Liver

Question 1

what are the 5 major functions of the liver?

Answer 1

1. metabolism and storage of fats, carbs, proteins, vitamins, and minerals
2. blood volume reservoir
3. blood filter
4. blood clotting factors (prothrombin and fibrinogen)
5. drug metabolism and detox

Question 2

what is the portal circulatory system?

Answer 2

vessels that bring blood from the stomach, intestines, spleen, and pancreas to the liver

Question 3

what is the name of the vessel that brings the blood into the liver?

Answer 3

the portal vein

Question 4

what levels will the nurse need to monitor with a patient with liver problems?

Answer 4

bilirubin, serum ammonia, serum protein, serum albumin, and PT

Question 5

how will the serum ammonia level change with decreased liver functioning?

Answer 5

increase

Question 6

how will the serum protein level change with decreased liver functioning?

Answer 6

decreased

Question 7

how will the serum albumin level change with decreased liver functioning?

Answer 7

decreased

Question 8

how will the PT level change with decreased liver functioning?

Answer 8

increased (LONGER TO CLOT)

Question 9

what causes jaundice?

Answer 9

increased bilirubin levels in the bloodstream (usually greater than 2 - 2.5 mg/dL)

Question 10

bilirubin is the byproduct of the breakdown of what?

Answer 10

hemoglobin

Question 11

conjugated bilirubin is also called:

Answer 11

direct bilirubin

Question 12

unconjugated bilirubin is also called:

Answer 12

indirect bilirubin

Question 13

if conjugated bilirubin is elevated - what does that mean about the liver?

Answer 13

means the liver is working but there is something causing the bilirubin not be to able to get out - like a bile duct obstruction or gallstones

Question 14

if unconjugated bilirubin is elevated - what does this mean about the liver?

Answer 14

means that there is either impaired liver function or an overproduction of bilirubin

Question 15

jaundice causes what type of discoloration of the skin?

Answer 15

yellow

Question 16

are liver enzymes elevated or depleted in the presence of jaundice?

Answer 16

elevated

Question 17

what is viral hepatitis?

Answer 17

systemic virus that mainly affects the liver and causes inflammation

Question 18

what are 2 other types of viruses (besides the hepatitis viruses) that lead to hepatitis

Answer 18

epstein barr, cytomegalovirus

Question 19

what are other causes (non-viral) of hepatitis?

Answer 19

alcohol abuse, drugs, chemicals, and bacteria

Question 20

what causes hepatocyte death in the case of hepatitis?

Answer 20

an infection causes an immune and inflammatory response which leads to lysing of the infected cells causing edema and tissue hypoxia which leads to the hepatocyte death

Question 21

what are the 3 stages of hepatitis?

Answer 21

prodromal
icteric
recovery

Question 22

what are the clinical manifestations of the prodromal stage of hepatitis?

Answer 22

fatigue, anorexia, malaise, n/v, headache, cough, hyperalgesia, low grade fever

Question 23

the prodromal stage of hepatitis begins __________ after exposure

Answer 23

2 weeks

Question 24

during what stage of hepatitis will the patient begin experiencing jaundice and an enlarged liver?

Answer 24

icteric

Question 25

what are the clinical manifestations of the icteric stage of hepatitis?

Answer 25

jaundice, dark urine, liver enlargement, painful palpation of the liver, fatigue, abdominal pain

Question 26

what are the transmission routes of hepatitis A?

Answer 26

fecal-oral, parenteral, sexual

Question 27

what is the onset of hepatitis A like?

Answer 27

acute with a fever

Question 28

does hepatitis A lead to chronic hepatitis?

Answer 28

no

Question 29

what age groups does hepatitis A usually affect?

Answer 29

children and adults

Question 30

what is the prevention of hepatitis A?

Answer 30

hand hygiene and hepatitis A vaccine

Question 31

what is the transmission of hepatitis B?

Answer 31

parenteral or sexual

Question 32

what is the onset of hepatitis B?

Answer 32

insidious, slow

Question 33

does hepatitis B lead to chronic hepatitis?

Answer 33

yes

Question 34

what is the incubation period of hepatitis B? (relative)

Answer 34

long

Question 35

what is the age range of those affected with hepatitis B?

Answer 35

any

Question 36

what is the prevention of hepatitis B?

Answer 36

hepatitis B vaccine and safe sex / hygiene

Question 37

what is the transmission of hepatitis C?

Answer 37

parental, sexual

Question 38

what is the onset of hepatitis C?

Answer 38

insidious, slow

Question 39

can hepatitis C develop into chronic hepatitis?

Answer 39

yes (80%)

Question 40

what types of hepatitis have vaccines?

Answer 40

A and B

Question 41

how many doses does the hepatitis B vaccine have?

Answer 41

3

Question 42

when does the vaccine for hepatitis B begin?

Answer 42

Infant

Question 43

how many doses does the hepatitis B vaccine have?

Answer 43

3

Question 44

when does the vaccine for hepatitis B start?

Answer 44

infant

Question 45

what is cirrhosis?

Answer 45

irreversible, inflammatory, fibrotic liver disease

Question 46

what are the causes of cirrhosis?

Answer 46

hepatitis B and C excessive alcohol intake idiopasthic non-alcoholic fatty liver disease

Question 47

when the liver is at the fatty liver stage can the damage be reversed?

Answer 47

yes

Question 48

what is alcoholic steatohepatitis?

Answer 48

a precursor to cirrhosis, includes inflammation and degeneration of hepatocytes Begins irreversible damage

Question 49

is alcohol cirrhosis reversible?

Answer 49

no

Question 50

what are the early clinical manifestations of liver cirrhosis?

Answer 50

-N/V -anorexia -flatulence -change in bowel habits -fever -weight loss -palpable liver

Question 51

what are the late clinical manifestations of liver cirrhosis?

Answer 51

-jaundice -peripheral edema -decreased albumin -ascites -vascular lesions -anemia / bleeding -endocrine problems (women = amenorrhea) -esophageal varices -anorectal varices -encephalopathy

Question 52

what is the primary factor associated with encephalopathy r/t cirrhosis

Answer 52

ammonia

Question 53

what does portal hypertension lead to?

Answer 53

varices and ascities

Question 54

what is the treatment for portal hypertension?

Answer 54

liver transplant

Question 55

what is the main concern with the development of portal hypertension?

Answer 55

development of varices that can then burst and cause internal bleeding

Question 56

what is acute liver failure?

Answer 56

separate liver failure not caused by cirrhosis or other types of liver disease

Question 57

what is the most common cause of acute liver failure?

Answer 57

acetaminophen overdose

Question 58

what is the antidote to acetaminophen overdose?

Answer 58

acetylcysteine

Question 59

how long after viral hepatitis or metabolic liver disease can acute liver failure happen?

Answer 59

6-8 weeks after

Question 60

how long after an acetaminophen overdose can acute liver failure happen?

Answer 60

5 days - 8 weeks