Liver

Question 1

What abdominal region is the liver located?
A. LUQ
B. RUQ
C. LLQ
D. RLQ

Answer 1

RUQ

Question 2

Each liver lobule has rows of hepatic cells called _________ which are arranged around a central vein

Answer 2

hepatocytes

Question 3

the _________ are in between the hepatocytes and are lined with kupffer cells

Answer 3

sinusoids

Question 4

________ _______ remove bacteria and toxins from the blood

Answer 4

Kupffer cells

Question 5

The portal circulatory system brings blood to the liver from the _________ , ___________ and __________.

Answer 5

stomach, intestines and spleen

Question 6

List some major functions of the liver

Answer 6

metabolism/storage (fat, CHO, PRO, vitamins and minerals), blood volume reservoir, blood filter, blood clotting factors, drug metabolism and detoxification

Question 7

Where does the “first pass effect” occur?

Answer 7

portal circulation system

Question 8

List some LFTs (Liver function tests)

Answer 8

ALT, AST, Alk Phos, Bilirubin, Ammonia, serum protein, serum albumin, PT

Question 9

What might you notice in a persons skin with liver issues due to increased levels of bilirubin?
A. Redness
B. Jaundice
C. Dusky
D. Pale

Answer 9

Jaundice

Question 10

Which hepatitis is transmissed via foodborne?

Answer 10

Hep A

Question 11

Complications of viral hepatitis include (SATA)
A. Chronic hepatitis
B. Liver cirrhosis
C. Liver cancer
D. Acute liver failure
E. Pancreatitis

Answer 11

A, B, C and D

Question 12

T/F : Hepatitis A leads to chronic hepatitis.

Answer 12

False; hep b/c can lead to chronic

Question 13

Which hepatitis does NOT have a vaccine?
A. HAV
B. HBV
C. HCV

Answer 13

HCV

Question 14

What is the method of transmission for Hep B/C?

Answer 14

Parental, sexual

Question 15

Which disease is considered a irreversible, inflammatory, fibrotic liver disease?

Answer 15

Cirrhosis

Question 16

4 common causes of cirrhosis

Answer 16

hep b/c
excessive etoh intake
idiopathic
NASH/NAFLD

Question 17

5 major functions of the liver

Answer 17

1.) Metabolism & storage of: fat, CHO, vitamins, PRO and minerals
2.) Blood volume reservoir
3.) Blood filter
4.) Blood clotting factors (prothrombin & fibrinogen)
5.) Drug metabolism and detoxification

Question 18

What causes jaundice?

Answer 18

Increased bilirubin in the blood. Liver is unable to metabolize bilirubin and because the edema, fibrosis, and scarring of the hepatic bile ducts interfere with normal bile and bilirubin secretion

Question 19

Match each jaundice classification correctly
A. Hemolytic
B. Hepatocellular
C. Obstructive

1.) decreased flow of bile (gallstones)
2.) liver is unable to process breakdown of bilirubin
3.) increased breakdown of RBCs

Answer 19

A - 3
B - 2
C - 1

Question 20

What is an example of direct (conjugated) bilirubin?
A. Hemolytic
B. Hepatocellular
C. Obstructive
D. Indirect

Answer 20

C. Obstructive - gallstones - unable to get bilirubin OUT

Question 21

What is an example of indirect (unconjugated) bilirubin?
A. Hemolytic
B. Hepatocellular
C. Obstructive
D. Direct

Answer 21

B. Hepatocellular - overproduction of impaired liver function. With this we know the liver is unable to process breakdown of bilirubin

Question 22

You have a patient experiencing jaundice. His urine is very amber and dark. Is this an expected finding with jaundice?

Answer 22

Yes

Question 23

You have a patient experiencing jaundice and puritis. What is the best explanation for the puritis?
A. Allergic reaction
B. Build up of bilirubin
C. Bed bugs

Answer 23

B. Liver is unable to process bilirubin

Question 24

Define hyperanalgesia

Answer 24

hyper sensitivity to pain

Question 25

T/F: during the prodromal stage, hepatitis is not transmissible

Answer 25

False, during the prodromal stage, hepatitis is HIGHLY transmissible. This stage occurs 2 weeks after initial exposure

Question 26

T/F: during the icteric and recovery phase the nurse may be able to palpate a large mass (liver).

Answer 26

True; during these phases liver is enlarged, tender and palpable

Question 27

T/F: Viral hepatitis can potentially cause fulminant viral hepatitis.

Answer 27

True; fulminant viral hep is acute liver failure - this is a complication

Question 28

When treating hep B, which two medication classes are used? SATA A. Interferons B. Anticholinergics C. Diuretics D. Nucleoside analogs

Answer 28

A & D

Question 29

What type of antiviral therapy is used to treat hep c? _______ ______

Answer 29

Direct acting

Question 30

What is the recommended dose per day for Tylenol for someone with hepatitis/liver issues?

Answer 30

No more than 2 grams per day

Question 31

T/F: Alcoholic fatty liver (stage 1 of ETOH cirrhosis) is reversible.

Answer 31

True

Question 32

Why are alcoholics more prone to becoming malnourished?

Answer 32

Acetaldehyde inhibits exports of proteins from the liver wheelchairs alters metabolism of vitamins and minerals and induces malnutrition

Question 33

Primary cell involved in liver fibrosis?

Answer 33

Hepatic Stellate cells

Question 34

Early manifestations of cirrhosis (SATA) A. Gi disturbances B. Fever C. Wt loss D. Palpable liver E. Jaundice F. Skin lesions

Answer 34

A, B, C, and D. E and F are late manifestations

Question 35

Treatment for portal hypertension A.) Chemo B. Radiation C. Liver biopsy D. Liver transplant

Answer 35

D.

Question 36

Patient has been admitted with hepatic encephalopathy. Pts ammonia level is 100mcg/dL (15-60mcg/dL). What medication would you anticipate the provider to order? A. Lactulose B. Rifaximin C. Pancrelipase D. Calcitriol

Answer 36

A. Lactulose Usually dosed/titration in correlation of liver lab (ammonia) and # BMs per day. Within the order - provider will usually specify “goal of __X__ # bms/day”

Question 37

Patient admitted for a suspected Tylenol overdose. What might occur? A. Portal Hypertension B. Hep C C. Cirrhosis D. Fulminant liver failure

Answer 37

D.

Question 38

Patient admitted for a suspected Tylenol overdose. What medication do you anticipate to administer? A. Sodium Bicarbonate B. BCG Vaccine C. Lactulose D. Acetylecystine

Answer 38

D