Liver Conditions

Vocabulary practice flashcards covering liver pathophysiology, viral hepatitis types, cirrhosis, clinical manifestations, complications, diagnostics, and interprofessional treatments from ATI Chapter 56.

Hepatitis

Inflammation of the liver caused most commonly by viruses (A, B, C, D, E), as well as alcohol, medications, toxic chemicals, autoimmune diseases, and metabolic abnormalities.

Hepatitis A Virus (HAV)

A form of viral hepatitis transmitted primarily through eating contaminated food or drinking contaminated water (fecal-oral route), prevented by good hygiene and vaccination, with no specific antiviral drug therapy required.

Hepatitis B Virus (HBV)

A bloodborne and sexually transmitted viral hepatitis spread through contact with infected blood or bodily fluids; preventable via vaccination and blood screening, and treated when severe with alpha interferon or peginterferon.

Hepatitis C Virus (HCV)

A viral infection spread exclusively through blood-to-blood contact that lacks a vaccine but can be effectively cured ($> 98\%$ cure rate) using direct-acting antiviral (DAA) medications.

Hepatitis D Virus (HDV)

A bloodborne virus that causes infection solely in individuals who are already infected with Hepatitis B, prevented by the Hepatitis B vaccine and treated with interferon.

Hepatitis E Virus (HEV)

A viral liver infection transmitted by ingesting water or food contaminated with feces, prevented through good hygiene and safe water consumption, which requires no specific medical treatment.

Jaundice (Icterus)

A yellowish discoloration of the skin and sclera resulting from elevated serum bilirubin levels during acute or advanced liver dysfunction, often accompanied by dark urine, clay-colored stools, and pruritus.

Convalescent Phase (Acute Hepatitis)

The recovery phase of acute viral hepatitis lasting $2\text{ to }4\text{ months}$, beginning as jaundice resolves, where major complaints include malaise and easy fatigability while hepatomegaly persists.

Asterixis

A rapid, motor flapping tremor of the hands and arms (termed 'liver flap') caused by neurotoxic accumulation of ammonia in hepatic encephalopathy.

Apraxia

A neurologic manifestation of hepatic encephalopathy resulting in impaired constructional ability, specifically making it difficult for the patient to write or move a pen from left to right.

Fetor Hepaticus

A sweet, musty odor on the patient's breath caused by metabolic byproducts that the failing liver is unable to detoxify.

Palmar Erythema

Redness over the palmar surfaces of the hands, commonly observed in chronic liver failure and cirrhosis due to circulating endocrine alterations.

Spider Angioma

Small, dilated blood vessels with a central red point and radiating spider-like branches appearing on the face, neck, upper chest, and arms in chronic liver disease.

Liver Biopsy

The gold standard and most definitive diagnostic procedure for liver disease, where a tissue core is extracted needle-biopsy style, requiring midnight fasting prior and post-procedure right side-lying positioning for several hours.

Ultrasound Elastography (FibroScan)

A non-invasive diagnostic ultrasound study used to assess liver stiffness, fibrosis, and cirrhosis development.

Cirrhosis

An end-stage chronic liver condition characterized by extensive degeneration and destruction of hepatocytes, resulting in replacement with disorganized fibrous bands and regenerative nodules.

Compensated Cirrhosis

Early-stage cirrhosis where the liver continues to function adequately; the patient presents with few early symptoms (such as fatigue or an enlarged liver) and may exhibit normal liver function tests.

Decompensated Cirrhosis

Advanced liver disease defined by the appearance of one or more serious complications, including portal hypertension, esophageal and gastric varices, peripheral edema, ascites, hepatic encephalopathy, or hepatorenal syndrome.

Primary Biliary Cirrhosis (PBC)

A form of biliary cirrhosis caused by chronic progressive inflammation and destruction of intrahepatic bile ducts.

Primary Sclerosing Cholangitis (PSC)

An autoimmune disorder in which the immune system mistakenly attacks, scars, and narrows the bile ducts, predisposing the patient to biliary cirrhosis.

Cardiac Cirrhosis

Liver fibrosis and necrosis resulting from severe, long-standing right-sided heart failure causing chronic hepatic venous congestion.

Portal Hypertension

An abnormally elevated venous blood pressure within the portal venous system leading to splenomegaly, collateral vein formation, ascites, and gastrointestinal varices.

Collateral Circulation

Alternate circulatory pathways developed to decompress portal venous hypertension, developing distended veins (varicosities) in areas like the lower esophagus, anterior abdominal wall, peritoneum, and rectum.

Caput Medusae

A visible ring of dilated, tortuous collateral veins radiating around the umbilicus, formed as a consequence of severe portal hypertension.

Esophageal and Gastric Varices

Fragile, distended collateral veins in the lower esophagus or stomach that rupture and bleed easily, representing the most life-threatening complication of portal hypertension.

Ascites

The abnormal accumulation of serous fluid inside the peritoneal cavity due to portal hypertension, hypoalbuminemia, and hyperaldosteronism, often causing marked abdominal distention.

Balloon Tamponade

A mechanical intervention utilizing multi-lumen inflatable tubes (such as the Sengstaken-Blakemore or Minnesota tube) to compress bleeding esophageal and gastric varices directly.

Transjugular Intrahepatic Portosystemic Shunt (TIPS)

A nonsurgical interventional radiological procedure that places a metal stent between the portal vein and hepatic vein to relieve portal hypertension and recurrent bleeding.

Hepatorenal Syndrome

Functional renal failure occurring in end-stage cirrhosis marked by azotemia, oliguria, intractable ascites, and renal vasoconstriction without intrinsic structural kidney defects, curable primarily via liver transplantation.

Hepatic Encephalopathy

A neuropsychiatric syndrome secondary to liver disease and toxic circulating ammonia levels that cross the blood-brain barrier, causing altered consciousness, confusion, agitation, asterixis, and coma.

Lactulose

A medication that prevents constipation and lowers blood ammonia levels by acidifying colon contents and trapping ammonia in the gut to facilitate excretion.