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− | *this results from inadequate [[Liver - Anatomy & Physiology|liver]] function
| + | ==Introduction== |
− | *occurs even though the [[Liver - Anatomy & Physiology|liver]] has a large functional reserve and a high regenerative capacity
| + | Liver failure results from inadequate [[Liver - Anatomy & Physiology|liver]] function. It occurs even though the [[Liver - Anatomy & Physiology|liver]] has a large functional reserve and a high regenerative capacity. |
− | ===Causes=== | + | |
− | *low liver mass
| + | ==Causes== |
− | **the functional reserve is depleted
| + | ===Low Liver Mass=== |
| + | |
| + | With low liver mass the functional reserve is depleted |
| + | |
| NB: [[Liver - Anatomy & Physiology|liver]] enzyme levels in blood may not be markedly raised in chronic ongoing [[Liver - Anatomy & Physiology|liver]] damage because there may be few [[Liver - Anatomy & Physiology|liver]] cells remaining to leak enyzmes | | NB: [[Liver - Anatomy & Physiology|liver]] enzyme levels in blood may not be markedly raised in chronic ongoing [[Liver - Anatomy & Physiology|liver]] damage because there may be few [[Liver - Anatomy & Physiology|liver]] cells remaining to leak enyzmes |
− | *remodelling of the vascular and connective components after damage
| |
− | **this may lead to inadequate nutritional supply to the hepatocytes, thus reducing their function
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− | *impaired function of one specific or many of its diverse functions
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− | **eg failure of detoxification
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− | ***aldosterone - a failure of its proper inactivation results in hypervolaemia since a feature of this hormone is to cause sodium and hence water rentention
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− | ****this is a factor in the development of ascites
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− | ***oestrogen - a failure of its proper inactivation will result in an accumulation of this hormone with atrophy of the genitals and an enlargement of the breasts in the male
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− | ***plant pigments - failure to detoxify will lead to their accumulation in the tissues and photosenistisation may result if they are photodynamic
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− | **eg metabolic upset
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− | ***the failing [[Liver - Anatomy & Physiology|liver]] is unable to convert ammonia to urea, resulting in a rise in the level of blood ammonia
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− | ***lowered level of plasma albumin contributes to the development of ascites
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− | ===Syndromes in liver failure=== | + | ===Remodelling of the Vascular and Connective Components after Damage=== |
| + | |
| + | This may lead to inadequate nutritional supply to the hepatocytes, thus reducing their function |
| + | |
| + | ===Impaired Function of One Specific/Many of its Diverse Functions=== |
| + | |
| + | '''1) Failure of detoxification''' |
| + | |
| + | '''Aldosterone''' - a failure of its proper inactivation results in hypervolaemia since a feature of this hormone is to cause sodium and hence water rentention. This is a factor in the development of ascites |
| + | |
| + | '''Oestrogen''' - a failure of its proper inactivation will result in an accumulation of this hormone with atrophy of the genitals and an enlargement of the breasts in the male |
| + | |
| + | '''Plant Pigments''' - failure to detoxify will lead to their accumulation in the tissues and photosenistisation may result if they are photodynamic |
| + | |
| + | '''2) Metabolic upset''' |
| + | *The failing [[Liver - Anatomy & Physiology|liver]] is unable to convert ammonia to urea, resulting in a rise in the level of blood ammonia |
| + | *Lowered level of plasma albumin contributes to the development of ascites |
| + | |
| + | ==Syndromes in liver failure== |
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| [[Icterus]] | | [[Icterus]] |
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| [[Category:Liver - General Pathology]] | | [[Category:Liver - General Pathology]] |
| [[Category:To_Do_-_Clinical]] | | [[Category:To_Do_-_Clinical]] |
| + | [[Category:To Do - Siobhan Brade]] |