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Hepatic Pathology and Respiratory System

Hepatic Pathology and Respiratory System. Topics in Human Pathophysiology Fall 2011 Gilead Drug Safety and Public Health. Outline. Hepatic Pathophysiology Digestive System Overview Placement and role of liver Liver microstructure Pathologies of liver Respiratory Structure and Function.

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Hepatic Pathology and Respiratory System

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  1. Hepatic Pathology and Respiratory System Topics in Human Pathophysiology Fall 2011 Gilead Drug Safety and Public Health

  2. Outline • Hepatic Pathophysiology • Digestive System Overview • Placement and role of liver • Liver microstructure • Pathologies of liver • Respiratory Structure and Function

  3. Digestive system

  4. The Liver

  5. Figure 14.11

  6. Hepatic Portal System

  7. Liver Functions

  8. Hepatitis • Inflammation of the liver • Causes include: • Viruses and other pathogens • Drug and alcohol toxicity • Environmental toxins • Obesity, autoimmune disorders

  9. Viral Hepatitis From http://www.cdc.gov/hepatitis/index.htm

  10. Figure 9.20 Reverse transcriptase required

  11. Pathophysiology of Hepatitis • Destruction of hepatocytes (necrosis) by inflammation • Altered blood flow through and to liver • Edema – both peripherally and in portal vessel area • Blockage of bile ducts leading to reduced bile in small intestine and problems with fat absorption • Reduction of ability to make blood proteins including albumin, clotting factors, complement • Buildup of blood toxins including urea and ammonia

  12. Symptoms of Hepatic Damage • Jaundice • Dark amber colored urine • Nausea/vomiting • Abdominal pain - R upper quad • Fatigue • Also- ascites, hepatic encephalopathy, coma, death

  13. Cirrhosis • Long term result of liver damage

  14. Liver Tests – Liver Panel • AST– liver enzyme, elevated with damage to cells • ALT - liver enzyme, elevated with damage to cells • ALP – enzyme related to bile ducts, levels elevate if there is a blockage • total bilirubin (blood)– may be elevated with liver damage or excessive RBC destruction • Albumin (blood) – checks on synthetic ability of liver cells • prothrombin time - decreased synthesis of clotting factors by liver See labtestsonline for more information

  15. CT Scan of the Liver Normal liver Nodular cirrhotic liver with ascites www.integris-health.com

  16. Drug Induced Hepatotoxicity • More than 900 drugs, toxins and herbs cause drug induced hepatotoxicity, • 20-40% of all fulminant liver failure cases are caused by drug induced hepatotoxicity • It is the most common reason a drug is withdrawn from approval • Damage to liver can be hepatocellular or cholestatic Drug-Induced Hepatotoxicity from http://www.emedicine.com/Med/topic3718.htm

  17. Figure 10.1 Respiratory System

  18. Respiratory Functions • Gas exchange • Protection • Speech • Compression of abdomen and spine stiffening • Acid-Base balance

  19. Figure 10.8

  20. Respiratory Interface • Alveolar wall • Capillary wall • Surfactant • Gas Exchange occurs by diffusion

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