PHRM4011 Lecture Notes - Lecture 6: Hyponatremia, Creatinine, Urobilinogen
Document Summary
Liver diseases: non-alcoholic ty liver disease, hepatitis c, hepatitis b, hepatitis a, cirrhosis of the liver, alcoholic hepatitis, hemochromatosis. Important for: bile production, clotting factors, fat metabolization, carbohydrate metabolism, production of albumin important for drugs, angiotensin synthesis. Ast/alt transaminase should be inside liver cells acute injury high, chronic none left therefore low: ratio >2. 5 alcohol liver disease, ratio >1 paracetamol od, ratio 1-2. 5 ischaemia, ccf, etc. Ggt, alp cholestasis bile excretion blockage goes up all the time. Alb/inr albumin how well liver makes thing inr goes up in liver disease. Bilirubin management: haemolysed blood cells unconjugated bilirubin bound to albumin conjugated (add glucose) excreted through bile broken down in small intestine urobilinogen 10% reabsorbed kidney, 90% excreted. Liver affects: hyponatraemia, hypokalaemia, decreased urea, decreased protein decreased creatinine (muscle breakdown) not necessarily bad renal. Creatinine kinase heart causes deranged lft by 3x upper limit. Meds: nsaid, paracetamol, antiepileptics (stop after 2 years seizure free, antibiotics.
