The document provides an overview of liver disease, including:
1) Jaundice and cholestasis which can occur due to increased bilirubin production, decreased uptake by hepatocytes, or impaired excretion.
2) Liver failure which can be acute or chronic, and results in hepatic encephalopathy, coagulopathy, and other systemic effects.
3) Cirrhosis, defined as diffuse liver scarring leading to regenerative nodules and altered vasculature, with complications including liver failure, portal hypertension, ascites, and hepatocellular carcinoma.
1. The document discusses various gastric disorders including pyloric stenosis, diaphragmatic hernia, gastric heterotopia, gastritis, gastric ulceration, and chronic gastritis.
2. Key points include that pyloric stenosis occurs in 1 in 300 to 900 live births and causes projectile vomiting in infants. Chronic gastritis is common and often caused by H. pylori infection, leading to conditions like peptic ulcers and gastric cancer.
3. Stress ulcers form in response to severe trauma, burns, or illness and are located in the stomach or duodenum, appearing as small circular lesions in the mucosa.
This document provides an overview of liver anatomy, functions, and diseases. It describes the liver's structure including liver cells, bile drainage system, and blood supply. The liver's key functions are metabolism, protein synthesis, storage, detoxification, and bile production. Investigation of liver diseases includes blood tests, imaging, and biopsy. Common liver diseases discussed are jaundice, cholestasis, liver failure, and cirrhosis. Cirrhosis is the end-stage of chronic liver disease and can result from infections, toxins, autoimmune conditions, and other etiologies.
The document discusses diseases of the liver. It begins by describing the liver's location and functions, including producing bile to aid digestion and regulating biochemical reactions. It then discusses the liver's blood supply, biliary flow, synthesis, breakdown, detoxification, protein synthesis, and glycogen regulation. Key clinical diseases are then outlined, such as alcoholic liver disease, hepatotoxicity from drug overdoses, and hepatic failure. Guidelines for ICD-10-CM coding of various liver diseases are provided.
Dr Dinah Parums. Principal Pathologist. Liver and Biliary Tract Pathology. Te...Dinah Parums
This document provides an overview of the normal anatomy and histology of the liver and biliary tract. It discusses common hepatic injuries and diseases including viral or drug-induced hepatitis, alcoholic liver disease, cirrhosis, and others. Specific conditions covered in more detail include Wilson's disease, alpha-1 antitrypsin deficiency, neonatal hepatitis, and Reye's syndrome. Morphologic features of various liver diseases are also described.
Liver disorder is one of the serious health problems.
Liver disease (also called hepatic disease) is a type of damage to or disorder of the liver.
Then some types of liver disease can lead to cirrhosis which can lead to liver failure or liver cancer.
Per an estimate, about 20,000 deaths occur every year due to liver disorder
This document provides an overview of liver diseases. It begins with an introduction to liver anatomy and functions. It then discusses signs and symptoms of liver problems. The main types of liver diseases covered are hepatitis, cirrhosis, fatty liver diseases, and liver cancer. Diagnostic tests for liver function are also mentioned. The document concludes with some dietary recommendations for supporting liver health.
1. Hepatology is the branch of medicine involving the liver, gallbladder, and pancreas. Diseases related to hepatitis viruses and alcohol are common reasons for consultation.
2. The liver performs many vital functions like breaking down red blood cells, storing glycogen, producing proteins and hormones, and detoxifying chemicals. Liver disease can result from cell damage, bile obstruction, fat accumulation, reduced blood flow, or infiltration by abnormal cells.
3. Dental treatment for patients with liver disease requires minimizing drugs metabolized by the liver like sedatives, using local anesthetics cautiously, and managing those with a history of viral hepatitis as potentially infectious.
1. The document discusses various gastric disorders including pyloric stenosis, diaphragmatic hernia, gastric heterotopia, gastritis, gastric ulceration, and chronic gastritis.
2. Key points include that pyloric stenosis occurs in 1 in 300 to 900 live births and causes projectile vomiting in infants. Chronic gastritis is common and often caused by H. pylori infection, leading to conditions like peptic ulcers and gastric cancer.
3. Stress ulcers form in response to severe trauma, burns, or illness and are located in the stomach or duodenum, appearing as small circular lesions in the mucosa.
This document provides an overview of liver anatomy, functions, and diseases. It describes the liver's structure including liver cells, bile drainage system, and blood supply. The liver's key functions are metabolism, protein synthesis, storage, detoxification, and bile production. Investigation of liver diseases includes blood tests, imaging, and biopsy. Common liver diseases discussed are jaundice, cholestasis, liver failure, and cirrhosis. Cirrhosis is the end-stage of chronic liver disease and can result from infections, toxins, autoimmune conditions, and other etiologies.
The document discusses diseases of the liver. It begins by describing the liver's location and functions, including producing bile to aid digestion and regulating biochemical reactions. It then discusses the liver's blood supply, biliary flow, synthesis, breakdown, detoxification, protein synthesis, and glycogen regulation. Key clinical diseases are then outlined, such as alcoholic liver disease, hepatotoxicity from drug overdoses, and hepatic failure. Guidelines for ICD-10-CM coding of various liver diseases are provided.
Dr Dinah Parums. Principal Pathologist. Liver and Biliary Tract Pathology. Te...Dinah Parums
This document provides an overview of the normal anatomy and histology of the liver and biliary tract. It discusses common hepatic injuries and diseases including viral or drug-induced hepatitis, alcoholic liver disease, cirrhosis, and others. Specific conditions covered in more detail include Wilson's disease, alpha-1 antitrypsin deficiency, neonatal hepatitis, and Reye's syndrome. Morphologic features of various liver diseases are also described.
Liver disorder is one of the serious health problems.
Liver disease (also called hepatic disease) is a type of damage to or disorder of the liver.
Then some types of liver disease can lead to cirrhosis which can lead to liver failure or liver cancer.
Per an estimate, about 20,000 deaths occur every year due to liver disorder
This document provides an overview of liver diseases. It begins with an introduction to liver anatomy and functions. It then discusses signs and symptoms of liver problems. The main types of liver diseases covered are hepatitis, cirrhosis, fatty liver diseases, and liver cancer. Diagnostic tests for liver function are also mentioned. The document concludes with some dietary recommendations for supporting liver health.
1. Hepatology is the branch of medicine involving the liver, gallbladder, and pancreas. Diseases related to hepatitis viruses and alcohol are common reasons for consultation.
2. The liver performs many vital functions like breaking down red blood cells, storing glycogen, producing proteins and hormones, and detoxifying chemicals. Liver disease can result from cell damage, bile obstruction, fat accumulation, reduced blood flow, or infiltration by abnormal cells.
3. Dental treatment for patients with liver disease requires minimizing drugs metabolized by the liver like sedatives, using local anesthetics cautiously, and managing those with a history of viral hepatitis as potentially infectious.
This document provides an overview of the liver and biliary tract anatomy and histology, as well as patterns of hepatic injury and disease. It describes the basic lobule structure of the liver and locations of the portal triad and central veins. Common liver diseases are summarized, including viral hepatitis, alcoholic hepatitis, cirrhosis, and malignancies like hepatocellular carcinoma. Biliary structures, gallbladder diseases, and extrahepatic considerations are also briefly covered.
The liver is the largest gland in the body and performs many critical metabolic functions like carbohydrate and protein metabolism. It also plays an important role in hormone regulation, bile production, and blood clotting factor synthesis. Chronic liver disease can lead to liver fibrosis and cirrhosis over many years. Cirrhosis is characterized by liver scarring and nodule formation, resulting in loss of liver function. Common causes include alcohol abuse, viral hepatitis, and non-alcoholic fatty liver disease. Complications arise due to portal hypertension and liver failure. Diagnosis involves liver biopsy or lab tests showing abnormalities in liver enzymes and clotting factors.
This document provides an overview of liver disease, including the anatomy and blood flow of the liver, histology, cirrhosis, and complications of liver disease such as portal hypertension, ascites, and hepatocellular carcinoma. It also discusses the evaluation and scoring of liver disease severity, as well as nutrition recommendations for patients with liver disease. Key points covered include maintaining adequate protein intake while limiting salt and, in some cases, fat and carbs depending on the stage of liver disease.
This document provides an overview of the liver, biliary tract, and associated pathologies. It discusses the anatomy and vascular supply of the liver. It then summarizes common patterns of hepatic injury including degeneration, inflammation, neoplasia, and metabolic diseases. Specific conditions covered include viral and alcoholic hepatitis, cirrhosis, cholestasis, hepatic tumors, and diseases of the extrahepatic bile ducts and gallbladder.
IT INCLUDES ANATOMY, PHYSIOLOGY AND PATHOLOGY OF LIVER .
THE SOURCES ARE:-
THE MEDICAL TEXT BOOK OF ROBBIN'S PATHOLOGY
AND OTHERS
IMAGES SOURCE :- ATLAS BOOKS AND INTERNET
The document discusses patterns of hepatic injury including degeneration, intracellular accumulation, necrosis, apoptosis, inflammation, fibrosis, and failure. Specific types of liver disease are also examined such as alcoholic liver disease which can cause steatosis, hepatitis, and cirrhosis due to effects of alcohol metabolism including induction of cytochrome P450 and increased lipid biosynthesis. Chronic alcohol intake over many years can lead to severe and irreversible liver injury.
This document provides an overview of liver anatomy and functions, as well as causes, classifications, and features of various hepatic disorders. Key points include:
- The liver's main functions are metabolism, protein synthesis, storage, detoxification, and bile production. It receives dual blood supply from the hepatic artery and portal vein.
- Liver diseases can be investigated through biochemical, hematological, immunological, and imaging tests as well as biopsy. Morphological patterns of injury include degeneration, necrosis, inflammation, regeneration, and fibrosis.
- Jaundice and cholestasis result from increased bilirubin production, decreased uptake/conjugation, or impaired excretion. They can be pre-hep
This document provides information on liver pathology and disease. It begins with the anatomy and functions of the liver. It then discusses various liver diseases including hepatic injury, cirrhosis, hepatitis, and tumors. It also provides in-depth descriptions of jaundice, portal hypertension, and hepatic encephalopathy - discussing their causes, signs/symptoms, investigations, and treatments. The document is an informative overview of liver conditions and diseases.
The liver is the largest organ in the body located primarily in the right hypochondrium. It has two lobes, with the right lobe being the largest. The portal triad serves as the point of entry and exit for the liver.
The liver has both a lobular and acinar microstructure. Within the lobules are hepatocytes arranged in plates with sinusoids in between. Bile canaliculi drain between hepatocytes into ductules.
Bilirubin is produced from the breakdown of heme from aged red blood cells. In the liver it is conjugated and excreted in bile. Elevated bilirubin levels can indicate prehepatic, hepatic, or posthep
This document describes various inflammatory disorders of the liver including viral hepatitis, autoimmune hepatitis, and liver abscesses. It discusses the clinical syndromes and outcomes of different viral hepatitis infections, noting that hepatitis B and C commonly progress to chronic hepatitis in 10-80% of cases. The morphology of acute and chronic hepatitis is described, including patterns of hepatic injury such as necrosis, inflammation, regeneration, and fibrosis. Specific features of hepatitis B and C infections are also outlined. Autoimmune hepatitis predominantly affects women and is associated with other autoimmune diseases. Liver abscesses can result from bacterial, amebic, or fungal infections reaching the liver through different pathways.
This document discusses occupational liver disorders and their causes. It covers viral, chemical, and physically induced liver injuries and diseases. Some key points include:
1. The liver is divided into three zones (periportal, midzonal, centrilobular) that are differentially affected by toxins.
2. Occupational liver disorders are challenging to diagnose due to non-specific symptoms and potential simultaneous conditions like viral hepatitis or substance abuse.
3. Serologic markers and liver enzymes can help identify liver damage and its cause. Cytotoxic injuries elevate less liver-specific enzymes while cholestatic injuries increase enzymes like alkaline phosphatase.
4. Chemicals from many industries can cause liver
The document discusses the anatomy, histology, functions and common pathologies of the liver. Key points include:
- The liver has four lobes and receives dual blood supply from the hepatic artery and portal vein. It performs many metabolic and synthetic functions.
- Common liver diseases include viral hepatitis, alcoholic liver disease and cirrhosis. Cirrhosis results from chronic liver injury and scarring that disrupts the liver architecture.
- Primary liver cancers like hepatocellular carcinoma often arise in the setting of chronic liver disease and cirrhosis. Treatment options are limited but may include transplantation or resection in early stages.
The document summarizes key aspects of the accessory organs of the digestive system including the liver, gallbladder and bile ducts, and pancreas. It describes the anatomy, functions, common diseases, and nursing care considerations for conditions that can affect each organ system.
The liver is organized into lobules centered around branches of the hepatic vein. Between the lobules are portal triads containing branches of the bile duct, portal vein, and hepatic artery. Hepatocytes within the lobules perform many metabolic functions. Liver disorders can result from infections, drugs, toxins, ischemia, autoimmune issues, or postoperative issues. Postoperative liver dysfunction may occur without preexisting liver disease due to ischemia or anesthesia and usually resolves, but can worsen preexisting conditions like hepatitis.
The document describes the anatomy and functions of the liver and gallbladder. It notes that the liver is located in the right upper abdomen and weighs about 1.5 kg. It has three ligaments that attach it to the diaphragm and divides it into lobes. The liver receives 80% of its blood from the portal vein and has three hepatic veins that drain into the inferior vena cava. The gallbladder is a pear-shaped organ that stores and concentrates bile produced by the liver. Bile contains bile salts that help digest and absorb fats.
DISORDERS OF LIVER, PANCREAS AND BILIARY TRACTAndhrapradesh
This document provides information on various disorders of the liver, pancreas, and biliary tract. It begins with an introduction to cirrhosis of the liver, including its definition, incidence, causes such as alcoholism and hepatitis, types, pathophysiology, clinical manifestations, diagnostic studies, medical and surgical management, complications, and nursing management. It then covers topics such as jaundice, hepatitis, liver abscess, Wilson's disease, Gilbert's syndrome, haemochromatosis, portal hypertension, and ascites. For each topic, it provides definitions, incidence, causes, pathophysiology, clinical manifestations, diagnostic studies, management, and other relevant details.
1. The document discusses liver diseases (yakrut vikara) and their signs, symptoms, causes and treatment. It describes the anatomy and physiology of the liver and normal liver function test values.
2. Elevated liver enzymes (ALT, AST) can indicate liver injury from various causes like viral hepatitis, alcohol, medications etc. Bilirubin levels and their direct/indirect fractions are discussed in the context of pre-hepatic, hepatic and post-hepatic diseases.
3. Complications of chronic liver disease like jaundice, portal hypertension and liver cirrhosis are explained. Treatment approaches for conditions like variceal bleeding and hepatic encephalopathy are also summarized.
Renal diseases occur when the kidneys become damaged and cannot properly filter waste from the blood. This can be caused by genetics, injuries, or medications. Renal failure results from significant loss of kidney function. Common symptoms include changes in urination and fluid retention. Renal diseases can be classified as inherited, congenital, or acquired. Glomerular diseases involve inflammation of the kidney filters while tubulointerstitial diseases affect the kidney tubules. Acute renal failure is a sudden decrease in kidney function marked by oliguria and fluid issues. Chronic renal failure is a progressive loss of function that eventually requires dialysis or transplantation. Renal function tests evaluate electrolytes, waste levels, and clearance to assess kidney performance.
Cirrhosis is a consequence of chronic liver disease characterized by diffuse scarring and regeneration of the liver. It results from many causes including alcohol, viral hepatitis, and genetic conditions. As the liver architecture is disrupted, liver function declines and complications develop. Investigation of cirrhosis involves blood tests to assess liver function and damage, imaging to evaluate the liver structure, and potentially biopsy to determine the specific cause. Common complications arise from portal hypertension and include variceal bleeding, ascites, and hepatic encephalopathy. Cirrhosis can ultimately lead to liver failure and death without treatment or transplantation.
Medical Surgical Nursing - I
UNIT: IV -Nursing Management of Patients With Disorder of Digestive System "Cirrhosis of liver"
the topic covers
- the stages, Pathophysiology and clinical manifestation of Cirrhosis of liver
- diagnostic evaluation and complication of Cirrhosis of liver
- medical, surgical and nursing management of patient with Cirrhosis of liver
This document provides an overview of the liver and biliary tract anatomy and histology, as well as patterns of hepatic injury and disease. It describes the basic lobule structure of the liver and locations of the portal triad and central veins. Common liver diseases are summarized, including viral hepatitis, alcoholic hepatitis, cirrhosis, and malignancies like hepatocellular carcinoma. Biliary structures, gallbladder diseases, and extrahepatic considerations are also briefly covered.
The liver is the largest gland in the body and performs many critical metabolic functions like carbohydrate and protein metabolism. It also plays an important role in hormone regulation, bile production, and blood clotting factor synthesis. Chronic liver disease can lead to liver fibrosis and cirrhosis over many years. Cirrhosis is characterized by liver scarring and nodule formation, resulting in loss of liver function. Common causes include alcohol abuse, viral hepatitis, and non-alcoholic fatty liver disease. Complications arise due to portal hypertension and liver failure. Diagnosis involves liver biopsy or lab tests showing abnormalities in liver enzymes and clotting factors.
This document provides an overview of liver disease, including the anatomy and blood flow of the liver, histology, cirrhosis, and complications of liver disease such as portal hypertension, ascites, and hepatocellular carcinoma. It also discusses the evaluation and scoring of liver disease severity, as well as nutrition recommendations for patients with liver disease. Key points covered include maintaining adequate protein intake while limiting salt and, in some cases, fat and carbs depending on the stage of liver disease.
This document provides an overview of the liver, biliary tract, and associated pathologies. It discusses the anatomy and vascular supply of the liver. It then summarizes common patterns of hepatic injury including degeneration, inflammation, neoplasia, and metabolic diseases. Specific conditions covered include viral and alcoholic hepatitis, cirrhosis, cholestasis, hepatic tumors, and diseases of the extrahepatic bile ducts and gallbladder.
IT INCLUDES ANATOMY, PHYSIOLOGY AND PATHOLOGY OF LIVER .
THE SOURCES ARE:-
THE MEDICAL TEXT BOOK OF ROBBIN'S PATHOLOGY
AND OTHERS
IMAGES SOURCE :- ATLAS BOOKS AND INTERNET
The document discusses patterns of hepatic injury including degeneration, intracellular accumulation, necrosis, apoptosis, inflammation, fibrosis, and failure. Specific types of liver disease are also examined such as alcoholic liver disease which can cause steatosis, hepatitis, and cirrhosis due to effects of alcohol metabolism including induction of cytochrome P450 and increased lipid biosynthesis. Chronic alcohol intake over many years can lead to severe and irreversible liver injury.
This document provides an overview of liver anatomy and functions, as well as causes, classifications, and features of various hepatic disorders. Key points include:
- The liver's main functions are metabolism, protein synthesis, storage, detoxification, and bile production. It receives dual blood supply from the hepatic artery and portal vein.
- Liver diseases can be investigated through biochemical, hematological, immunological, and imaging tests as well as biopsy. Morphological patterns of injury include degeneration, necrosis, inflammation, regeneration, and fibrosis.
- Jaundice and cholestasis result from increased bilirubin production, decreased uptake/conjugation, or impaired excretion. They can be pre-hep
This document provides information on liver pathology and disease. It begins with the anatomy and functions of the liver. It then discusses various liver diseases including hepatic injury, cirrhosis, hepatitis, and tumors. It also provides in-depth descriptions of jaundice, portal hypertension, and hepatic encephalopathy - discussing their causes, signs/symptoms, investigations, and treatments. The document is an informative overview of liver conditions and diseases.
The liver is the largest organ in the body located primarily in the right hypochondrium. It has two lobes, with the right lobe being the largest. The portal triad serves as the point of entry and exit for the liver.
The liver has both a lobular and acinar microstructure. Within the lobules are hepatocytes arranged in plates with sinusoids in between. Bile canaliculi drain between hepatocytes into ductules.
Bilirubin is produced from the breakdown of heme from aged red blood cells. In the liver it is conjugated and excreted in bile. Elevated bilirubin levels can indicate prehepatic, hepatic, or posthep
This document describes various inflammatory disorders of the liver including viral hepatitis, autoimmune hepatitis, and liver abscesses. It discusses the clinical syndromes and outcomes of different viral hepatitis infections, noting that hepatitis B and C commonly progress to chronic hepatitis in 10-80% of cases. The morphology of acute and chronic hepatitis is described, including patterns of hepatic injury such as necrosis, inflammation, regeneration, and fibrosis. Specific features of hepatitis B and C infections are also outlined. Autoimmune hepatitis predominantly affects women and is associated with other autoimmune diseases. Liver abscesses can result from bacterial, amebic, or fungal infections reaching the liver through different pathways.
This document discusses occupational liver disorders and their causes. It covers viral, chemical, and physically induced liver injuries and diseases. Some key points include:
1. The liver is divided into three zones (periportal, midzonal, centrilobular) that are differentially affected by toxins.
2. Occupational liver disorders are challenging to diagnose due to non-specific symptoms and potential simultaneous conditions like viral hepatitis or substance abuse.
3. Serologic markers and liver enzymes can help identify liver damage and its cause. Cytotoxic injuries elevate less liver-specific enzymes while cholestatic injuries increase enzymes like alkaline phosphatase.
4. Chemicals from many industries can cause liver
The document discusses the anatomy, histology, functions and common pathologies of the liver. Key points include:
- The liver has four lobes and receives dual blood supply from the hepatic artery and portal vein. It performs many metabolic and synthetic functions.
- Common liver diseases include viral hepatitis, alcoholic liver disease and cirrhosis. Cirrhosis results from chronic liver injury and scarring that disrupts the liver architecture.
- Primary liver cancers like hepatocellular carcinoma often arise in the setting of chronic liver disease and cirrhosis. Treatment options are limited but may include transplantation or resection in early stages.
The document summarizes key aspects of the accessory organs of the digestive system including the liver, gallbladder and bile ducts, and pancreas. It describes the anatomy, functions, common diseases, and nursing care considerations for conditions that can affect each organ system.
The liver is organized into lobules centered around branches of the hepatic vein. Between the lobules are portal triads containing branches of the bile duct, portal vein, and hepatic artery. Hepatocytes within the lobules perform many metabolic functions. Liver disorders can result from infections, drugs, toxins, ischemia, autoimmune issues, or postoperative issues. Postoperative liver dysfunction may occur without preexisting liver disease due to ischemia or anesthesia and usually resolves, but can worsen preexisting conditions like hepatitis.
The document describes the anatomy and functions of the liver and gallbladder. It notes that the liver is located in the right upper abdomen and weighs about 1.5 kg. It has three ligaments that attach it to the diaphragm and divides it into lobes. The liver receives 80% of its blood from the portal vein and has three hepatic veins that drain into the inferior vena cava. The gallbladder is a pear-shaped organ that stores and concentrates bile produced by the liver. Bile contains bile salts that help digest and absorb fats.
DISORDERS OF LIVER, PANCREAS AND BILIARY TRACTAndhrapradesh
This document provides information on various disorders of the liver, pancreas, and biliary tract. It begins with an introduction to cirrhosis of the liver, including its definition, incidence, causes such as alcoholism and hepatitis, types, pathophysiology, clinical manifestations, diagnostic studies, medical and surgical management, complications, and nursing management. It then covers topics such as jaundice, hepatitis, liver abscess, Wilson's disease, Gilbert's syndrome, haemochromatosis, portal hypertension, and ascites. For each topic, it provides definitions, incidence, causes, pathophysiology, clinical manifestations, diagnostic studies, management, and other relevant details.
1. The document discusses liver diseases (yakrut vikara) and their signs, symptoms, causes and treatment. It describes the anatomy and physiology of the liver and normal liver function test values.
2. Elevated liver enzymes (ALT, AST) can indicate liver injury from various causes like viral hepatitis, alcohol, medications etc. Bilirubin levels and their direct/indirect fractions are discussed in the context of pre-hepatic, hepatic and post-hepatic diseases.
3. Complications of chronic liver disease like jaundice, portal hypertension and liver cirrhosis are explained. Treatment approaches for conditions like variceal bleeding and hepatic encephalopathy are also summarized.
Renal diseases occur when the kidneys become damaged and cannot properly filter waste from the blood. This can be caused by genetics, injuries, or medications. Renal failure results from significant loss of kidney function. Common symptoms include changes in urination and fluid retention. Renal diseases can be classified as inherited, congenital, or acquired. Glomerular diseases involve inflammation of the kidney filters while tubulointerstitial diseases affect the kidney tubules. Acute renal failure is a sudden decrease in kidney function marked by oliguria and fluid issues. Chronic renal failure is a progressive loss of function that eventually requires dialysis or transplantation. Renal function tests evaluate electrolytes, waste levels, and clearance to assess kidney performance.
Cirrhosis is a consequence of chronic liver disease characterized by diffuse scarring and regeneration of the liver. It results from many causes including alcohol, viral hepatitis, and genetic conditions. As the liver architecture is disrupted, liver function declines and complications develop. Investigation of cirrhosis involves blood tests to assess liver function and damage, imaging to evaluate the liver structure, and potentially biopsy to determine the specific cause. Common complications arise from portal hypertension and include variceal bleeding, ascites, and hepatic encephalopathy. Cirrhosis can ultimately lead to liver failure and death without treatment or transplantation.
Medical Surgical Nursing - I
UNIT: IV -Nursing Management of Patients With Disorder of Digestive System "Cirrhosis of liver"
the topic covers
- the stages, Pathophysiology and clinical manifestation of Cirrhosis of liver
- diagnostic evaluation and complication of Cirrhosis of liver
- medical, surgical and nursing management of patient with Cirrhosis of liver
The document discusses the anatomy, physiology, and common diseases of the liver. It begins with a brief history of liver surgery and anatomy including liver innervation and lymph drainage. It then covers liver physiology including metabolism of nutrients, proteins, and drugs. Common liver diseases are summarized such as viral hepatitis, alcohol-related disease, cirrhosis, portal hypertension, and liver cancer. Specific conditions like fatty liver disease, jaundice, acute liver failure, and infections are also reviewed. Imaging findings and treatments for various benign and malignant liver lesions are mentioned.
This document provides information about the liver and cirrhosis. It begins with the normal histology and architecture of the liver. It then discusses cirrhosis, defining it as a degenerative disease marked by excess connective tissue formation. Cirrhosis is characterized by bridging fibrous septa, parenchymal nodules, and disruption of liver architecture. The document discusses the classification, etiology, pathogenesis, clinical features, and complications of cirrhosis.
The document provides information on the anatomy, physiology, and pathologic conditions of the spleen. It discusses the spleen's development, location, vasculature, and functions including filtering blood and immune roles. Secondary hypersplenism is defined as being caused by an underlying disease like disorders of splenic blood flow, hematopoietic disorders, immune disorders, infiltrative disorders, infections, or neoplasms. Specific conditions discussed in detail include hereditary spherocytosis, idiopathic thrombocytopenic purpura, myeloid metaplasia, and splenic abscess.
1 curs nefrologie-de prezentat-ii- 23 februariei-2016andrei victor
The document discusses rapidly progressive glomerulonephritis (RPGN), which is characterized by a rapid decrease in kidney function over a short period from a few days to 3 months. It can be caused by antineutrophil cytoplasmic antibodies (ANCA)-associated vasculitis. Histologically, it shows diffuse proliferative and necrotizing glomerulonephritis with crescent formation and fibrinoid necrosis. Patients present with symptoms of renal failure as well as hematuria and systemic symptoms. Diagnosis involves lab tests showing increased creatinine, hematuria on urinalysis, and presence of ANCA. Timely diagnosis is important for organ preservation.
This document discusses fulminant hepatic failure (FHF), including defining FHF, listing its causes, identifying its pathophysiology, diagnostic tests, medical management, complications, and nursing care plan. FHF is defined as severe acute liver injury with impaired function and encephalopathy in someone who previously had a normal liver. Its causes include acetaminophen, various viral hepatitises, and other drugs/conditions. Management involves treating precipitating factors, managing complications, and considering liver transplantation.
1. Renal failure can be acute or chronic and is classified based on the underlying cause and pathology. Acute renal failure (ARF) is characterized by a rapid decline in renal function and accumulation of waste products in the blood. Common causes of ARF include decreased blood flow to the kidneys, direct kidney damage, or urinary tract obstruction.
2. Chronic renal failure (CRF) is an irreversible deterioration of renal function that develops slowly over time. It can be caused by diseases affecting the glomeruli or tubulointerstitial tissues. CRF results in fluid and electrolyte imbalances as well as metabolic abnormalities that manifest as uraemic symptoms.
3. Laboratory findings in renal
This document defines and describes cirrhosis of the liver. It is a chronic, progressive disease characterized by extensive scarring and destruction of liver tissue. There are four types classified by etiology: alcoholic, postnecrotic, biliary, and cardiac. Symptoms range from mild gastrointestinal issues to later complications of liver failure like jaundice, edema, and encephalopathy. Diagnosis involves liver function tests, biopsy, and imaging. Treatment focuses on managing complications through dietary changes, diuretics, banding of varices, and sometimes shunt procedures. Nursing care addresses symptoms, nutrition, skin integrity, and risk for bleeding.
Liver failure can occur suddenly in healthy livers (acute) or gradually due to the decompensation of chronic liver disease (chronic). Fulminant liver failure results from massive liver cell necrosis and severe impairment of liver function. Nitrogenous waste builds up and passes to the brain, causing cerebral edema and hepatic encephalopathy ranging from altered mood to coma. Causes include viral hepatitis, drugs like paracetamol, toxins, vascular issues like Budd-Chiari syndrome, and other conditions. Symptoms include jaundice, encephalopathy, fetor hepaticus, asterixis, and signs of chronic liver disease. Treatment focuses on airway protection, monitoring fluid status, managing complications, and
Cirrhosis is the end stage of chronic liver disease caused by various chronic stress factors that damage the liver over time. This results in progressive fibrosis that destroys the liver's normal structure and function. Common causes include alcohol, hepatitis B/C, toxins, and unknown factors. Complications arise from portal hypertension and liver dysfunction, such as ascites, hepatic encephalopathy, and bleeding disorders. Management focuses on treating complications, slowing fibrosis, and preventing further liver damage through lifestyle changes and medications.
1. Autosomal dominant polycystic kidney disease (ADPKD) is characterized by multiple renal cysts that increase in size and number over time, eventually leading to kidney failure in half of patients by age 60.
2. ADPKD is caused by mutations in genes that regulate renal tubule cell proliferation and results in the monoclonal expansion of tubular epithelial cells.
3. Clinical manifestations include chronic flank pain, urinary tract infections, kidney stones, hypertension, liver cysts, and cerebral aneurysms. Treatment focuses on blood pressure control and management of complications.
Common presentation and investigation of Kidney diseasesEzmeer Emiral
This document provides an overview of the common presentations, investigations, and features of major renal diseases. It discusses the normal functions of the kidney and outlines typical symptoms of renal disease like dysuria, polyuria, oliguria, and hematuria. Specific conditions covered include glomerulonephritis, urinary tract infections, renal failure, polycystic kidney disease, and urinary tract obstruction. Investigations involve urine analysis, blood tests, imaging, and renal biopsy. Features, causes, and clinical presentations of various renal conditions are described in detail.
1. Liver cirrhosis is the end stage of many chronic liver diseases and is characterized by diffuse hepatic fibrosis and parenchymal nodule formation.
2. Liver abscesses can be caused by parasitic or pyogenic infections and present as solitary or multiple lesions on gross and microscopic examination.
3. Alcoholic liver diseases include fatty liver, alcoholic steatohepatitis (ASH), and alcoholic cirrhosis, progressing from steatosis to necroinflammation and fibrosis.
The document provides information about cirrhosis of the liver. It defines cirrhosis as a chronic, progressive disease characterized by diffuse damage to liver cells with fibrosis and nodular regeneration. Cirrhosis results in the loss of the liver's normal lobular architecture and the formation of scar tissue and regenerative nodules. Common causes include alcohol abuse, viral hepatitis, and other conditions that result in chronic liver inflammation. Patients may experience complications such as ascites, variceal bleeding, jaundice, and hepatic encephalopathy as the disease progresses. Diagnosis involves clinical examination, lab tests, imaging and sometimes liver biopsy. Treatment focuses on managing complications and the underlying cause.
The document discusses diseases of the urinary system. It covers the physiology of the kidneys and renal tubules, including their roles in excretion and homeostasis. Common causes of renal insufficiency and failure are described, such as decreased glomerular filtration rate. Clinical findings of urinary tract diseases include abnormal urine constituents like proteinuria, hematuria, and hemoglobinuria. The causes and pathophysiology of these urine abnormalities are explained in detail.
This document discusses obstructive jaundice and approaches to evaluation. It begins by describing the history and definitions of jaundice and obstructive jaundice. It then discusses the effects of biliary obstruction on various organ systems including the intestines, coagulation, renal, hepatic, and dermatologic systems. The document outlines the clinical evaluation of a patient with obstructive jaundice including history, examination, and initial investigations. It proposes an algorithm for imaging based on ultrasound findings and evaluates modalities like CT, MRCP, ERCP, EUS, and percutaneous transhepatic cholangiography.
Chronic renal failure or chronic kidney disease management, pharmacist role, medical management objectives, goals of the therapy .
What are the risk factors of chronic renal failure, clinical manifestations of chronic renal failure, renal failure complications, pathophysiology of chronic renal failure.
Local Advanced Lung Cancer: Artificial Intelligence, Synergetics, Complex Sys...Oleg Kshivets
Overall life span (LS) was 1671.7±1721.6 days and cumulative 5YS reached 62.4%, 10 years – 50.4%, 20 years – 44.6%. 94 LCP lived more than 5 years without cancer (LS=2958.6±1723.6 days), 22 – more than 10 years (LS=5571±1841.8 days). 67 LCP died because of LC (LS=471.9±344 days). AT significantly improved 5YS (68% vs. 53.7%) (P=0.028 by log-rank test). Cox modeling displayed that 5YS of LCP significantly depended on: N0-N12, T3-4, blood cell circuit, cell ratio factors (ratio between cancer cells-CC and blood cells subpopulations), LC cell dynamics, recalcification time, heparin tolerance, prothrombin index, protein, AT, procedure type (P=0.000-0.031). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and N0-12 (rank=1), thrombocytes/CC (rank=2), segmented neutrophils/CC (3), eosinophils/CC (4), erythrocytes/CC (5), healthy cells/CC (6), lymphocytes/CC (7), stick neutrophils/CC (8), leucocytes/CC (9), monocytes/CC (10). Correct prediction of 5YS was 100% by neural networks computing (error=0.000; area under ROC curve=1.0).
share - Lions, tigers, AI and health misinformation, oh my!.pptxTina Purnat
• Pitfalls and pivots needed to use AI effectively in public health
• Evidence-based strategies to address health misinformation effectively
• Building trust with communities online and offline
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These lecture slides, by Dr Sidra Arshad, offer a quick overview of the physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar lead (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
6. Describe the flow of current around the heart during the cardiac cycle
7. Discuss the placement and polarity of the leads of electrocardiograph
8. Describe the normal electrocardiograms recorded from the limb leads and explain the physiological basis of the different records that are obtained
9. Define mean electrical vector (axis) of the heart and give the normal range
10. Define the mean QRS vector
11. Describe the axes of leads (hexagonal reference system)
12. Comprehend the vectorial analysis of the normal ECG
13. Determine the mean electrical axis of the ventricular QRS and appreciate the mean axis deviation
14. Explain the concepts of current of injury, J point, and their significance
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. Chapter 3, Cardiology Explained, https://www.ncbi.nlm.nih.gov/books/NBK2214/
7. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
3. INTRODUCTION
• Liver weight 1400 - 1600gm.
• Parenchyma - liver cells (hepatocytes) trabeculae 1 cell thick in adults.
- Kupffer cells in sinusoids are phagocytes.
- hepatic stellate cells in space of Disse, store vitamin A,
transform into collagen-producing myofibroblasts,
regulate blood flow in sinusoids.
- liver-associated lymphocytes.
• Biliary drainage system - canaliculi (in centre of liver cell plates).
- canals of Hering & cholangioles.
- intra-hepatic bile ducts.
- extra-hepatic bile ducts.
• Vasculature - portal vein supplies 70% of the blood flow.
- hepatic artery supplies 30% of the blood flow.
- sinusoids lined by fenestrated endothelium.
- hepatic venules, hepatic veins drain into the IVC.
4.
5.
6. • The functional unit of the liver parenchyma is the hepatic acinus with zones 1,2 & 3.
Zone 1 is periportal, zone 3 is perivenular, zone 2 intermediate.
• Portal tracts composed of fibrous tissue ramify in the liver and contain 3 structures,
portal vein, hepatic artery, bile duct (portal triad).
• The liver is important for - metabolism of carbohydrate, protein,lipids.
- protein synthesis, albumin, coagulation factors,
complement factors etc.
- storage of iron, copper, vitamins A,D,B12.
- detoxification/drug metabolism.
- bile production.
• Investigation of liver diseases.
Biochemical - enzymes, proteins, bilirubin.
Haematological - coagulation factors among others.
Immunological - antibodies (viruses, autoimmune).
Imaging - ultrasound,CT,MRI,ERCP,MRCP.
Liver biopsy - percutaneous needle biopsy, transjugular biopsy, wedge biopsy
at laparoscopy or open surgery. Useful in providing information as to the aetiology
and severity of the liver disease, ruling out the presence of other concomitant
disease, monitoring response to therapy. Focal lesions require US or CT guidance.
7. • Morphological patterns of liver injury.
1. Degeneration - ballooning degeneration (hydropic change);
- feathery degeneration (bile-induced damage).
Intracellular accumulations - fat (steatosis), iron, copper, bile, Mallory’s
hyaline.
2. Necrosis - (coagulative or lytic) and apoptosis. Necrosis may be
randomly focal (spotty necrosis), zonal eg zone 3, bridging (bridging hepatic
necrosis, eg portal to venular), involve most or almost all of the liver
(submassive and massive respectively). Zone 3 is most prone to injury as it
is farthest from the blood supply and is the area containing most drug-
metabolising enzymes.
3. Inflammation - acute, chronic or granulomatous. May be portal, periportal
(interface hepatitis) or acinar (focal, or panacinar).
4. Regeneration - hepatocytes have great ability to regenerate. The reserve
compartment is the canal of Hering/bile ductule compartment. Activation is
described as the ductular reaction.
5. Fibrosis forms in response to inflammation or direct toxic injury. Can be
portal, perivenular, form bridging fibrosis, finally cirrhosis.
The great variety of liver diseases and the liver’s limited patterns of response
means that close clinicopathological correlation is required for their diagnosis.
8. JAUNDICE AND CHOLESTASIS
• Jaundice (or icterus) - yellow discolouration of the skin, sclerae and
mucous membranes due to excess plasma bilirubin
(hyperbilirubinemia).
Jaundice appears when plasma bilirubin exceeds 50umol/l.
(Normal 3 -
17umol/l)
Liver disease is not the only cause of jaundice and many
patients with significant liver disease do not have jaundice (are
anicteric).
• Cholestasis - arrest of bile flow. A failure of adequate amounts of bile
to reach the duodenum - due to interference anywhere from liver cell
microsomes to the duodenum.
9.
10.
11. MECHANISMS AND CLASSIFICATION OF JAUNDICE
• Mechanisms - Increased bilirubin production.
- Decreased uptake by hepatocytes.
- Impaired conjugation.
- Impaired excretion - intrahepatic
- extrahepatic.
• Classification.
Pre-hepatic - haemolysis most important of several causes.
Unconjugated bilirubin insoluble in water, not excreted in urine.
Risk of brain damage in neonates (kernicterus); pigment gallstones in
adults. Hepatic - eg hepatitis,intra-hepatic bile duct damage,
congenital hyperbilirubinemias eg Gilbert’s syndrome. Mainly
conjugated (except Gilbert’s syndrome) so soluble in water resulting in
dark urine. Post-hepatic - obstruction to extra-hepatic bile
ducts by gallstone, stricture, tumour, or congenital biliary atresia.
Conjugated bilirubin.
12. • In cases of hepatic jaundice, when there is predominantly hepatocyte
damage, the patient is often very symptomatic and raised serum
transaminases are the predominant biochemical finding. This is
sometimes called “hepatocellular jaundice.”
• In cases where there is biliary obstruction, whether intra- or extra-
hepatic, the patient has what is called “cholestatic jaundice” with
pruritis, dark urine and pale stools, and with time may develop skin
xanthelasmas and steatorrhoea. Serum alkaline phosphatase is
raised.
• Mixed patterns occur.
• Distinction between intra-hepatic and extra-hepatic obstruction requires
imaging. This should be done urgently and the obstruction relieved
where at all possible.
13. LIVER FAILURE
• Classification. Acute - no pre-existing liver disease.
Chronic - pre-existing liver disease.
• Causes. Acute - viral hepatitis, drugs, toxins, severe fatty change (eg
fatty liver of pregnancy, Reye syndrome), vascular.
Chronic - cirrhosis, chronic hepatitis.
• Morphology. Acute - varying degrees of necrosis up to massive liver
necrosis (zonal to panacinar histologically).
Chronic - that of cirrhosis or chronic hepatitis.
Chronic liver failure is more common than acute liver failure.
Mortality from liver failure without liver transplantation is 75% to
90%. Drugs and viruses account for about 80% & 15% of cases of
acute liver failure respectively; figures vary according to geographical
area.
14. FEATURES OF LIVER FAILURE
• Hepatic encephalopathy - a neuropsychiatric disturbance leading to
coma. The cardinal feature of acute liver failure, progressing
over hours to days. More insidious in chronic liver failure when it is a sign
of worsening liver failure.
Pathogenesis:- nitrogenous compounds derived from bacterial action
in the colon are not metabolised in the failing liver; in addition shunting of
portal blood to systemic circulation by-passes the liver.
Compounds involved - ammonia and derivatives of aromatic amino
acids (eg mercaptans, a cause of foetor hepaticus)
- false neurotransmitters (eg octopamine)
- neuroinhibitors, eg gamma-aminobutyric acid
(GABA), endogenous benzodiazepines.
Morphology of brain - oedema; Alzheimer type 2 astrocytic reaction.
15. • Jaundice - hyperbilirubinaemia; deep jaundice = worse prognosis.
• Haematological - decreased clotting factors (II,VII,IX,X) results in a
bleeding tendency.
• Cardiovascular - hyperkinetic circulation.
• Respiratory - hepatopulmonary syndrome.
• Renal - hepatorenal syndrome.
• Endocrine - in chronic failure - gonadal atrophy, gynaecomastia,
amenorrhoea.
• Skin changes - in chronic failure - spider naevi, palmer erythema.
• Others - impaired metabolism of amino acids, carbohydrates
(hypoglycaemia) and drugs; impaired protein synthesis (low albumin),
systemic infections and endotoxaemia.
Laboratory investigations - bilirubin (>300umol/l = poor prognosis).
- prothrombin (>50sec.= poor prognosis).
- transaminases.
- albumin.
Possible factors precipitating liver failure in chronic liver disease:-
increase in liver injury due to virus or alcoholic binge, infection,
GIT haemorrhage (which can precipitate encephalopathy, as can
excess dietary protein,constipation, drugs, uraemia, hypokalaemia).
16. CIRRHOSIS
• Definition. Cirrhosis is a diffuse process in which bridging fibrosis and
regenerative parenchymal nodules result in disruption of the
architecture.
Regenerative nodules surrounded by fibrosis are necessary for
the diagnosis. These may be <3mm (micronodular cirrhosis) or >3mm
(macronodular cirrhosis). A micronodular cirrhosis can transform into a
macronodular cirrhosis.
The microvasculature of the liver is markedly altered.
Cirrhosis is the end stage of chronic liver disease.
It is best classified according to aetiology.
17.
18.
19.
20.
21. • Infections. Viral hepatitis.
• Toxins and drugs. Alcohol.
Therapeutic drugs.
• Autoimmune. Hepatitis.
Primary biliary cirrhosis.
• Metabolic. Haemochromatosis.
Wilson disease.
Alpha-1-antitrypsin deficiency.
Glycogen storage disease and many others.
• Biliary obstruction. Congenital atresia.
Sclerosing cholangitis.
• Hepatic outflow obstruction.
• Cryptogenic.
The aetiology of cirrhosis varies throughout the world. In the Western world, alcohol is
the most common factor at 60% and viral hepatitis 10%. Viral hepatitis is the most common
factor in Asia and Africa. Cryptogenic cirrhosis (cause unknown) forms 10%.
Once cirrhosis has developed, it is usually not possible to determine the aetiology by
morphology alone and results of other investigations are required.
22. • Pathogenesis.
Liver injury results in chronic inflammation and activation of Kupffer
cell, and other endogenous liver cells with the production of cytokines.
These, together with disruption of the extracellular matrix activates
hepatic stellate cells (HSC). Toxins may activate HSCs. These
transform into myofibroblasts which produce collagen and constrict
sinusoids.
Collagen in the space of Disse leads to “capillarisation” of the
sinusoids and loss of endothelial fenestrations, hindering exchange of
solutes.
New vascular channels in fibrous bands link inflow of blood (venous
& arterial) with outflow (hepatic venules) thus by- passing parenchyma.
Existing vascular channels and biliary channels may be obliterated.
The results are internal vascular shunts and portal hypertension.
The hepatocytes in the regenerative nodules may appear normal
microscopically but are unable to adequately fulfill their functions.
Function will be further reduced if there is continuing liver cell damage.
23. CLINICAL FEATURES
• Cirrhosis may be asymptomatic.
• When symptomatic, the features are nonspecific - weakness, fatigue,
weight loss, anorexia, nausea, gaseous abdominal distension, upper
abdominal discomfort.
• The liver may be enlarged, hard and irregular or smaller than normal.
• At this stage the patient is said to have compensated cirrhosis.
• Decompensated cirrhosis manifests as signs of liver failure or
complications of portal hypertension. Deterioration in liver function can
be an indication of the development of hepatocellular carcinoma.
• Death is usually due to one of these 3 conditions.
24. COMPLICATIONS OF CIRRHOSIS
• Liver failure.
• Portal hypertension. Portal venous pressure >10mmHg.
Splenomegaly - hypersplenism leading to thrombocytopenia.
Portal-systemic shunts where portal venous system
anastomoses with the systemic venous system.
Lower end of oesophagus leading to oesophageal varices and risk of
massive GIT haemorrhage. Periumbilical (“caput medusae”), lower
rectum (haemorrhoids), posterior abdominal wall.
Ascites, ie excess fluid in the peritoneal cavity. A transudate
(<3gm/dL protein),straw coloured or pale green, a few mononuclear
cells. Risk of spontaneous infection when polymorphs predominate.
Is due to aldosterone-induced retention of Na & water, low oncotic
pressure (low albumin), and portal hypertension. Excess hepatic lymph
and intestinal fluid leakage also contributes to ascites.
• Hepatocellular carcinoma.