Jaundice and chronic liver disease

7 flashcards · Biology · by Anonymous Sloth

1. Functions of the liver

   Synthetic function Clotting factors Bile acids Carbohydrates Proteins Lipids Hormones Detoxification Immune function Storage function

2. What is tested in a liver function test

   Bilirubin Biproduct of haeme metabolism Conjugated in the liver (solubilise) Aminotransferases Enzyme of the hepatocyte Alkaline phosphatase Present in the bile duct Elevated with obstruction or infiltration Also found in bone, placenta and intestines Gamma GT Non-specific liver enzyme Elevation in alcohol use Can be raised bu NSAIDs Albumin Tests synthetic liver function Low levels indicates chronic liver disease Also caused by kidney disorder and malnutrition Prothrombin time Tells degree of…

3. What is jaundice

   Yellowing of the skin, sclerae and other tissue caused by excess bilirubin in the systemic circulation

4. Describe how the liver produces bilirubin

   Haem of old and damaged RBC is broke down to biliverdin by enzymes then to bilirubin by further enzymes. This is then converted to bilirubin diglucoronide by UGT. This is then secreted to the gallbladder which combines in bile and is released into the alimentary canal to be excreted in stool It is also then reabsorbed in the terminal ileum (extra hepatic recirculation)

5. State the classification of jaundice

   Pre-hepatic (unconjugated) Increased quantity of bilirubin Impaired transport Hepatic (conjugated) Defective uptakes of bilirubin Defective conjugation Defective excretion Post-hepatic (conjugated) Defective transport of bilirubin by biliary ducts

6. History for jaundice

   Pre-hepatic Anaemia (fatigue, dyspnoea, chest pain) Acholuric jaundice Hepatic Risk factors of liver disease (IVDU and Decompensation (ascites, varicella bleeding, encephalopathy) Post-hepatic Abdominal pain Cholestasis (pruritus, pale stools, coloured urine)

7. Clinical examination for jaundice

   Pre-hepatic pallor Splenomegaly