 1

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Author:
jld15
ID:
305742
Filename:
Patho 3 1
Updated:
2015-07-26 18:04:48
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Patho
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Patho 3 1
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  1. Liver Function
    • Filters blood from GI tract
    • Conversion and secretion of bilirubin (Product of breakdown of hem)
    • Sole source of albumin (pulls fluid into kidneys for excretion)
    • Produces bile
    • Production of clotting factors
    • Storage of vitamins
  2. Liver Disease: Signs and Symptoms
    • Edema (Ascites)
    • Dark colored urine
    • Light colored stools
    • Abdominal pain (URQ)
    • Jaundice
    • Asterixis (Flapping tremor)
    • Coagulopathy (easy bruising)
    • -----Clotting factors not produced bc liver damaged
  3. Liver Failure
    • Often occurs gradually
    • Signs/symptoms
    • -----Hepatic encephalopathy
    • -----Mental status changes due to liver damage
    • Treatment
    • -----Liver transplant (end stage/chronic)
    • -----Supportive measures while take its course (chronic viral)
  4. Chronic liver failure
    • More common
    • Hep B/C
    • ETOH abuse
  5. Acute liver failure
    • Rare
    • Occurs within 48hrs of damage of liver
    • Tylenol overdose
    • Poisonous wildness mushroom
  6. Liver Injury
    • Parenchymal regeneration
    • ----Depending on severity
    • Formation of scar
    • ----Depending on severity
    • Fibrosis – cirrhosis
    • ----Parenchymal regeneration and scar formation cause fibrosis and enough fibrosis causes cirrhosis
  7. Cirrhosis
    • Group of end-stage diseases of the liver
    • Combination of two lesions
    • ----Fibrosis
    • ----Regeneration nodules
    • Caused by ETOH abuse and Hep C
    • When 80% tissue fibrotic there is a significant loss of liver function
  8. Cirrhosis Signs/Symptoms
    • Interferes with liver function
    • Storage and release of blood
    • Metabolism
    • ----Drugs as well as it used to be (can’t tolerate it as well)
    • Regulation
    • ----Na and fluid regulation
    • Production
    • ----Problem with clotting
    • ----Occurs over many yrs.
    • Fatigue, weight loss, jaundice, ascites
    • Can go undetected if mild
  9. Cirrhosis Diagnosis
    • Lab values
    • ----ALT, AST elevated if liver damaged
    • ----Albumin: low bc liver not producing it
  10. Cirrhosis Treatment
    • Maximize function
    • Minimizing toxic factors
    • No cure
    • Prognosis: Transplantation
  11. Liver disease complications
    • Jaundice
    • Portal hypertension
    • Hepatic encephalopathy
    • Ascites
    • Hepatorenal syndrome
  12. Jaundice (Icterus)
    • Due to:
    • overproduction of bilirubin
    • defect in bilirubin metabolism
    • liver disease
    • obstruction of bile flow
    • Classified according to location
    • ----Pre-hepatic
    • ----Hepatic
    • ----Post-hepatic Ex: gallstones
  13. Jaundice PT implications
    • Pt needs to REST!!
    • Don’t over fatigue
    • Walking program vs heavy duty exercises
  14. Portal Hypertension
    • Abnormally high BP in the portal venous system
    • Result of obstruction
    • ----Fluid backs up into GI track
    • Sx
    • ----Varices (Dilated fragile bv, Potential for bleeding and GI bleeding)
    • ----Ascites
    • ----Splenomegaly
    • Dx
    • ----Endoscopy
    • Management
    • ----Band ligation- Can tie off varices
    • ----B-blockers
    • ----Prevent portal pressure

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