Laboratory and Diagnostic Tests for Hepatobiliary and Pancreatic Disorders

Question 1

Increases primarily in liver disorders

Answer 1

Alanine Aminotransferase (ALT)

Question 2

-Used to monitor the course of illness in hepatitis or cirrhosis

-Used to monitor effects of treatments that may be toxic to the liver

Answer 2

Alanine Aminotransferase (ALT)

Question 3

Present in tissues with high metabolic activity (i.e., heart, liver, skeletal muscle, kidneys)

Answer 3

Aspartate aminotransferase (AST)

Question 4

-Determines hepatocyte dysfunction

-A sensitive indicator of cholestasis

Answer 4

Gamma-glutamyl transferase (GGT)

Question 5

Secreted by liver (80%), bones, intestines, and kidneys and elevated in the presence of biliary obstruction

Answer 5

Alkaline phosphatase

Question 6

-An enzyme present in almost all body tissues

-Released by cells into the bloodstream upon tissue damage

Answer 6

Lactate Dehydrogenase (LDH)

Question 7

Most abundant protein in the blood

Answer 7

Serum Albumin

Question 8

It maintains the colloid oncotic pressure

Answer 8

Serum Albumin

Question 9

It synthesized in the liver and rapidly excreted into the blood stream

Answer 9

Serum Albumin

Question 10

Elevation in Serum Albumin can only be caused by

Answer 10

Dehydration

Question 11

Pressure that pushes plasma out of the blood

Answer 11

Hydrostatic Pressure

Question 12

Pressure that maintains plasma inside the blood vessel

Answer 12

Osmotic Pressure

Question 13

Subtype of osmotic pressure

Answer 13

Oncotic Pressure

Question 14

A yellowish pigment that is a metabolite of heme and is a potentially toxic substance

Answer 14

Bilirubin

Question 15

It is an actual energy of the cell

Answer 15

ATP

Question 16

What is ATA

Answer 16

Adenosine Triphosphate

Question 17

It maintains osmotic pressure

Answer 17

Albumin

Question 18

Other term of unconjugated bilirubin

Answer 18

Indirect

Question 19

Other term for conjugated bilirubin

Answer 19

Direct

Question 20

-A by- product of protein metabolism

-A potent neurotoxin

-Elevation is attributed to liver diseases

Answer 20

Serum Ammonia

Question 21

Is synthesized in the lover with the help of vitamin K

Answer 21

Prothrombin

Question 22

What are the factors that are also produced in the liver?

Answer 22

Factors VII, IX, and X

Question 23

2 types of Lipids

Answer 23

1. Triglycerides
2. Cholesterol

Question 24

The most common type of fat in the blood and is obtained through dietary sources

Answer 24

Triglycerides

Question 25

T/F Excess calories are stored as triglycerides in adipose tissues

Answer 25

TRUE

Question 26

A waxy, fat-like substance

Answer 26

Cholesterol

Question 28

Cell membrane synthesis, steroid hormone synthesis, bile acid synthesis, vitamin D (cholecalciferol) synthesis

Answer 28

Cholesterol

Question 29

What are the 2 types of cholesterol?

Answer 29

1. High-density lipopproteins (HDL) 2. Low-density lipoproteins (LDL)

Question 30

Removes LDL and VDL from the arteries

Answer 30

High- density lipoproteins (HDL)

Question 31

Facilitates build-up of cholesterol in the arteries

Answer 31

VLDL

Question 32

What is VLDL?

Answer 32

Very Low Density Lipoproteins

Question 33

The meaning of TB-DB-IB

Answer 33

Total Direct, Indirect, Bilirubin

Question 34

How many hours does the patient need to fast when having a lipoprotein fractionation testing

Answer 34

6 to 12 hours

Question 35

Known as bad cholesterol

Answer 35

LDL

Question 36

Known as Good Cholesterol

Answer 36

HDL

Question 37

Enzyme for CHO digestion

Answer 37

Amylase

Question 38

It is secreted by pancreatic acinar cells

Answer 38

Amylase

Question 39

Enzyme for fat digestion

Answer 39

Lipase

Question 40

Means ductless

Answer 40

Endocrine

Question 41

Means ducts

Answer 41

Exocrine

Question 42

It produces enzyme

Answer 42

Acinar Cell

Question 43

It consists primarily of triglycerides (neutral fats), fatty acids, and fatty acid salts.

Answer 43

Fecal Fat

Question 44

High fecal fat content

Answer 44

Steatorrhea

Question 45

T/F High fat diet 5 days before test.

Answer 45

FALSE. High fat diet is 3 days before test

Question 45

The time of fecal fat analysis

Answer 45

72-hour collection (3 days)

Question 46

Stones within the gallbadder

Answer 46

Cholelithiasis

Question 47

Stones in the common bile duct (CBD)

Answer 47

Choledocholithiasis

Question 48

Made up of calcium bilirubinate

Answer 48

Pigment Stones

Question 49

Form in infected bile

Answer 49

Brown pigment stones

Question 50

Form in sterile gallbladder

Answer 50

Black pigment stones

Question 51

Made up of cholesterol crystals

Answer 51

Cholesterol stones

Question 52

Risk Factor of Gall Bladder Stones

Answer 52

5 F f-female f- fat f-forty f- fertile f-fregnant

Question 53

Clinical Manifestations of Gall Bladder Stones

Answer 53

A-Abdominal Pain, RUQ (Biliary Colic) F- Fever A- Acholic Stools M- Murphy's Sign J- Jaundice U- Unable to absorb fat-soluble vitamins D- Dark colored stools

Question 54

What is the diagnostic procedure of choice for Gall Bladder Stones?

Answer 54

Abdominal Ultrasound

Question 55

What is the meaning of ERCP?

Answer 55

Endoscopic Retrograde Cholangiopancreatography (ERCP)

Question 56

It permits the direct visualization of the hepatobiliary system using a flexible fiberoptic endoscope

Answer 56

Endoscopic Retrograde Cholangiopancreatography (ERCP)

Question 57

What is the inital position of ERCP?

Answer 57

Left semi-prone

Question 58

Drug of choice for acute cholecystitis

Answer 58

Meperidine (demerol)

Question 59

Small, radiolucent cholesterol stones

Answer 59

Ursodeoxycholic Acid (UDCA)

Question 60

This is for patient who refuse surgery

Answer 60

UDSA (Ursodeoxycholic Acid)

Question 61

This is a preferred method if surgery

Answer 61

Laparoscopic Cholecystectomy

Question 62

Intraoperative ppositioning of Laparoscopic Cholecystectomy

Answer 62

-Supine (initially) - Reverse Trendelenburg (after insufflation)

Question 63

Incision for Laparoscopic Cholecystectomy is

Answer 63

Three to four small incisions

Question 64

Immediate post op of Cholecystectomy

Answer 64

Low fat, high protein and high carbohydrate diet

Question 65

Removal of gallbladder

Answer 65

Cholecystectomy

Question 66

Its mechanism of action inhibits cholesterol synthesis and secretion, thereby desaturating bile

Answer 66

Ursodeoxycholic Acid (UDCA)

Question 67

It means stone

Answer 67

Lithiasis

Question 68

What is Lithiasis in plural?

Answer 68

Lithiases

Question 69

Gold standard surgical procedure for gall stones

Answer 69

Laparoscopic Cholecystectomy

Question 70

A same day procedure, minimally invasive and better surgical outcomes

Answer 70

Laparoscopic Cholecystectomy

Question 71

Longer hospital stay and higher risk for post-op complications

Answer 71

Open cholecystectomy

Question 72

Open cholecystectomy incision is only one, what does one incision means?

Answer 72

Kocher incision (right subcostal)

Question 73

Pre-operative nursing care of cholecystectomy

Answer 73

- Facilitate signing of consent form -Alley anxiety and fears - Teach patient about breathing exercises, splinting, getting out of bed, and assisted ambulation - Administer medications , as ordered (anxiolytics and antibiotics (as prophylaxis) ) - Remove jewelries, dentures, nail polish, cosmetics - Facilitate NPO, as ordered

Question 74

Post-Operative Nursing Care of Cholecystectomy

Answer 74

- Monitor V/S and I&O - Monitor incision site for presence of signs of infection - Provide regular, meticulous wound care - Facilitate performance of post- operative exercises (deep breathing exercises, turning, and splinting (esp. for open) - Early ambulation (post-op day 0- for laparoscopic

Question 75

What's the immediate post-op diet for laparoscopic cholecystectomy?

Answer 75

Low fat, high protein, high carbohydrate diet

Question 76

What's the diet for Open Cholecystectomy?

Answer 76

- NPO until return of bowel sounds - Progressive diet until able to tolerate pre-operative diet