Impaired Liver Function

Judy  Thomas
Mind Map by Judy Thomas, updated more than 1 year ago
Judy  Thomas
Created by Judy Thomas over 6 years ago


Mind Map on Impaired Liver Function, created by Judy Thomas on 05/28/2015.

Resource summary

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