Liver: Largest internal organ and gland
Gerontologic Consideration of Liver Disease
* Increase liver disease rate with age because of liver structure changes with age
* Decrease liver volume – Because liver size will change with age
* Decrease in hepatobilary function
* Decrease drug metabolism: which increases the vulnerability for drug-induced hepatitis and increase risk for drug interactions
* Decrease ability to respond to injury
Most common cause for liver inflammation is viral infection
* Inflammation causes damage liver cell and may develop into hepatic cell necrosis.
* If there are no complications, the liver cells can ...view middle of the document...
* Protein will be decrased because the liver is unable to produce the proteins
* Increase Bilirubin
* Indirect or unconjugated bilirubin
* Prolonged prothrombin time (increase clotting time): because the liver is unable to produce clotting factors.
*IMPORTANT CONCEPT* RBC are broken down, broken down in 3 pieces , globin, iron, heme. Heme will be further broken down into greenish pigment call biliverdin, quickly converted to yellow pigment call bilirubin. This bilirubin is known as indirect /Unconjugated bilirubin(In the blood). This bilirubin will go into the liver by binding with albumin(transporter), and once it enters the liver, it will mix with glucuronic acid. The glucuronic acid will make the indirect/unconjugated bilirubin into more solid form call direct/conjugated bilirubin. Will go back into the biliary system and mix with bile and use the biles for digestive process.
*If you understand the concept, then you understand how this works* That is why patients with hepatitis will have elevated indirect/unconjugated bilirubin because the liver cannot process all that unconjugated bilirubin, and that is also why the patient has clay color stools. This is also why the person looks jaundice.
Patient who have uncompatable blood transfusion will have pre-hepatic jaundice
Patient who has viral hepatitis or cirrhosis will have hepatic jaundice
Patient who problems with the biliary system(gallbladder and pancreas), they will have First-Hepatic Jaundice.
General Home Care:
Not everyone goes to hospital when they have mild or moderate case of hepatitis and go through home remedy.
* Well Balanced Diet
* Low Fat, High carbohydrate, High Protein
* Maintain fluid & electrolyte balance
* Vitamin supplement: B-Complex(help regenerate liver tissues)
* 6 types of hepatitis virus: A-E, & G
* To determine which viral antibody a patient has, it will depend on what antigen and antibodies are found in the system.
Transmitted through fecal to oral route (touching feces, putting it in the mouth)
37% of outbreaks of HepA are from eating contaminated food or drinking contaminated water.
* Poor hygiene
* Improper handling of foods
* Crowded situations
* Poor sanitary conditions
* Replication starts at the oropharynx/GI tract
* Transport to liver-Major site for replication, and then sheds into the bile and transported into the intestine.
* And the bile is excreted into the feces which is why we can get viral culture from feces.
* There is a brief viremia(virus in the blood)
* And then our immune system will control the virus.
Average Incubation period: 28 days(15-50 days)
Virus can be found in the stool 2 weeks before symptoms starts to show or up to 1 week after begin to have jaundice.
You will get a negative stool test for virus if you get it after incubation period, BUT we can...