hepatic, pancreatic, and biliary systems

Question 1

5 system functions of the liver

Answer 1

digestive
endocrine
excretory
hematologic
immune

Question 2

where is albumin produced

Answer 2

Liver

Question 3

the liver converts and excretes…

Answer 3

bilirubin

Question 4

what makes the pancreas an exocrine gland?

Answer 4

digestion!
it releases digestive enzymes and pancreatic juices to help the GI system

Question 5

what makes the pancreas an endocrine gland?

Answer 5

glucagon and insulin secretion for metabolism

Question 6

what is the function of the gallbladder

Answer 6

reservoir for bile
releases bile in duodenum in response to food

Question 7

what does bile do

Answer 7

alkalinizes the intestinal contents and plays arole in emulsification, absorption, and digestion of fat

Question 8

dark urine and light stools occur in association with…

Answer 8

jaundice

Question 9

3 indications of hepatic issues

Answer 9

skin changes
spider angiomas
palmar erythema (warm palms)

Question 10

jaundice can be diagnosed when _________ levels increase

Answer 10

serum bilirubin

Question 11

why is stool normally brown?

Answer 11

bile and bilirubin

Question 12

what does light-colored stool and tea/cola colored urine indicate

Answer 12

bilirubin goes to urinary system rather than digestive system

Question 13

hepatic encephalopathy (or portosystemic encephalopathy)

Answer 13

reversible neuro-psychological symptoms caused by liver failure and metabolic buildup of toxins

Question 14

asterixis

Answer 14

inability to maintain wrist extension with forward flexion of the upper extremity

Question 15

musculoskeletal symptoms with liver disease

Answer 15

thoracic pain between scaps, right shoulder, right upper traps, right interscap, right subscap

Question 16

hepatic osteodystrophy

Answer 16

abnormal development of bone associated with liver malfunction

Question 17

due to skin changes in liver disease, individuals are more susceptible to ________

Answer 17

pressure ulcers

Question 18

coagulopathy

Answer 18

easy bruising and bleeding under the skin or into joints in response to the slightest taumas

Question 19

liver __(increases/decreases)__ size, weight, and blood flow with age

Answer 19

decreases

Question 20

lipophilic

Answer 20

strong affinity for lipids

Question 21

why does the decrease of albumin production impact how drug dosages are given

Answer 21

drugs typically bind to albumin

Question 22

what is the livers role in the immune system response

Answer 22

it produces proteins associated with acute inflammatory reactions

Question 23

5 severe complications that result from liver damage/nonfunctioning

Answer 23

1. jaundice
2. cirrhosis
3. portal hypertension
4. hepatic encephalopathy
5. ascites

Question 24

characteristics of jaundice (icterus)

Answer 24

yellow discoloration of the skin/eyes
urine turns dark
stool turns light

Question 25

4 common causes of jaundice

Answer 25

1. increase bilirubin production 2. decreased uptake in bilirubin metabolism 3. hepatocyte dysfunction 4. impaired bile flow

Question 26

cirrhosis

Answer 26

fibrosis and nodular regeneration of the liver from chronic inflammation

Question 27

jaundice of newborns is caused by

Answer 27

a decreased uptake in bilirubin metabolism

Question 28

portal hypertension

Answer 28

higher portal vein pressure (entry) than inferior vena cava pressure (exit)

Question 29

what usually causes portal hypertension

Answer 29

cirrhosis

Question 30

Lab findings in cirrhosis

Answer 30

- decreased albumin - increased prothrombin time (longer to form blood clots) - anemia - increased alanine aminotransferase, lactate dehydrogenase

Question 31

clinical presentations of cirrhosis

Answer 31

Hepatomegaly Spider angiomata Splenomegaly GI bleeding Edema Jaundice Portal hypertension Ascites

Question 32

decreased plasma proteins results in what 2 symptoms

Answer 32

ascites and edema

Question 33

what happens to the body when metabolism of proteins, carbs, and fats occurs

Answer 33

the body becomes hypoglycemic

Question 34

3 direct symptoms of liver inflammation

Answer 34

pain, fever, GI symptoms

Question 35

Ascites

Answer 35

abnormal accumulation of fluid within the peritoneal cavity

Question 36

what is the most common cause of ascites

Answer 36

liver cirrhosis (85%)

Question 37

spontaneous bacterial peritonitis

Answer 37

infection of ascitic fluid in the setting of portal hypertension

Question 38

an increase of urobilinogen is an indication of

Answer 38

liver necrosis

Question 39

a DECREASE in bilirubin metabolism, bile in GI tract, vitamin K absorption is an indication of

Answer 39

liver necrosis

Question 40

what does a decreased hormone metabolism result in and what are the symptoms

Answer 40

increased androgens and estrogens in the body spider angiomas palmar erythema loss of body hair

Question 41

what is hepatitis

Answer 41

acute or chronic inflammation of the liver

Question 42

what can cause hepatitis

Answer 42

virus (main) chemical/drug/alcohol abuse

Question 43

how long must a person have hepatitis for it to be considered CHRONIC

Answer 43

6 months

Question 44

what liver disease can chronic hepatitis lead to

Answer 44

cirrhosis

Question 45

what is the most common cause of acute liver failure

Answer 45

acetaminophen hepatotoxicity (50% of cases)

Question 46

fulminant hepatic failure

Answer 46

acute liver failure that is rare but can be fatal

Question 47

t/f: viral hepatitis can be easily spread even if symptoms are not present

Answer 47

true

Question 48

how is hepatitis A transmitted

Answer 48

fecal-oral route (consuming contaminated water/food)

Question 49

what two types of viral hepatitis are transmitted through the fecal-oral route

Answer 49

Hepatitis A and E

Question 50

hepatitis A results ONLY this type of infection

Answer 50

acute infection

Question 51

____ occurs in 90% of heavy drinkers

Answer 51

alcoholic steatosis (fatty liver)

Question 52

how is hepatitis B transmitted

Answer 52

sexually transmitted disease (percutaneous or mucosal contact)

Question 53

how long can HBV survive on environmental surfaces

Answer 53

1 week

Question 54

how is hepatitis C developed

Answer 54

injection drug use

Question 55

what form of hepatitis is uncommon in the US

Answer 55

hepatitis D

Question 56

how is hepatitis D transmitted

Answer 56

it is a coinfection or superinfection of hepatitis B (it needs hep b to replicate)

Question 57

what causes oxidative stress to the hepatocytes in the liver

Answer 57

metabolizing alcohol

Question 58

how does the liver respond to inflammation and injury

Answer 58

by forming scars (fibroids)

Question 59

nonalcoholic fatty liver disease (NAFLD) causes

Answer 59

related to diabetes and insulin resistance genetic, environmental, and inflammatory factors

Question 60

what quadrant is the pancreas located

Answer 60

left upper quadrant (near stomach)

Question 61

what is the pancreas's dual function

Answer 61

secrete insulin/glucagon acts as endocrine gland

Question 62

2/3rds of acute pancreatitis involve what

Answer 62

gallstones and chronic alcohol consumption

Question 63

what type of pancreatitis makes up 80% of cases

Answer 63

interstitial pancreatitis

Question 64

what type of pancreatitis makes up 20% of cases

Answer 64

necrotizing pancreatitis

Question 65

is necrotizing pancreatitis or interstitial pancreatitis more severe

Answer 65

necrotizing pancreatitis

Question 66

moderately severe acute pancreatitis is related to

Answer 66

the gallbladder

Question 67

chronic pancreatitis

Answer 67

the development of irreversible changes in the pancreas secondary to chronic inflammation

Question 68

what are the 3 risk factors of chronic pancreatitis

Answer 68

chronic alcohol consumption smoking genetic predisposition

Question 69

the pancreas is able to work until more than __% of pancreatic function is lost

Answer 69

90%

Question 70

what is the 3rd leading cause of cancer mortality in the US

Answer 70

pancreatic cancer

Question 71

what cancer has the lowest 5-year survival rate after diagnosis

Answer 71

pancreatic cancer

Question 72

95% of pancreatic cancers are _____. Where is it located in the pancreas?

Answer 72

adenocarcinomas head of pancreas

Question 73

what disease can increase the risk of developing pancreatic cancer

Answer 73

type II diabetes (glucose tolerance)

Question 74

what are the 3 main clinical manifestations of pancreatic cancer

Answer 74

abdominal pain weight loss jaundice

Question 75

t/f: tumors in the head of the pancreas are 2x as likely to metastasize to peritoneum than in the body or tail

Answer 75

false the body/tail tumors are 2x more likely to metastasize

Question 76

chole-

Answer 76

pertaining to bile

Question 77

cholang-

Answer 77

pertaining to bile ducts

Question 78

cholangiography

Answer 78

radiographic study of bile ducts

Question 79

cholangitis

Answer 79

inflammation of bile duct

Question 80

cholecyst-

Answer 80

pertaining to gallbladder

Question 81

cholecystectomy

Answer 81

removal of gallbladder

Question 82

cholecystitis

Answer 82

inflammation of gallbladder

Question 83

cholecystostomy

Answer 83

incision and drainage of gallbladder

Question 84

choledocho-

Answer 84

pertaining to common bile duct

Question 85

choledocholithiasis

Answer 85

stones in common bile duct

Question 86

choledochostomy

Answer 86

exploration of common bile duct

Question 87

cholelith-

Answer 87

gallstones

Question 88

cholelithiasis

Answer 88

presence of gallstones

Question 89

cholescintigraphy

Answer 89

radionuclide imaging of biliary system

Question 90

cholestasis

Answer 90

stoppage or suppression of bile flow

Question 91

lith-

Answer 91

stone

Question 92

what are gallstones made of

Answer 92

75% cholesterol 25% bilirubin salts (pigment stones)

Question 93

cholelithiasis happens more in men or women

Answer 93

women

Question 94

what does it mean to be litho-genic

Answer 94

to be more prone to stone formation

Question 95

what causes cholelithiasis

Answer 95

changes in composition of bile salts, bilirubin, and cholesterol due to supersaturation

Question 96

2 main complications of cholelithiasis

Answer 96

1. cholecystitis (inflammation of gallbladder) 2. cholangitis (inflammation of bile duct)

Question 97

charcot triad

Answer 97

pain fever jaundice

Question 98

peynolds pentad

Answer 98

pain fever jaundice hypotension mental confusion

Question 99

___ may be the only presenting sign of acute cholangitis in the elderly

Answer 99

hypotension

Question 100

acute cholangitis

Answer 100

obstruction and stasis of bile from choledocholithiasis (stones in common bile duct), biliary strictures, or malignancies

Question 101

how long does acute cholecystitis abdominal pain last for

Answer 101

greater than 6 hours