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Flashcards in Ch 30 Deck (11)
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1

The liver has many jobs. One of the most important functions of the liver is to cleanse the portal blood of old and defective blood cells, bacteria in the bloodstream, and any foreign material. Which cells in the liver are capable of removing bacteria and foreign material from the portal blood?

a. Kupffer cells
b. Langerhans cells
c. Epstein cells
d. Davidoff cells

a. Kupffer cells

Kupffer cells are reticuloendothelial cells that are capable of removing and phagocytizing old and defective blood cells. bacteria, and other foreign material form the portal blood as it flows through the sinusoid. Langerhans cells are stellate dendritic cells found mostly in the stratum spinosum of the epidermis. Epstein cellsdo not exist. Davidoff cells are large granular epithelial cells found in intestinal glands.

2

Cholestasis is a condition in shich there is a decreases in bile flow through the intrhepatic canaliculi and a reduction in secretion of water, bilirubin, and bile acids by the hepatocytes. Cholestasis can have more than one cause, but, in all types of cholestasis, there is what?

a. Accumulation of bile pigment in the gallbladder
b. Accumulation of bile pigment in the liver
c. Accumulation of bile pigment in the blood
d. Accumulation of bile pigment in the portal vein

b. Accumulation of bile pigment in the liver

The morpholigic features of cholestasis depend on the underlying cause. Common to all types of obstructive and hepatocellular cholestasis is the accumulation of bile pigment in the liver. The other answers are incorrect.

3

What is considered the normal amount of serum bilirubin found in the blood?

a. 1 to 2 mg/dL
b. 0.01 to 0.02 mg/dL
c. 0.1 to 0.2 mg/dL
d. 0.001 to 0.002 mg/dL

c. 0.1 to 0.2 mg/dL

4

Many drugs are metabolized and detoxified in the liver. Most drug metabolizing occurs in the central zones of the liver. What condition is caused by these drug metabolizing actions?

a. central cirrhosis
b. lobular cirrhosis
c. lobular necrosis
d. centrilobular necrosis

d. centrilobular necrosis

Because of the greater oactivity of the drug-metabolizing enzymes in the central zones of the liver, these agents typically cause centrilobular necrosis. The other answers are incorect.

5

Primary biliary cirrhosis is an autoimmune disease that destroys the small ibtrahepatic bile ducts causing cholestasis. It is insidious in onset and is a progressive disease. What are the earliest symptoms of the disease.

a. Unexplained pruritus
b. Weight gain
c. Pale urine
d. Dark stools

a. Unexplained pruritus

The earliest symptoms are unexplained pruritus or itching, weight loss, and fatique, followed by dark urine and pale stools. The other answers are not indicative of primary biliary cirrhosis.

6

One of the jobs the liver performs is to export triglyceride. When the liver's capacity to export triglyceride is maximized, excess fatty acid accumulates in the liver. what is the disease these excess fatty acids contribute to?

a. Biliary cirrhosis
b. Nonalcoholic fatty liver disease
c. Cholelithiasis
d. Alcoholic fatty liver disease

b. Nonalcoholic fatty liver disease

When the capacity of the liver to export triglycerides is saturated, excess fatty acids contribute to the formation of fatty liver.

7

Ascites is an accumulation of fluid in the peritoneal cavity and usually occurs in advanced cirrhosis. What is the treatment choice for ascites?

a. Paracentesis
b. Thoracentesis
c. Diuretics
d. DDAVP

c. Diuretics

Because of the many limitations in sodium restriction, the use of diuretics has become the mainstay of treatment for ascites. A parancentesis may be done if the diuretics do not correct the problem. A thoracentesis would never be done for ascites. DDAVP is given to decrease urine output not increase it.

8

A client is suspected of having liver cancer. What diagnostic tests would be ordered to confirm the diagnosis.

a. Serum A-fetaprotein
b. Endoscopy
c. Ultrasound of the liver
d. MRI of the liver

Diagnostic methods include ultrsound CT scan and MRI. Liver biopsy may be used to confirm the diagnosis. The serun fetaprotein can be indicative of liver cancer, but not confirmatory. An endoscopy is of no value. An ultrasound of the liver is not confirmatory of liver cancer.

9

Gall stones are made up mostly of cholesterol. What is thought to be a precursor of gallstones?

a. Gallbladder sludge
b. Thinned mucoprotein
c. Pieces of hard food trapped in the gallbladder.
d. Thickened bile

a. Gallbladder sludge

Gallbladder sludge (thickened gallbladder mucoprotein with tiny trapped cholesterol crystals) is thought to be a precursor of gallstones. The other answers are incorrect.

10

What laboratory markers are most commonly used to diagnose acute pancreatitis?

a. Amylase and cholesterol
b. Serum amylase and Lipase
c. Lipase and triglycerides
d. Cholesterol and triglycerides

b. Serum amylase and Lipase

Serum amylase and lipase are the laboratory markers most commonly used to establish a diagnosis of acute pancreatitis. Cholesterol and triglycerides are not used as laboratory markers for pancreatitis.

11

All diseases have risk factors. What is the most significant environmental risk factor for pancreatic cancer?

a. Air pollution
b. Water pollution
c. Cigarette smoking
d. Heavy metal toxicity

c. Cigarette smoking

In pancreatic cancer, the most significant and reproducible environmental risk factor is cigarette smoking. The other answers are incorrect