Liver disease

• What are the main diagnostic functions of the liver?

  • Synthesis/secretion of bile
  • Plasma proteins (albumin and clotting factors)
  • Metabolism (drugs, glucose, NH3, lipids)
  • Storage (Fe, vitamin A, B12)
  • Enzyme production (IGF-1)
• What are the consequences of liver impairment?

  1. Low glucose homeostasis
  2. Low protein synthesis
  3. Failure of bilirubin metabolism
  4. Loss of immune cells
  5. Loss of lipid nerve cells
  6. Altered drug metabolism
• What are some common causes of liver disease?

  • Alcohol consumption
  • Non-alcoholic fatty liver disease (obesity)
  • Metabolic disorders
  • Genetic predisposition
  • Autoimmune hepatitis
  • Cholestatic disorders
  • Toxins (e.g., paracetamol overdose)
• What are the stages of liver disease progression?

  1. Normal
  2. Early fibrosis
  3. Cirrhosis
  4. Hepatocellular carcinoma
• What are the early symptoms of liver disease?

  Early symptoms are largely asymptomatic.
• What are the later symptoms of liver disease?

  • Fluid retention (swelling of legs, ankles/feet, abdomen)
  • Portal hypertension (variceal bleeding, ascites)
• What are some relatively severe symptoms of liver disease?

  • Loss of urination and/or poor nerve innervation
  • Pruritus, jaundice, bleeding, coma
  • Enlarged breasts (women), enlarged testes (men)
  • Irregular or lack of menstrual periods (women)
  • Confusion, memory disturbances, alcohol intolerance
• What are some additional symptoms associated with liver disease?

  • Sensitivity
  • Memory loss
  • Enlarged spleen
  • Hepatomegaly
  • Gait disturbances
• What tests are used to detect liver disease?

  • DLFTS (liver function tests)
  • GGT (Gamma-glutamyl transferase)
  • Bilirubin levels
  • ALP (Alkaline phosphatase)
  • ALT (Alanine aminotransferase)
• What does a decrease in albumin indicate in liver disease?

  It indicates impaired synthesis of proteins.
• What can an increase in ammonia levels in the blood cause?

  It may cause encephalopathy.
• What are the risk factors for Non-Alcoholic Fatty Liver Disease (NAFLD) and Non-Alcoholic Steatohepatitis (NASH)?

  • Family history
  • High cholesterol
  • Age
  • Obesity
  • Inactivity
  • High blood pressure
• Is Hepatitis C curable?

  Yes, Hepatitis C is curable.
• What are some recommended lifestyle changes for managing liver disease?

  • Alcohol abstinence
  • Healthy diet
  • Regular exercise
• What are some treatments for liver disease symptoms?

  • Medications for symptoms
  • Nutritional support
  • Management of complications
• What should be assessed in patients undergoing alcohol withdrawal?

  Assess for signs of withdrawal using the CIWA scale.