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FN 125 > MNT for Liver > Flashcards

MNT for Liver Flashcards

(76 cards)

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1
Q

The liver has over ____ functions

A

500

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2
Q

Manufactures blood proteins

A

Rough ER

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3
Q

Produce bile salts and detoxifies blood-borne poisons

A

Smooth ER

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4
Q

Detoxify other poisons, including alcohol

A

Peroxisomes

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5
Q

Supplies energy

A

Mitochondria

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6
Q

Packages

A

Golgi apparatus

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7
Q

Stores sugar and regulates blood glucose levels

A

Glycosomes

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8
Q

Produce ____ - _____ mL bile each day

A

500-1000

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9
Q

Regeneration capacity is done through:

A

Liver stem cells

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10
Q

Liver manufactures

A

Protein
Glycogen
Bile
Cholesterol

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11
Q

Liver stores

A

Iron
Fat-soluble vitamins
Glycogen

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12
Q

Liver wastes

A

Ammonia
Drugs and alcohol
Bilirubin
Bacteria

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13
Q

Diseases of the liver

A

Hepatitis - acute viral, fulminant, chronic
Alcoholic liver disease, alcoholic hepatitis, and cirrhosis
NASH
Cholestatic liver disease (primary biliary cirrhosis, cholangitis)
Inherited disorders
Other liver diseases

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14
Q

Features similar to acute hepatitis but with more severe liver damage and serious clinical state

A

Acute liver failure

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15
Q

Present in acute liver failure but not in acute hepatitis

A

Encephalopathy
Poor coagulation
Hepatic atrophy
Brain edema
High risk of death without transplant

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16
Q

Hallmark of infection

A

HBsAg

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17
Q

Acute infection (serological marker)

A

Anti-HBc IgM

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18
Q

Resolved infection (serological marker)

A

Anti-HBc total

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19
Q

High viral load and high infectivity

A

HBeAg

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20
Q

Antibody to HBeAg, indicates decreasing HBV DNA

A

Anti-HBe

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21
Q

Recovery from acute infection

A

Anti-HBs

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22
Q

Widespread inflammation of the liver caused by hepatitis viruses A, B, C, D, and E

A

Acute hepatitis

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23
Q

Hepatitis A:

A

Oral and fecal route

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24
Q

Hepatitis B and C:

A

Body fluids

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25
Hepatitis D
Occurs only in parts with B
26
Hepatitis E:
Oral fecal route, most seen in Asia, Africa, and Mexico
27
4 phases of symptoms
Prodromal Pre-icteric Icteric Convalescent
28
Malaise, fatigue, low-grade fever, nausea vomiting, aversion to food, mild itching, joint/muscle pain
Prodromal
29
Icteric
Yellow eyes, dark urine, light stool
30
Gradual recovery
Convalescent
31
Risk factors for chronic hepatitis
Injection drug use Chronic hemodialysis Blood transfusion Blood receipt Clotting factor receipt Unvaccinated health care worker Asian ancestry Birth to mother with chronic HBV or HCV
32
Possible risk factors
Piercings or tattoos Multiple sexual partners Health care worker Exposure to positive person
33
6-month course of hepatitis or evidences of liver disease with confirmatory biopsy
Chronic hepatitis
34
Caused by alcohol excess and abuse
Alcohol liver disease
35
Most common liver disease
Alcoholic liver disease
36
Stages of alcoholic liver disease
Hepatic steatosis (fatty liver) Alcoholic Hepatitis Alcoholic Cirrhosis
37
Alcoholic liver disease: metabolic changes
Steatorrhea Wernicke-Korsakoff syndrome Pellagrous psychosis Peripheral neuropathy Folate deficiency
38
Possible characteristics of end-stage alcoholic liver disease
Malnutrition Portal hypertension with varices Ascites Hyponatremia Hepatic encephalopathy Glucose alteration Fat malabsorption Osteopenia Thrombocytopenia with anemia
39
Histologically resembles alcoholic hepatitis Most common cause of chronic hepatic injury other than viruses or alcohol Most common cause of cryptogenic cirrhosis Common in middle-aged women with obesity or diabetes
NASH
40
True or False: ALT is higher than AST for NASH
True
41
True or False: ALT is higher than AST for NASH
True
42
T or F: People with NASH generally have normal lipid profiles
False
43
Give some clinical manifestations of cirrhosis
Ascites Spider angioma Jaundice Testicular atrophy Caput medusae Gynecomastia Alopecia Icteric sclera Asterixis Palmar erythema Altered hair distribution Edema Bruising Muscle wasting
44
These are the enzymes released into circulation following injury or death of cells in the liver, heart, lungs, etc.
ALT and AST
45
True or False. High AST and ALT are indicative of liver disease in the presence of jaundice or other symptoms. Levels are lower for acute hepatic injury than in chronic liver disease
Statement 1 - True Statement 2 - False (higher)
46
Transaminase levels will relate more to the ____ rather than the _____.
Cause; prognosis
47
Usually normal in chronic and acute liver disease
ALP
48
ALP
Alkaline phosphatase
49
High levels are indicative of obstruction of biliary drainage
ALP
50
Viral hepatitis: bilirubin is
>257 mcmol
51
Alcoholic hepatitis, bilirubin is
>428 mcmoles per L - likelihood of death
52
Protein-bound, related to the breakdown of RBCs
Unconjugated/indirect bilirubin
53
Non-protein bound with increased in blockage of the liver
Conjugated/direct bilirubin
54
Non-protein bound with increased in blockage of the liver
Conjugated/direct
55
Conditions related to increased direct bilirubin
Viral hepatitis Cirrhosis Infectious mononucleosis Reaction to drugs (chlorpromazine - a sedative used for psychotic orders) Obstruction of the CBD (gallstones, neoplasms)
56
Conditions related to increased indirect bilirubin
Blood transfusion Pernicious anemia Sickle cell anemia Transfusion reactions
57
Low ceruloplasmin indicates
High unbound copper
58
Hepatolenticular degeneration caused by abnormal copper accumulation in the body
Wilson’s disease
59
Most cost-effective screening test for metabolic or drug-induced liver injury
ALT
60
Predictors of prognosis
PTT Albumin - low - high risk of death
61
Causes of Malnutrition in Liver disease
Restricted diets Anorexia Altered metabolism Maldigestion of malabsorption Early satiety or dysguesia Nausea and vomiting
62
Medical Management of liver disease
Diuretic therapy Management of portal hypertensive bleeding Medication of encephalopathy Monitoring of blood glucose
63
MNT for liver disease
Increased energy intake - small, frequent feedings Sodium restriction for ascites Fluid restriction for hyponatremia Carbohydrate-controlled for hyperglycemia V &M Supplements Oral liquid supplements or TF
64
Vitamin/Mineral Deficits in severe liver disease
ADEK B1 B3 B6 B9 B12 Zn Mg Fe K P
65
Refers to any type pf cerebral dysfunction that is due to liver insufficiency and/or portosystemic shnting
Hepatic encephalopathy
66
Major causes of encephalopathy
GI bleeding Fluid and electrolyte abnormalities Uremia Use of sedatives Hypo/hyperglycemia Alcohol withdrawal Constipation Acidosis
67
Non-absorbable disaccharide that acidifies colonic contents and acts as laxative
Lactulose
68
Non-absorbable antibiotic that decreases colonic ammonia production
Neomycin
69
True or false: Ascites increases REE by 10%
True
70
Energy, protein, and fat recommendations for MNT end-stage liver disease
Energy - 25-30 kcal/kg BW Protein - 1-1.5 g/kg Fat - 25-40% of kcal
71
Recommendations for sodium
1500-2000 mg/day
72
Recommendations for fluid
1000-1500 mL/day
73
In liver diseases, aromatic AA are usually decreased and BCAAs are increased
False
74
Aromatic AA
Free tryptophan, tyrosine, phenylalanine
75
If steatorrhea is present, replace
LCT with MCT
76
If steatorrhea is present, replace
LCT with MCT

FN 125 (3 decks)

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