Acute liver failure
Lernkarten zu PACT
Lernkarten zu PACT
Kartei Details
Karten | 8 |
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Sprache | Deutsch |
Kategorie | Medizin |
Stufe | Universität |
Erstellt / Aktualisiert | 27.09.2014 / 29.07.2017 |
Lizenzierung | Keine Angabe |
Weblink |
https://card2brain.ch/box/acute_liver_failure
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Einbinden |
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Wie ist acute liver failure definiert?
Chronic liver failure?
the development of severe hepatic dysfunction within six months of the onset of symptoms
chronic liver disease is said to be manifest when cirrhosis or another inflammatory/fibrotic process has been present for more than six months
Warum steigt die Inzidenz der Leberzirrhose? 3
viral hepatitides, non-alcoholic fatty liver disease (as a component of the metabolic syndrome) and alcohol-related liver disease
Wann ist das Leberversagen
hyperakut?
akut?
subakut?
- Hyperacute – in which encephalopathy occurs within seven days of jaundice.
- Acute – with an interval of eight to 28 days from jaundice to encephalopathy.
- Subacute – with encephalopathy occurring 28 days to 12 weeks after jaundice.
Warum ist Acteaminofen in hoher Dosis toxisch?
Cytochrome P450 enzymes convert ~5% of acetaminophen to N-acetyl p-benzoquinoneimine (NAPQI), a metabolite which is normally detoxified by conjugation with hepatic glutathione. Hepatocellular glutathione becomes rapidly depleted in overdose, and NAPQI persists, causing damage to cell membranes leading to hepatocyte death
Wann ist die Prognose eines Leberversagens schlecht? 6
- in patients who are younger than 10 years or older than 40 years
- those who have causes other than acetaminophen toxicity or hepatitis A and B virus infection
- when there is a long period between the development of symptoms and encephalopathy
- Persistent acidosis
- INR >3.5
- increasing serum bilirubin and creatinine concentrations also suggest a worse prognosis in those with non-acetaminophen aetiologies.
Welche Faktoren führen bei chron. Lebererkrankung zu Encephalopathie? 6
- Infection.
- Metabolic disturbances (electrolyte abnormalities, excessive diuretic therapy or fluid restriction, excessive paracentesis, uraemia, alkalosis, anaemia, hypoxaemia).
- Gastrointestinal disturbances (haemorrhage, constipation, excessive protein load).
- Hepatic abnormalities (acute liver necrosis, disease progression, portal vein thrombosis, ischaemia, hepatoma, spontaneous portosystemic shunting that may not be associated with liver disease, TIPS or surgical shunts).
- Psychoactive drugs.
- Medication non-compliance.
Welche Stoffe lösen Encephalopathie aus? 6
- ammonia
- mercaptans
- gamma-aminobutyric acid
- endogenous benzodiazepines
- serotonin/tryptophan.
Einteilung der hep. Enzephalopathie?
- Grad 1: Konzentrationsstörungen, Stimmungsschwankungen, Probleme beim Lösen einfacher Rechenaufgaben.
- Grad 2: vermehrte Schläfrigkeit und eingeschränkte zeitliche Orientierung.
- Grad 3: Somnolenz, unzusammenhängende Sprache bei Erwecken
- Grad 4: Coma hepaticum (Leberkoma)