1. 1.What is liver?

    • Liver is the largest organ, weighing about 1.2-1.5 kg. It is chocolate colored, situated on the right upper part of the abdominal cavity.

  2. 2. What are the functions of liver?

    • i) Metabolism: It metabolizes carbohydrate, proteins, fat, drugs, alchohol and vitamines
      ii) Detoxification: It detoxicates toxins from the body.
      iii)Synthesis: It synthesizes protein - albumin, globulin and waste products like urea, NPN, uric acid etc.
      iv) Storage: It stores glycogen, iron, copper, Vitamin A, D, B12, vit K and folate
      v) Excretion: It execrates bile salt & bilirubin.
      vi) Digestion of food materials

  3. 3.What is Hepatitis? What are the causes of Hepatitis?

    • Hepatitis is defined as inflammation of the liver which causes damage to the hepatocytes with subsequent cell death. Causes:
      I) Viral infection—HAV, HBV, HCV, HDV, HEV, EBV, CMV, Herpes etc.
      II) Autoimmune Disorder- Autoimmune chronic hepatitis, toxins, drugs (INH, Refampicin, CPZ & Halothane) and alcohol.
      III) Miscellaneous: Wilson’s disease, α1 – Anti trypsin deficiency.

  4. 4.How Hepatitis-B patient should lead his/her life?

    • i) Avoid medication without medical guidance.
      ii) Avoid alcohol consumption.
      iii)Regular surveillance with blood tests.
      iv) Emphasize food hygiene to prevent other viral hepatitis. eg. Hepatitis A & E.
      v) Balance diet should be taken & over exhaustion should be avoided.
      vi) Apply proper wound care after injury.
      vii)Screen family members & sexual partners for HBV & consider vaccination.
      viii)Avoid sexual promiscuity; use of condom can reduce the risk for transmission.
      ix) Maintain personal hygiene; don’t share personal items with others eg. Razor, toothbrush etc.
      x) No sharing of syringe & needle.

  5. 5.What are the types of Hepatitis?

    • i) Hepatitis B Virus (HBV)
      ii) Hepatitis C Virus (HCV)
      iii)Hepatitis D Virus (HDV)
      iv) Hepatitis A Virus (HAV)
      v) Hepatitis E Virus (HEV)

  6. 6.What are the symptoms & signs of Hepatitis?

    • Symptoms:
      i) Headache
      ii) Malaise
      iii)Anorexia
      iv) Nausea/Vomiting
      v) Upper abdominal discomfort
      vi) Yellowish discolouration of conjunctiva and urine
      vii) Itching
      Signs:
      i) Enlarged Liver.
      ii) Tender Liver (Pain on pressure)
      iii)Jaundice
      iv) Palpable cervical lymph node (Occasional)
      v) Enlarged spleen (Occasional)
      vi) Serum sickness syndrome with skin rashes & arthralgia (rare)
  7. 7.What is Jaundice?

    • It is a sign manifested by yellowish discoloration of skin sclera & mucous membrane resulting from increased bilirubin concentration in the body fluids.

  8. 8.Classify Jaundice?

    • Obstructive Jaundice: It is due to obstruction to bile flow.
      Hepatocellular Jaundice: It is due to damage of liver cells.
      Haemolytic Jaundice: It is due to breakdown of RBC.

  9. 9.How hepatitis patient should lead his life?

    • i) Be active and do everything.
      ii) Don’t sit idle and be a victim of depression.
      iii)Take all kinds of food without restriction.
      iv) Consult your doctor regarding intake on the quantity of salt and meat.
      v) Take rest if you feel tired.
      vi) Do not opt for any liver tonic that is popular in the market, it may be harmful.
      vii)Be alert and cautious if suffering from fever and consult a doctor.
      viii)Please take advice from doctor regarding intake of medicine.

  10. 10.What is cirrhosis of liver?

    • When the liver is damaged with persistant inflammation the liver cells will die. Some other cells (stellate) and fibers (collagen) encircle the dead cells and all become fibrosed and ineffective. This type of agglomeration of dead liver cells, fibers and stellate cells will lead to cirrhosis of liver, resulting in irregular shape of liver.

  11. 11.How cirrhosis patient should lead his life?

    • i) In primary stage of cirrhosis there should not be any change in lifestyle.
      ii) If tiredness is felt take rest in between work.
      iii)In cirrhosis there is breakdown of protein in the body, so in the initial stage the protein intake should be high.
      iv) If there is edema or ascites no extra salt should be taken and medicine should be taken empirically.
      v) If there is temperature or abdominal pain in cirrhosis patient - consult doctor as it may be due to other bacterial infection/asctic fluid infection.

  12. 12.What a pregnant woman with Hepatitis B should do?

    • i) There is nothing to be anxious.
      ii) Baby will be born in a complete healthy state.
      iii)Only vaccination at birth & some medicines should be taken as prescribed by the doctor.
      iv) Abortion for being Hep-B positive is not only unnecessary but also a crime.

  13. 13.What is transplantation of liver?

    • Transplantation of liver means transplant of liver tissue from a healthy donor to a recipient. It can be done to patients with end stage liver disease.

  14. 14.In transplantation how much part of liver is necessary?

    • In transplantation approximately 25% of healthy liver tissue is necessary.

  15. 15.What are the indications of liver transplantation?

    • Liver transplantation may be required for patient suffering from acute & chronic liver failure due to Hepatitis Virus, cholestetic forms of cirrhosis (Primary Biliary Cirrhosis), alcoholic cirrhosis and rarely due to metabolic disease (i.e. α1- Anti-trypsin Deficiency & Haemochromotosis).

  16. 16.What is Gilbert Syndrome?

    • Gilbert Syndrome is congenital liver disease & is characterized by non-hemolytic hyperbilirubinaemia. In adults the prognosis is excellent, needs no treatment, but occasionally Phenoberbitone is given & is clinically important only because it may be mistaken for more serious liver diseases.
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