Zusammenfassung der Ressource
Impaired Liver Function
- Hepatocellular Injury
- Injury to hepatocytes
- Some causes: viral hepatitis,
alcohol/drug toxicity, NAFLD,
haemochromatosis
- Cholestasis
- Decreased bile flow
- Some causes: obstruction by gall
stones & malignancies, drugs, biliary
cirrhosis
- Liver Failure
- Massive liver destruction
- Fulminant/
chronic
cirrhosis
- Bilirubin Metabolism
- Normal: Liver conjugates and
excretes bilirubin
- Abnormal: Jaundice (icterus) - bilirubin
accumulates in tissues e.g. skin/sclera
- Pre-hepatic - increased
haemolysis and unconjugated
bilirubin levels
- Intrahepatic - liver damage
reduces bilirubin conjugation
and/or secretion
- Post-hepatic - obstruction of
bile flow after liver/cholestasis
(e.g. gallstones)
- Abnormal: Kernicterus - unconjugated
bilirubin crosses BBB in premature babies
- Abnormal: Steatorrhoea (pale fatty
stools) - unable to produce/secrete bile
needed for fat digestion
- Alcohol & Drug Metabolism
- Normal: detoxification of drugs
& alcohol
- Abnormal: Inadequate detox -
leads to cell toxicity
- Cholesterol & Steroid Metabolism
- Normal: synthesis of lipoproteins,
metabolism of steroids
- Abnormal: inadequate
metabolism leads to low
serum cholesterol
- Abnormal: increased
steroid hormone levels
- High sex hormones
- Gynecomastia in males
- High aldosterone
- Fluid retention, edema
- Carbohydrate Metabolism
- Normal: glycogenesis (absorptive state);
glycogenolysis & gluconeogenesis
(post-absorptive state)
- Abnormal: risk of hypoglycemia
- Storage of Vitamins & Minerals
- Normal: Stores Vit A, B12,
D, E & K, Fe, Cu
- Abnormal: impaired absorption of
fat-soluble vitamins, high free iron (cell
toxicity)
- Protein Metabolism
- Normal: synthesise albumin
- Abnormal: low plasma albumin
- Ascites
- Normal: synthesise clotting factors
- Abnormal: low clotting factors
- Bleeding tendency
- Normal: form urea from
protein deamination
- Abnormal: elevated ammonia levels
- Cell toxicity