Pathophysiology – Liver Diseases (Lecture Review)

Vocabulary flashcards covering liver anatomy, physiology, clinical manifestations, major hepatic disorders, pediatric and geriatric considerations, and transplant concepts from the lecture notes.

Right Upper Quadrant (RUQ)

Anatomical location of the liver in the abdominal cavity.

Dual Blood Supply

Liver receives blood from both the hepatic artery (oxygen-rich) and the portal vein (nutrient-rich).

Portal Circulation

Venous drainage from the GI tract that enters the liver via the portal vein for nutrient processing.

Bile Salts

Substances secreted by the liver that emulsify fats for digestion.

Vitamin & Mineral Storage (Liver)

Hepatic function that stores fat-soluble vitamins (A, D, E, K) and minerals such as iron and copper.

Glucocorticoid Metabolism

Endocrine role of the liver in breaking down and converting cortisol.

Mineralocorticoid Metabolism

Hepatic processing of aldosterone and related hormones.

Hepatocellular Failure

Loss of liver cell function manifested by jaundice, muscle wasting, ascites, coagulopathy, and hormone imbalances.

Jaundice

Yellow discoloration of skin and sclera from elevated bilirubin; may be prehepatic, hepatic, posthepatic, or cholestatic.

Portal Hypertension

Increased resistance to blood flow through the liver causing elevated portal venous pressure.

Gastroesophageal Varices

Dilated submucosal veins in the esophagus or stomach secondary to portal hypertension; prone to life-threatening bleeding.

Hepatic Encephalopathy

Neuropsychiatric syndrome (grades 1–4) ranging from confusion to coma due to liver failure.

Cerebral Edema (Liver Disease)

Brain swelling that can accompany grade 3–4 hepatic encephalopathy, increasing intracranial pressure.

Ascites

Pathologic accumulation of fluid in the peritoneal cavity, often from portal hypertension and hypoalbuminemia.

Spontaneous Bacterial Peritonitis

Infection of ascitic fluid, commonly by Streptococcus pneumoniae or Escherichia coli, unrelated to bowel perforation.

Hepatorenal Syndrome

Functional renal failure caused by severe liver disease and altered hemodynamics.

Acute Viral Hepatitis

Inflammation of liver parenchyma caused by viral infection; serology differentiates types.

Hepatitis A (HAV)

RNA virus spread via fecal-oral route; usually self-limiting.

Hepatitis B (HBV)

Partially double-stranded DNA virus transmitted by blood or body fluids; prevented by highly immunogenic vaccine.

HBsAg (Hepatitis B Surface Antigen)

Serologic marker indicating active HBV infection.

HBcAg (Hepatitis B Core Antigen)

First antigen to appear in acute HBV infection; later converts to core antibody (HBcAb).

Hepatitis C (HCV)

Single-stranded RNA Flavivirus often leading to chronic infection.

Hepatitis D (Delta)

Defective RNA virus that requires HBV co-infection to replicate.

Hepatitis E (HEV)

RNA virus transmitted via contaminated water; fecal-oral spread.

Chronic Hepatitis

Liver inflammation persisting ≥6 months.

Chronic Persistent Hepatitis

Low-grade, non-progressive liver inflammation, also called triaditis or transaminitis.

Chronic Active Hepatitis

Progressive inflammatory disease that extends beyond portal triads into lobules, causing hepatic destruction.

Autoimmune Hepatitis

Progressive liver inflammation with autoantibodies and polyclonal hypergammaglobulinemia.

Biliary Cirrhosis

Liver scarring resulting from prolonged bile duct inflammation and obstruction.

Primary Sclerosing Cholangitis

Autoimmune inflammation and fibrosis of bile ducts, frequently associated with ulcerative colitis.

Alcoholic Steatohepatitis (Fatty Liver)

Accumulation of fat in hepatocytes from excess alcohol intake or altered lipid metabolism.

Alcoholic Hepatitis

Active inflammation and hepatocyte necrosis with Mallory bodies in chronic alcohol users.

Mallory Bodies

Intracellular hepatocyte inclusions composed of damaged cytokeratin filaments seen in alcoholic hepatitis.

Hereditary Hemochromatosis

Genetic iron overload disorder caused by mutant HFE gene leading to excessive GI iron absorption.

Wilson Disease

Autosomal recessive condition with toxic copper accumulation in liver and other organs.

N-acetyl-p-benzoquinone Imine (NAPQI)

Toxic metabolite of acetaminophen responsible for hepatic necrosis in overdose.

Large Volume Paracentesis (LVP)

Therapeutic removal of several liters of ascitic fluid to relieve abdominal distension.

Spironolactone

Potassium-sparing diuretic and antihypertensive used to treat ascites and portal hypertension.

Furosemide

Loop diuretic often combined with spironolactone for fluid management in cirrhosis.

Liver Abscess

Localized collection of pus within the liver, often from ascending cholangitis or portal vein seeding.

Hepatocellular Carcinoma (HCC)

Primary malignant tumor of hepatocytes; more common in older adults and chronic liver disease.

Physiologic Jaundice of the Newborn

Harmless hyperbilirubinemia occurring within first 2 weeks of life.

Biliary Atresia

Congenital extrahepatic cholestatic condition causing obstruction of bile ducts in infants.

Liver Transplantation

Surgical replacement of diseased liver; about 8,000 procedures annually in the U.S.

Acute Rejection (Liver Transplant)

Immunologic attack on transplanted liver, most common on postoperative days 4–10, presenting with fever, pain, reduced bile flow, and jaundice.

Portal-Systemic Encephalopathy

Alternate term for hepatic encephalopathy due to shunting of ammonia-rich blood past the liver.

Grade 1–4 Encephalopathy Scale

Clinical classification from mild confusion (grade 1) to coma (grade 4).

Kayser-Fleischer Ring

Copper deposition in the cornea characteristic of Wilson disease (implied by copper overload).

Ischemic Hepatitis

Liver injury from hypoperfusion, more common in older adults.

Metabolic Half-Life Prolongation (Elderly Liver)

Age-related reduction in hepatic clearance causing longer drug half-lives.