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Liver Failure

Terms in this set (51)

How is liver failure defined?
Sudden and severe onset of liver dysfunction/jaundice in patients with no hx of liver disease and hepatic encepholopathy within the first 8 weeks of initial onset.
What is the treatment for acute liver failure?
Liver transplant
What is the mortality rate of acute liver failure?
Mortality rate --> 80%
Can Reye's Syndrome cause liver failure?
Yes
Can hypoperfusion cause liver failure?
Yes
Can mushroom poisoning cause liver failure?
Yes
What happens to the body's ability to clear lactate with liver failure?
This ability decreases leading to metabolic acidosis
Why would someone with liver failure have altered nutrition and be in a catabolic state?
Loss of protein, carbs, and fat metabolism.
Why would there be a loss of oncotic pressure with liver failure?
Because of inability to synthesize albumin/plasma proteins.
Explain the differences between prehepatic, hepatic, and post Hepatic jaundice
1) Hemolytic = prehepatic
2) Hepatocellular = hepatic
3) Obstructive = post hepatic
What is prehepatic liver failure?
Prehaptic--> increased RBC breakdown
What is hepatic liver failure?
Liver unable to take up bilirubin or to conjugate/excrete it
What is post hepatic liver failure?
Obstructed flow or bile
What are s/s of hepatorenal syndrom?
- Azotemia
- Oliguria
- Hyponatremia
- Hypotension
What happens to potassium with liver failure?
It goes down, unless the patient is in renal failure
What happens to Na with liver failure?
It goes down
What happens to glucose when a patient is in liver failure?
It goes down
What happens to albumin when a patient is in liver failure?
It goes down
Can a pt in liver failure have increased ICP?
Yes, it is the leading cause of death
What is normal ammonia level?
9-33
What is the scale used to grade hepatic encepholopathy?
Grade Scale I through IV
What are the dx finding for liver failure?
- Increased serum ammonia level
- Phos
- Increased ALT (most specific)
- Increased bilirubin
- Increased WBC
- Prolonged PT, INR, and decreased platelet count
- Decreased H/H
- Decreased albumin
What happens to serum glucose w/ liver failure?
Decreased
What happens to BUN/creatinine with liver failure?
Increased
What is normal value for direct bilirubin (conjugated bilirubin)?
0.0 - 0.4
Direct bilirubin is the same as?
Conjugated bilirubin
What is normal value for indirect bilirubin?
< 1.1
Indirect bilirubin is the same as?
Unconjugated Bilirubin
What is total bilirubin?
Sum of direct and indirect
What is the normal value of total bilirubin?
0.2 - 1.3
What is the #1 etiology of liver failure?
Alcoholism
What is Laennec's Cirrhosis?
Liver failure in which the architectural structure of the liver is lost. Two possible causes are 1) malnutrition (i.e. starving) and 2) alcoholism
What is Postnecrotic cirrhosis?
Caused by massive necrosis of the liver
What is cardiac cirrhosis?
Develops in relation to right sided heart failure
What are the 2 sources of blood flow to the liver?
1) Hepatic artery
2) Portal Vein
What happens to blood when it reaches the portal veins?
It branches into sinusoids to transport blood to each lobule
What happens to the sinusoids with cirrhosis?
The scarring damages the sinusoids so resistance to portal blood flow is increased and pressure within the liver goes up (portal HTN)
What causes splenomegaly with liver failure?
The backward venous congestion secondary to portal hypertension
What does splenomegaly lead to?
Pancytopenia and spleen pain. Assess for coagulopathies and treat
t/f: Cirrhosis can cause endocrine disturbances?
True
t/f: Cirrhosis can cause hyperaldosteronism?
True
t/f: Cirrhosis can cause testicular atrophy?
True
t/f: Cirrhosis can cause gynecomastia?
True
t/f: Cirrhosis can cause palmar erythema?
true
t/f: Cirrhosis can cause caput medusae? If so, what is it?
True. Caput medusae is based on medusula's head...so looks like snakes sitting in abdomen
t/f: Cirrhosis can cause peripheral neuropathy?
True
t/f: Cirrhosis can causes peritonitis?
True
t/f: Cirrhosis can cause cachexia? If so, what is it?
True...cachexia is muscle wasting
Describe fatty liver
Deposits of fat causes liver enlargement. Strict abstinence can lead to full recovery.
Describe liver fibrosis
Scar tissue forms. Recovery is possible, but scar tissue remains
Describe cirrhosis
Growth of connectice tissue destroys liver cells. The damage is irreversible.
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