gi notes 2

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Evaluation of the Liver Patient Roles of the liver • Protein synthesis / proteolysis – Factors for the coagulation cascade – Acute phase reactants • Major source of glucose production and release in the body • Provides a defense against colonic bacteria (Koupper Cells) • Clears & metabolizes ammonia – Colonic bacteria – Enterocte metabolism of glutamine !e"nitions • Cholestasis # $mpaired bile %o • Intrahepatic cholestasis# $mpaired bile %o ithin the liver • Extrahepatic cholestasis# $mpaired bile %o in bile ducts outside the liver • Cholangitis # 'ile duct in%ammation – 'acterial viral parasitic autoimmune • Hepatitis# ecrosis and in%ammation of the liver ***ot all hepatitis is viral hepatitis++ ,mptoms of -iver !isease . if smptomatic+ • Right upper /uadrant pain • !ar0 urine and light stools (bile gets stuc0 in the blood 1 loses color) • Pruritus • Anore2ia (loss of appetite) • ausea and vomiting • Alteration of taste 3 dsgeusia • Fever and chills Pruritus 4Rule of 5humb6 • Intrahepatic cholestas is causes pruritus a s an early sympto m – Primar biliar cirrhosis and earl itching – $tch "rst 7aundice later • Extrahepatic cholestas is results in pruritus as a late symptom – 'ile duct obstruction ma not even cause itching – 8aundice "rst itch later ,cleral $cterus $C5ER9, preceeds 7aundice *,clera has a high a:nit for bilirubin ,pider Angiomata End3stage liver disease Pregnanc 9se of birth control pills ;perthroidism

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