PSYCH 1XX3 Lecture Notes - Lecture 21: Esophageal Varices, Hepatocellular Carcinoma, Viral Hepatitis
19 May 2018
School
Department
Course
Professor
Cirrhosis
Whole liver involved with triad of:
• Fibrosis
• Nodules of regenerating hepatocytes
• Distortion of liver architecture
• Complications
o Hepatic failure (decompensation)
o Hepatocellular carcinoma
o Portal hypertension
o Ascites
o Porto-systemic shunts
o Oesophageal varices,
haemorrhoids, caput medusa
o Splenomegaly (hypersplenism)
• Causes
Cause
Deficit
Features
Alcohol
Alcohol byproducts activate Hepatic
Stellate Cells → Firosis
3 distinct pathologies
- Alcoholic Hepatitis
- Alcoholic Fatty Liver
- Alcoholic Cirrhosis
Viral hepatitis
Steatohepatitis
Non-alcoholic liver disease
Similar appearance but associated with
metabolic syndrome
? Insulin resistance (reduced peripheral
lipolysis)
Continuum
- Non-alcoholic fatty liver disease
- Non-alcoholic steatohepatitis (may lead
to cirrhosis)
Wilsonʼs disease
Disorder of ATPase Copper transport
protein
Accumulation of copper in liver →
hepatolenticular degeneration
AD transmission
Neurology + Kayser-Fleisher rings
Low caeruloplasmin + low copper
Haemochromatosis
HFE gene C282Y mutation → excessive GI
absorption of iron
AR + manifests > 40 years old
Liver
– cirrhosis
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