Medicine an Surgery notes

Apr 24th, 2015
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DR ANN MULIOUTLINEDEFINITIONANATOMY AND PHYSIOLOGYEPIDEMIOLOGYETIOLOGYPATHOPHYSIOLOGYALCOHOLIC CIRRHOSISBILIARY CIRRHOSISPOSTHEPATITIC CIRRHOSISCARDIAC CIRRHOSISPORTAL HYPERTENSIONHEPATIC ENCEPHALOPATHYDEFINITION Cirrhosis is defined histologically as a diffuse hepatic processcharacterized by fibrosis and the conversion of normal liverarchitecture into structurally abnormal nodules.ANATOMY AND PHYSIOLOGYBlood Supply Two sources: The first is the hepatic artery which delivers oxygenated bloodfrom the general circulation. The second is the hepatic portal vein delivering deoxygenatedblood from the small intestine containing nutrients. The blood drains out of the liver via the hepatic vein.Fxns of the liver1. Excretion of body wastes ,hormones, toxins as well as drugs.2. Synthesis of plasma proteins,- albumin, clotting factors etc.3. Production of immune factors & helping the body fightinfections.4. Bile production5. Excretion of bilirubin6. Storage of vitamins, minerals, and carbohydrates.ETIOLOGYMost common causes of cirrhosis1. Hepatitis C2. Alcoholic fatty liver disease(21%3. Hepatitis C plus alcoholic liver disease (15%)4. Hepatitis B which may be coincident with Heptitis D (15%)5. Miscellaneous (5%)liver disease and cirrhosisAutoimmune hepatitisPrimary biliary cirrhosisSecondary biliary cirrhosis (associated with chronic extrahepatic bile ductobstructi

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