Hepatic System Part 1

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40 Terms

1

Liver

The largest internal organ. Consists of two main lobes separated by the hepatic vein. Located in the upper right corner of the abdomen.

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2

Hepatic artery

Supplies 25% of the liver's blood flow and provides most of the oxygen required.

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3

Portal vein

Drains most of the GI tract and supplies 75% of the liver's blood supply. Transports recently absorbed material from the intestines to the liver.

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4

Homeostasis

The liver plays a major role in maintaining protein, carbohydrate, and lipid balance in the body.

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5

What does the liver store?

Glycogen, vitamins and iron. Iron is predominantly recycled in the body

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6

Blood cell production and breakdown

liver contains an extensive reticuloendothelial system

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7

First pass metabolism

Liver cells metabolise, detoxify and excrete endogenous and exogenous compounds.

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8

Liver disease diagnosis

Personal and family medical history and food/drink habits considered. Liver function tests, complete blood count tests, imaging scans and sometimes biopsies are done

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9

Jaundice

A symptom of liver disease caused by high bilirubin levels

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10

Functional reserve capacity

The liver has a large capacity to compensate for damage, with liver cancer patients surviving even with up to 95% of their liver removed.

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11

Lifestyle changes to control symptoms of liver disease

Limiting alcohol, maintaining a healthy weight, increasing water intake and dietary fibre, decreasing fat, sugar and salt

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12

Antiviral drugs

Used to treat hepatitis

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13

Steroids

used to reduce liver inflammation

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14

Hepatic portal hypertension

Causes liver damage, varicose veins, haemorrhoids, and oesophageal varices. Treated with blood pressure medication

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15

Hepatitis strains

There are 5 strains (A to E), with hepatitis C being one of the most common

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16

hepatitis C

Acute or chronic. Spread through contact with infected blood. No symptoms in early stages. Can cause permanent liver damage.

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17

major causes of chronic hepatitis

Hepatitis B and C

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18

interferon alfa (currently unlicensed)

Stimulates T cells and other immune cells to attack disease agents. May reduce risk of chronic infection if used to treat acute hepatitis C

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19

ombitasvir with paritaprevir and ritonavir

inhibit wide range of both DNA and RNA viruses

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20

sofosbuvir

inhibits NS5B protein of hepatitis C virus

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21

Fatty liver disease

Can be alcoholic or non-alcoholic. Caused by fat build-up in liver → liver damage, cirrhosis and liver failure if unmanaged.

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22

cirrhosis

degenerative liver disease causing scarring and liver failure

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23

How does pioglitazone help treat advanced liver fibrosis?

Improves tissue sensitivity to insulin

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24

What is pioglitazone?

Synthetic ligand for peroxisome proliferator-activated receptors (PPARs)

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25

What do peroxisome proliferator-activated receptors (PPARs) do?

transcription factors which regulate glucose and lipid metabolism

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26

Autoimmune hepatitis

The immune system attacks the liver, resulting in inflammation.

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27

Primary biliary cirrhosis

Damage to the bile ducts in the liver causes bile build-up, potentially leading to cirrhosis and liver failure.

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28

Primary sclerosing cholangitis

inflammatory condition causing gradual bile duct damage and blockage → liver bile build-up, cirrhosis or liver failure.

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29

Prednisolone to treat autoimmune liver conditions

increases neutrophil concentration and decreases T/B cells, monocytes, eosinophils and basophils. Decreases cytokine release eg IL-2 and TNF-α

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30

azathioprine

immunosuppressive agent which antagonises purine metabolism, inhibiting DNA, RNA and protein synthesis

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31

vitamin E

potent antioxidant taken by patients with advanced liver fibrosis

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32

Liver cancers

Develop in the liver, with hepatocellular carcinoma being the most common type.

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33

secondary liver cancer

cancer which has metastasized to the liver. More common than primary liver cancer

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34

hepatocellular carcinoma

typically develops as several small cancer spots, although it may also start as a single tumour

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35

Monoclonal antibodies

Used for cancer treatment eg ipilimumab and tremelimumab

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36

everolimus

Inhibits mammalian target of rapamycin (mTOR). Used to treat liver cancer

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37

Cholestasis

Impairment of bile formation/flow

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38

symptoms of cholestasis

fatigue, pruritus, dark urine, pale stools, jaundice and signs of fat soluble vitamin deficiencies

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39

colestyramine

bile acid sequestrant used in cholestasis treatment

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40

SSRIs eg sertraline

used to treat pruritus caused by jaundice

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