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liver pathology

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6 general liver functions:
"Excretory/detoxification (in bile)
General examples of substances stored in liver
vitamin K, iron, copper, fat soluble vitamins, glycogen
Examples of substances synthesized in liver
albumin, alpha I antitrypsin; proteins of coagulation cascade (fibrinogen, prothrombin, VIII,IX, X, XI, and Xli), bile
Liver failure becomes apparent when _______ of liver is destroyed or dysfunctional
80%
"
"Jaundice of skin and eyes
7 general signs of liver failure:
"Jaundice, Hypoalbumenernia, Hepatorenal syndrome, Portal hypertension, Encephalopathy, Endocrine abnormalities, coagulopathy
Encephalopathy I liver failure is due to the failure of the liver to remover _________ from the .
ammonia
2 major functions of hepatic bile
"elimination of bilirubrin and cholesterol
_______ occurs if bilirubin levels are greater than _______mg/dl.
Jaundice, 1.2
Jaundice is best recognized in the __________.
sclera
Which type of bilirubin is tightly bound to albumin?
Unconjugated bilirubin:
Which type of bilirubin is water soluble?
Conjugated bilirubin
Which type of bilirubin can be excreted in ?
conjugated
Conjugation of bilirubin takes place where?
Liver --No Eric, it is not the breast
A manifestation of Gilbert's disease is:
Prehepatic Jaundice
Hepatic Jaundice is seen under what general conditions?
viral or -induced hepatitis, alcoholic hepatitis, tumors, and cirrhosis
T/F Hepatic Jaundice is associated with a buildup of conjugated bilirubin only.
False: It is mixed conjugated and unconjugated
Conjugated hyperbilirubinemia is manifest in what condition?
post-hepatic jaundice
post-hepatic jaundice is seen in _________ disorders such as gallstones, tumors of bile ducts, pancreas, or duodenum
obstructive
_________ is the accumulation of unconjugated bilirubin (usually> 20 mg/dl) in the brain causing severe neurologic damage
Kernicterus
Kernicterus can be seen in this condition that affects infants:
hemolytic disease of the newborn (erythroblastosis fetalis)
Additional causes of jaundice:
"antifungals, high amounts of beta-carotene, medications
Elevated ammonia levels in the from liver failure that lead to disturbances in consciousness ranging from behavioral abnormalities to coma is called:
hepatic encephalopathy
Hepatorenal syndrome:
liver fails--> kidneys fail drop in output, increase in urea nitrogen/creatine levels (in end-stage liver disease)
______ is synonymous with end-stage liver disease
Cirrhosis
T/F Cirrhosis is among the top ten causes of I western society.
TRUE
Cirrhosis may take one to ___ years to develop.
20
What is the major pathologic process that accompanies cirrhosis?
"progressive fibrosis (regenerative firm nodular surface)
⬢ Necrosis of hepatocytes (councilman bodies) are shrunken eosinophilic apoptotic anuclear fragments of hepatocytes)"
"Morphologic changes seen with viral hepatitis
• Hepatitis B— ground glass hepatocytes— due to accumulation of HBsAg; sanded nuclei due to abundant HBcAg"
"Morphologic changes seen with viral hepatitis
With viral hepatitis, what is the timeline established for acute vs. chronic infection?
"acute = resolves within 6 months
1 in __ patients is a carrier"
"4 million
characteristics of fulminant hepatitis include:
"severe acute iiver damage, encephalopathy, coaguiopathy with high risk of approaching 80%
fulminant hepatitis develops within _____ weeks of the onset of liver disease.
8
⬢ donations not screened for Hepatitis A"
"Hepatits A:
⬢ Can remain infective on operatory surfaces up to 7 days, cold sterilization ineffective"
"Hepatitis B
⬢9 documented cases of transmission from dental provider to patient over past 30 years"
"Hepatitis B

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