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Understanding Human Disease Exam 3 > Chapter 14 > Flashcards

Chapter 14 Flashcards

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1
Q

liver functions

A
  • metabolism (CHO, protein, fat)
  • synthesis of bile
  • detox
  • storage (vitamin B12/fat soluble vitamins)
  • synthesis plasma proteins and clotting factors
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2
Q

livers function in clearing waste products

A
  • drug and hormone metabolism (detox/inactivation)
  • cytochrome p450 enzymes
  • synthesis of urea (takes away nitrogen)
  • removal of bilirubin
  • alcohol metabolism
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3
Q

what organ is the only organ that can remove heme waste products?

A

liver

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4
Q

bilirubin metabolism

A
  1. liver conjugates bilirubin (makes more soluble)
  2. secreted in bile
  3. also eliminated in urine
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5
Q

jaundice

A

accumulation of bilirubin in blood, often symptomatic of liver/gallbladder problem

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6
Q

biliary colic (signs and symptoms)

A

severe right upper quadrant and side pain caused by obstruction of biliary ductal system by stones

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7
Q

what is another sign/symptom of liver problems?

A

unintentional weight loss (could indicate pancreatic problem also)

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8
Q

steatorrhea (signs and symptoms)

A

passage of smelly, greasy stools that float in water, indicative of malabsorption of fats

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9
Q

hepatomegaly (signs and symptoms)

A

increase in size of liver, prominent in alcoholic fatty liver and metastatic disease

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10
Q

liver enzyme test

A

look for aspartate amiotransferase (AST), alanine aminotransferase (ALT), and alkaline phosphatase (AP) in blood, not normally there if liver is functioning normally

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11
Q

liver albumin test

A

check to see how much albumin is in the blood, too little could indicate a problem

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12
Q

hepatitis

A

inflammation of the liver due to virus

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13
Q

viral hepatitis is distinguished by..

A
  • mode of transmission
  • carrier state
  • chronic
  • vaccine
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14
Q

hepatitis A is also known as..

A

HAV

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15
Q

how is hepatitis A transmitted?

A

primarily fecal-oral, mucosal secretions

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16
Q

abrupt symptoms of hepatitis A

A
  • fever, nausea, vomiting, and loss of appetite
  • enlarged, tender liver and dark urine
  • serum AST strikingly elevated
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17
Q

where is hepatitis A more common?

A

developing nations, ~10,000 new cases/year in U.S.

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18
Q

treatment for hepatitis A

A

nothing specific, rest

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19
Q

do a lot of people die from hepatitis A?

A

no, rare

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20
Q

is there a vaccine for hepatitis A?

A

yes

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21
Q

hepatitis B is also known as..

A

HBV

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22
Q

hepatitis B can..

A

cause acute illness that manifests with fever, malaise, and jaundice

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23
Q

can an individual infected with hepatitis B become an asymptomatic carrier?

A

yes, can also develop chronic hepatitis and eventually cirrhosis

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24
Q

how is hepatitis B transmitted?

A

contact with infected blood, body fluids, shared needles, fetus in utero or during vaginal delivery

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25
can hepatitis A become chronic?
no
26
is there a vaccine available for hepatitis B?
yes
27
is hepatitis B acute or chronic?
both
28
how is hepatitis C spread?
primarily by blood to blood contact
29
____ of hepatitis C cases result in chronic hepatitis
80%
30
risk factors for hepatitis C
- contact with blood at work - unprotected sex (less common than B) - blood transfusion
31
is there a vaccine for hepatitis C?
no
32
treatment for hepatitis C
direct-acting antiviral (DAA) drugs - introduced in 2011 - 12 weeks of treatment (expensive)
33
___ of HBV cases are resolved
90%
34
fulminant liver failure
liver fails acutely
35
cirrhosis
describes end stage of most serious chronic types of liver disease
36
hepatitis D
- depends on hepatitis B for replication - have to be infected with HBV to get hepatitis D
37
hepatitis E
- fecal-oral transmission - developing countries - mild and self limiting - epidemic in India
38
why are pharmaceutical drugs been linked to liver injury?
- blood runs through liver with drugs in blood stream - tylenol is toxic
39
chemical injury to the liver can be predictable or..
idiosyncratic: can tell how damaging doses of medicine will be
40
patients with severe acute or chronic liver disease are more susceptible to..
toxic hepatic injury
41
example of toxic drug to liver
acetaminophen - choice for people attempting suicide - most common drug accidentally ingested in large doses by children - large doses lead to production of metabolic by-product highly toxic to hepatocytes
42
fatty liver disease
fat accumulates in hepatocytes secondary to injury (hepatic steatosis, yellow and swollen)
43
most common causes of fatty liver disease
alcohol and obesity
44
is fatty liver disease reversible?
impaired liver function but injury is reversible
45
what can fatty liver disease lead to?
steatohepatitis: inflammation of the liver
46
is fatty liver disease symptomatic or asymptomatic?
asymptomatic
47
cholelithiasis
gallstones in the gallbladder or biliary tree (usually multiple)
48
is cholelithiasis common?
yes, ~1 million new cases/year in U.S.
49
what do cholelithiasis look like?
- hard, pebble like deposits - cholesterol - pigmented (comes from bilirubin
50
risk factors for gallstones
- increase with age - women more than men - obesity - family history
51
symptoms of cholelithiasis
- usually no symptoms until they begin to move; mid-size stones are the worst - painful cramps in RUQ (often after meals, especially high in fat) - nausea/vomiting
52
complications of gallstones
- cholecystitis: inflammation of gallbladder because of gallstone - pancreatitis: inflammation to the pancreas due to blockages - perforation - biliary obstruction (jaundice) - infection (peritonitis - gallbladder cancer
53
2 types of liver neoplasms
- primary: hepatocellular carcinoma, most often due to chronic hepatitis - metastatic: most liver neoplasm has metastasized to liver from somewhere else (colon, lung, stomach, breast)
54
what does the prognosis look like for liver cancer?
poor
55
acute liver failure
- results from massive death of hepatocytes - most common causes: viral hepatitis and drug reactions - can be fatal
56
cirrhosis is characterized by..
fibrosis
57
causes of cirrhosis
- chronic hepatitis - chronic alcohol consumption - biliary obstruction - cryptogenic: having liver failure but unknown why
58
cirrhosis treatment
liver transplant
59
complications of cirrhosis
- portal hypertension - passive congestion and enlargement of spleen - hyperammonemia and hepatic encephalopathy (liver failure leading to brain issues)
60
clinical features of cirrhosis
- failure to metabolize estrogen and ammonia (breast development ini males) - protein synthesis failure (decrease clotting. edema) - excretory failure
61
hepatic encephalopathy
deterioration of brain function characterized by impaired consciousness, confusion, disorientation, and eventually coma
62
hepatic encephalopathy is from..
accumulation of toxic substances in the blood that are normally detoxified and excreted by the liver
63
alcoholic liver disease
refers to a group of structural and functional changes in the liver resulting from excessive alcohol consumption
64
what does severity depend on for alcoholic liver disease?
amount and duration of alcohol consumption
65
what are the 3 stages of progression for alcoholic liver disease?
- alcoholic fatty liver - alcoholic hepatitis - alcoholic cirrhosis
66
how does cystic fibrosis effect the pancreas?
- pancreas disfigured and destroyed by mucus plug - patient suffers repeated bouts of pancreatitis - damage to pancreas is irreversible
67
pancreatitis
inflammation and autodigestion of pancreas by pancreatic digestive juices
68
manifestations of pancreatitis
- severe upper abdominal pain - anorexia - malabsorption - hemorrhagic pancreatitis (surgical emergency, progess to shock)
69
diagnosis of pancreatitis
amylase and lipase is elevated in the blood, normally not found
70
acute pancreatitis
- reversible inflammation - rapid onset of symptoms
71
causes of acute pancreatitis
- chronic alcohol abuse causes 2/3 cases - half of patients have gallstones
72
chronic pancreatitis
irreversible, caused by repeated bouts of acute pancreatitis, chronic alcohol abuse cases 2/3 cases, half of patients have gallstones
73
conditions causing chronic injury to pancreas
- cystic fibrosis - acute pancreatitis - repeated attacks of gallstone pancreatitis - obstruction of pancreatic ducts by disease
74
symptoms of chronic pancreatitis
- malabsorption - steatorrhea - hemorrhage
75
complications of chronic pancreatitis
diabetes
76
diagnosis of chronic pancreatitis
enzyme leakage in the blood
77
treatment of chronic pancreatitis
limit activity of gland, total parenteral nutrition, nutrients come into the blood

Understanding Human Disease Exam 3 (5 decks)

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