Liver Flashcards Preview

Test 2 > Liver > Flashcards

Flashcards in Liver Deck (49):
1

Jaundice

Yellowish discoloration of the body tissues that results from an alteration in normal bilirubin metabolism, flow of bile into the hepatic or biliary duct systems

2

Hemolytic Jaundice

Due to an increased breakdown of RBCs
-produces an increased amount of unconjugated bilirubin in the blood

3

Obstructive Jaundice

Due to decreased or obstructed flow of bile through the liver or biliary duct system

4

Hepatitis

Inflammation of the liver

5

Hepatitis A

RNA virus
Fecal-oral route
Fecal contamination of food or drinking water
2 or more weeks before onset of symptoms
Causes:improper food handling, poor hygiene, crowded situations, or poor sanitation

6

Hepatitis B

DNA virus
Spread perinatally by infected mothers, percutaneously (iV drug use, accidently needle stick punctures) or mucosal exposure to infectous blood, blood products, other body fluids
Tattoo/ body piercing with contaminated needles
Carriers for lifetime

7

Hepatitis C

Percutaneous
High risk sexual contact
Perinatal contact
Source:blood and blood products, needles and syringes, sexual activity with infected partners
75-85% go on to develop chronic hep c

8

Hepatitis D

Must have HBV in order to contract HDV

9

Hepatitis E

Fecal oral
Contaminated water, poor sanitation

10

Autoimmune Hepatitis

Chronic inflammatory disorder of the liver of unknown cause

11

Hepatocellular Jaundice

Altered ability to take up bilirubin from the blood, conjugate, or excrete it
Hepatocytes damaged and leak bilirubin
Increases levels of conjugated bilirubin

12

Wilsons disease

Progressive, familial, terminal neurologic disease accompanied by chronic liver disease leading to cirrhosis

13

Hemochromatosis

Systemic disease that affects the liver, heart, pancreas, and endocrine system.
Caused by increased and inappropriate absorption of dietary iron

14

Primary Biliary cirrhosis

Chronic inflammatory condition of the liver
Characterized by general prurtius, hepatomegaly, hyperpigmentation of the skin and fatigue

15

Nonalcoholic fatty liver disease

Group of disorders characterized by hepatic steatosis (accumulation of fat in the liver) not associTed with hepatitis, autoimmune disease, or alcohol
Fatty changes in hepatocytes

16

Cirrhosis

Chronic progressive disease of the liver characterized by extensive degeneration and destruction of the liver parenchymal cells
Regeneration is disorganized resulting in abnormal blood vessels and bile duct architecture

17

Portal Hypertension

Increased venous pressure in the portal circulation, splenomagaly, large collateral veins, ascites, systemic hypertension, and gastric and esophageal varices

18

Hepatic Encephalopathy

Neuropsychiatric manifestation of liver damage
Ammonia enters the systemic circulation without liver detoxification
Variable levels of cerebral edema

19

Asterixis

Flapping tremors usually of arms and legs
Sign of hepatic encephalopathy

20

Hepatorenal syndrome

Functional renal failure with advancing azotemia, oliguria, and intractable ascites
Complication of of cirrhosis

21

Ascites management

Sodium restriction
Diuretics
Fluid removal

22

Liver Function

Bile production and secretion
Vitamin and mineral storage
Metabolic functions- synthesis of amino acids and stores glucose as glycogen

23

Parencentesis

Needlepuncture of abdomen performed to remove ascitic fluid

24

Icteric

Jaundice
Dark urine
Clay cored stool
Pruritis
Gi symptoms
Fatigue

25

Liver damage

AST and ALT levels elevated
Increased bilirubin
Alkaline phosphatase increased
Decreased total protein

26

Anti HAV IgM

Acute infection
Active

27

Anti HAV IgG

Previous infection
Immunity
Infection gone

28

Secondary prevention hepatitis

Rest
High calorie
High protein
High CHO
Low fat diet
Antiemetics
No phenothiazines
No alcohol or medications metabolized by liver

29

Cirrhosis

Four types-
Alcoholic
Post-necrotic
Biliary
Cardiac

30

Alcoholic cirrhosis

Excessive results in accumulation

31

Post necrotic cirrhosis

Viral, toxic, or autoimmune

32

Biliary cirrhosis

Chronic biliary obstruction

33

Cardiac cirrhosis

Right sided heart failure

34

Early manifestations of cirrhosis

Gi:anorexia, flatulence, NV, diarrhea, constipation
Abdominal pain-dull heavy feeling in RUQ and epigastrum
Fever
Weight loss
Hepatomegaly/splenomegaly

35

Late clinical manifestations of cirrhosis

Jaundice
Peripheral edema
Ascites
Skin lesions
Hematologic problems
Endocrine disturbances
Peripheral neuropathy

36

Cirrhosis complications

Portal hypertension
Esophegeal varices
Peripheral edema
Ascites
Hepatorenal syndrome
Hepatic encephalopathy
-Asterixis
-Fetor hepaticus

37

Portal hypertension

Compression/destruction of portal and hepatic veins
Results in portal HTN
Develop splenomegaly, collaterol veins-varices esophageal and gastric
Ascites

38

Esophageal varices

Veins at end of esophagus

39

Medications for tx of varices

Beta blockers
Octreotide
Vasopressin
Nitroglycerin
Propranolol inderal

40

Treatment of esophageal varices

Endoscopic examination
Sclerotherapy/banding
Balloon tamponade
-Sengstaken- blakemore tube
FFP/RBCs
Vitamin k
Lactulose(Cephulac)

41

Portosystemic shunt

Portocaval- conne ction portal vein and inferior vena cava

Splenorenal- connect splenic vein to vein renal

42

Ascites

Accumulation of fluid in peritoneal or abdominal cavity

43

Ascites causes

Protein movement
Impaired liver doesnt synthesis albumin
Elevated aldosterone

44

Ascites clinical manifestations

Weight gain
Abdominal striae
Signs of dehydration
Decreased urinary output
Hypokalemia

45

Ascites treatment

Low sodium diet
Diuretics/ aldactone
Salt poor albumin/ lasix
Parencentesis
-Void first
-Monitor for hypovolemia
-Check site for bleeding

46

Peritoneovenous shunt

Candidate
-Diuretic resistant
-Noncandidate for serial taps
-No practical unavailable to perform

47

Hepatorenal syndrome

Complication of cirrhosis
Renal failure
Occurs after diuretic therapy, GI hemorrhage, or parencentesis
Kidney not adequately perfused

48

Hepatic encephalopathy

Neuropsychiatric manifestations of liver disease
Considered a terminal complication
Related to high ammonia levels
High mortality rate
Changes in neurological and mental state
-Asterixis
-Fetor hepaticus

49

Treatment of hepatic encephalopathy

Reduce ammonia levels
Protein restriction
Lactulose (cephulac)
Neomycin
Treat precipitating causes (GI bleed)
Same dietary as hepatitis