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NHM 365 Liver, Biliary, Diabetes

Terms in this set (64)

Liver functions
CHO metabolism (glycogenesis, glycogenolysis)
CHO storage (glycogen)
CHO synthesis (gluconeogenesis)

PRO metabolism (transamination, deamination)
PRO synthesis (Non-essential AAs, plasma pros)

Lipid metabolism (b-oxidation, ketone bodies)
Lipid synthesis (TGs, phospholipids, cholesterol, conversion of FSV to active forms)
ALT/ AST
enzymes involved in hepatic AA metabolism
- increased blood levels= liver damage
ALP
enzyme in liver, bile ducts, bone
-increased blood levels= liver damage or blocked duct
Bilirubin
produced from RBC breakdown, normally passed on to liver and excreted in bile
-increased blood levels= liver damage (jaundice)
Albumin
most abundant plasma protein, synthesized in liver, helps maintain osmotic balance in body
-decreased levels= liver damage (ascites)
PT/INR
prothrombin: clotting factor synthesized in liver
-increased time= blood isn't clotting & inadequate synthesis of clotting factors
Hepatitis
widespread inflammation of liver due to toxins, infection, and autoimmune processes
S/s of Hepatitis
headache, muscle ache, NVD, RUQ pain, abdominal discomfort, jaundice
Acute Hep
<6 mos
Chronic Hep
> 6 mos
may lead to ESLD & liver failure
Fulminant Hep
severe liver dysfunction (acute liver failure) accompanied by hepatic encephalopathy & necrosis
-causes similar to regular hep, but no liver regeneration
-fatal if untreated
MNT for Hepatitis
-promote liver regeneration & rest
-prevent weight loss
-frequent small meals
-PRO needs: 1-1.2g/kg(acute), DRI(chronic)
ESLD
liver is severely & irreversibly damaged
-can be caused by another disease
-complications:hepatic enceph
-pathology:
1)accumulation of ammonia in serum(grade 1-4)
2)altered neurotransmitters (secondary to abnormal plasma AAs)
MNT for ESLD
-lower ammonia (lactulose)
-increase BCAA intake
-small frequent meals
-PRO needs: .8-1 g/kg
Alcoholic liver disease
liver damage caused by acetaldehyde, a byproduct of ETOH metabolism
-3 stages
1)Hepatic steatosis (fatty liver)
2)alcoholic hepatitis
3)cirrhosis
-PHTN, esophageal varices, ascites
-malnutrition due to impaired digestion & absorption of fats and AA
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