Health alterations class 21:inflammation (liver/cirrhosis)

Cirrhosis

Permanent injury to the liver, related to chronic inflammation (may be chronic hepatitis, causes scarring)

Liver disease

Hepatitis a-e

Nonalcoholic fatty liver disease and non alcoholic steatohepatitis

Alcohol and drug induced hepatitis

Autoimmune and genetic liver diseases

Cirrhosis

Nonalcoholic fatty liver disease progression

Simple fatty liver with no hepatic inflammation then nonalcoholic steatohepatitis then cirrhosis

NAFLD

Accumulation of fat in liver cells

Not associated with inflammation or alcohol intake

Treatment is directed at reducing risk factors (treat diabetes, reduce body weight, eliminate harmful meds)

Liver cirrhosis

Normal tissue replaced when fibrious tissue that interrupt function

Permanent scarring of liver cells

Liver is inflamed, bile duct obstructed, infection, scar tissue, obstructed blood flow to portal regions

Final stage of chronic liver disease

3 types of liver cirrhosis

Alcoholic

Post necrotic

Biliary

Alcoholic cirrhosis

Build of scar tissue around hepatic portal system

Chronic alcoholism

Most common

Post necrotic cirrhosis

Associated with acute hepatitis

Profuse scar tissue

Biliary cirrhosis

Scarring around bile duct Associated with chronic biliary obstruction or infection (gallstones)

Compensated liver cirrhosis

Liver able to function normally despite scar tissue

LFTs, albumin, bilirubin and PTT at or near normal

Could have for years (if develops and then stop risk factors)

Decompensated cirrhosis

Advanced cirrhosis, liver can’t keep up

One or more complications of liver cirrhosis occurs

Clinical manifestations of cirrhosis

Symptoms are often vague

Abdominal pain (dull, heavy, RUQ)

Anorexia

Dyspepsia

Nausea and vomiting

Weakness, muscle loss

Fatigue

Slight weight loss

Hepatomegaly and splenomegaly

Manifestations of decompensated cirrhosis

Jaundice

Skin lesions (spider angioplasty, palmar erythema)

Hematological conditions (thrombocytopenia, leukopenia, anemia, coagulation disorders)

Endocrine disorders (older women-vaginal bleeding, younger women-ammenohrea, men-gynecomastia)

Peripheral neuropathy (vitamin b 12 deficiency)

Major complications of cirrhosis

Automatically have decompensated cirrhosis if 1 is present

Portal hypertensions and esophageal and gastric varices

Peripheral edema and ascites

Hepatic encephalopathy

Hepato-renal syndrome

Portal hypertension