GIT EMERGENCIES

Question 1

this is also known as hepatic failure

Answer 1

liver cirrhosis

Question 2

a condition in which the liver fails to fulfill its
functions or is unable to meet the demands placed upon it

Answer 2

liver cirrhosis

Question 3

s/sx in liver cirrhosis related to glycogen storage and production

Answer 3

hypoglycemia

Question 4

s/sx in liver cirrhosis related to protein synthesis

Answer 4

edema/ascites

Question 5

why does low protein manifests as edema?

Answer 5

because albumin exerts OP that pulls the water in to prevent leakage of fluid outside the cell

Question 6

most abundant protein in body

Answer 6

albumin

Question 7

s/sx in liver cirrhosis related to synthesis of globulins

Answer 7

immunocompromised

Question 8

why does low globulin synthesis contributes to px w/ liver cirrhosis to be immunocompromised?

Answer 8

because globulin produces antibodies

Question 9

s/sx in liver cirrhosis related to synthesis of CF

Answer 9

bleeding tendencies

Question 10

s/sx in liver cirrhosis related to bile secretion

Answer 10

jaundice, pruritus

Question 11

why is bile increased in liver cirrhosis?

Answer 11

because bile can’t flow outside properly due to scarring of the liver leading to buildup in the liver

Question 12

s/sx in liver cirrhosis related to conversion of ammonia to urea

Answer 12

hepatic encephalopathy

Question 13

hallmark of hepatic encephalopathy

Answer 13

asterixis

Question 14

what is asterixis?

Answer 14

flapping tremor of the hand

Question 15

why is jaundice present in liver cirrhosis?

Answer 15

there is buildup of bilirubin in the liver

Question 16

why is pruritus present in liver cirrhosis?

Answer 16

there is buildup of bile salts in the liver

Question 17

components of bile

Answer 17

bilirubin
bile salts
water
cholesterol

Question 18

s/sx in liver cirrhosis related to storage of vitamins and minerals

Answer 18

low vit. and minerals/avitaminemia

Question 19

s/sx in liver cirrhosis related to metabolism of estrogen

Answer 19

gynecomastia
testes atrophy
hair loss

Question 20

causes of ascites in liver failure

Answer 20

low OP
high HP - due to portal HTN

Question 21

why is there easy bleeding/bruising in liver cirrhosis?

Answer 21

no synthesis of CF

Question 22

esophageal varices is due to

Answer 22

portal HTN

Question 23

dilated submucosal distal esophageal veins connecting the portal and systemic circulations

Answer 23

esophageal varices

Question 24

complication of esophageal varices

Answer 24

bleeding - BV are very fragile and thin

Question 25

why does neovascularization happens?

Answer 25

to redirect congested blood in the liver

Question 26

spider angioma is due to

Answer 26

neovascularization

Question 27

fragile, thin-walled, distended esophageal veins that become irritated and rupture

Answer 27

bleeding esophageal varices

Question 28

why does blood in upper GIT becomes black when pooped out?

Answer 28

blood is being digested and contact with HCL acid makes it black

Question 29

first line treatment for esophageal varices

Answer 29

vasopressin

Question 30

why is vasopressin the first line treatment for esophageal varices?

Answer 30

it makes the BV constrict hence stopping the bleeding

Question 31

2 balloon tamponades to prevent rupture of esophageal varices

Answer 31

sengstaken blakemore tube minnesota tubes

Question 32

this is essential in the bedside of pt w/ balloon tamponade in case of respiratory emergencies

Answer 32

scissor

Question 33

first line to correct bleeding

Answer 33

IV fluid replacement

Question 34

blood transfusion will only be allowed in esophageal varices if pt has hemoglobin of?

Answer 34

7 g/dl

Question 35

prophylactic antibiotic for esophageal varices

Answer 35

iv ceftriaxone oral norfloxacin

Question 36

why do we administer beta blockers for pt w/ esophageal varices?

Answer 36

to correct portal hypertension

Question 37

NSBB that is increasingly used that has a greater portal pressure reducing effect than propranolol

Answer 37

carvedilol

Question 38

why is lactulose being given to patients with hepatic encephalopathy?

Answer 38

lactulose binds with ammonia to facilitate excretion

Question 39

why is neomycin being given to patients with hepatic encephalopathy?

Answer 39

to kill the bacteria in the colon that acts up on protein to convert it to ammonia

Question 40

end-stage of liver cirrhosis

Answer 40

hepatic encephalopathy