Unit 2 Ch 35 liver, pancreatic, and gallbladder disorders

Question 1

Cirrhosis, chronic liver disease

Answer 1

Progressive irreversible replacement of healthy liver tissue with scar tissue

Often irreversible unless early treatment 

Question 2

Cause of chronic liver disease and cirrhosis

Answer 2

Chronic alcohol use most common
Chronic HBV or HCV
Fatty liver NASH
Dietary fat
Diabetes
Obesity
Heart disease 

Question 3

Cirrhosis and chronic liver disease pathophysiology

Answer 3

Inflammation of liver cells
Infiltration with fat and white blood cells
Fibroid scar tissue, replaces liver tissue
Abnormal regeneration
Impaired liver, blood flow perfusion
Impaired liver functioning, bilirubin increases

Question 4

Oliguria

Answer 4

No urine or a decreasing urine

Needs to be at least 30 mL an hour

Question 5

Signs and symptoms of chronic liver disease

Answer 5

Asites build up
Lumpy, hard margins when pate liver
Clay colored stools
Liver produces clotting factors, risk of bleeding
Jaundice
Itching
Diarrhea or constipation

Question 6

Amenorrhea

Answer 6

An abnormal absence of menstruating

Question 7

Complications of cirrhosis, chronic liver disease

Answer 7

Clotting defects
Portal, hypertension
Varices
Ascites
Hepatic encephalopathy
Hepatorenal syndrome
Wernicke- Korsakoff syndrome

Question 8

Wernicke- Korsakoff

Answer 8

Alcoholics, decrease thymine, and vitamin B

Question 9

Diagnosing cirrhosis

Answer 9

Liver enzymes
Bilirubin
Ammonia
PT
Bleeding clotting
Abnormal x-ray or ultrasound
Duodenoscopy
Liver biopsy
Reduce sodium

Question 10

Paracentesis

Answer 10

Take fluid out of stomach

Question 11

Therapeutic intervention for cirrhosis

Answer 11

Ascites
diuretics
Sodium restriction
Albumin infusion
Paracentesis
Transjugular, intrahepatic, shunt
Vasoconstrictor
Vasile ligation
Transfusion
Antibiotic prophylaxis

Question 12

Cirrhosis of the liver therapeutic interventions, hepatic encephalopathy

Answer 12

Lactulose
Rifaximin. Caravan
Neomycin. Neo-Fradin

Question 13

Patient education for acute liver, failure, and cirrhosis

Answer 13

Disease process
Signs and symptoms to report
Adequate rest
Avoid narcotics, sedatives, tranquilizers and alcohol
Follow up here

Question 14

Hepatitis

Answer 14

Inflammation of the cells of the liver

Question 15

Causes of hepatitis

Answer 15

Bacterial infection
Medication’s
Alcohol
Chemicals toxic to the liver
Metabolic and vascular disorders
Often caused by a virus

Question 16

Types of hepatitis found in the US

Answer 16

Hepatitis, a b and c

Question 17

Hepatitis E

Answer 17

Travel contamination from human feces

Question 18

Hepatitis d

Answer 18

If you have hepatitis d you usually have hepatitis B?

Question 19

How do you get hepatitis A?

Answer 19

Fecal oral route or from raw shellfish

Question 20

How do you get hepatitis B C and D

Answer 20

Healthcare related from body fluids

Question 21

Hepatitis prevention

Answer 21

Transmission precautions
Standard precautions
Hand hygiene
Vaccines
Immunoglobulin
Public health majors

Question 22

What is immunoglobulin?

Answer 22

It’s a passive short term protection doesn’t build up protection

Question 23

Hepatitis signs and symptoms

Answer 23

Can be asymptomatic
Prodromal stage
Flu like symptoms right upper quadrant pain
Icteric stage
Jaundice worsening symptoms
Convalescent
Returning to normal liver function

Question 24

What is convalescent?

Answer 24

Returning to normal

Question 25

Complications of hepatitis

Answer 25

Liver failure Fulminant Acute Chronic Chronic infection Carrier of the virus Puts you at risk of liver cancer

Question 26

What does fulminate mean?

Answer 26

Sudden and severe

Question 27

HBV and HCV

Answer 27

Chronic infection

Question 28

Hepatitis diagnostic test

Answer 28

Serum test Liver enzymes Serum bilirubin Prothrombin Serological test Liver biopsy

Question 29

Hepatitis therapeutic interventions

Answer 29

Identify cause Monitor liver function Relieve symptoms Prevent cirrhosis Educate on hydration and nutrients Rest Avoid alcohol and liver, toxic drugs

Question 30

HBV and HDV therapeutic interventions

Answer 30

Pegylated interferon therapy

Question 31

HBV

Answer 31

Antivirals Pegg related interferon therapy Liver transplant

Question 32

Can you cure hepatitis B or hepatitis C?

Answer 32

No

Question 33

Types of antivirals that will treat hepatitis C

Answer 33

Albacore/grazoprevir Sofosbivor/ledipasvir

Question 34

Gallbladder disorder

Answer 34

Inflammation of the gallbladder called cholecystitis

Question 35

Causes of gallbladder disorder

Answer 35

Risk increases with age Family history Bile stasis High cholesterol Fasting Sedentary lifestyle More often in women

Question 36

Signs and symptoms of gallbladder disorder

Answer 36

Silent stones Elevated vital signs Vomiting Jaundice Epigastric pain Nausea Indigestion Right upper quadrant tenderness Positive Murphy sign Biliary colic

Question 37

What is a positive Murphy sign?

Answer 37

You can’t take a deep breath when your liver is pressed

Question 38

What is biliary colic?

Answer 38

Pain in your right shoulder and back. You should reduce fat intake.

Question 39

Complications of gallbladder disorder

Answer 39

Cholangitis Necrosis perforation of the gallbladder Empyema Fistulas Adenocarcinoma Acute pancreatitis

Question 40

Cholangitis

Answer 40

Bile duct inflamed

Question 41

Empyema

Answer 41

Puss in plural cavity

Question 42

Diagnostic test for gallbladder disorder

Answer 42

Endoscopic ultrasound CT scan MRI ERCP HITA scan White blood cells elevated Elevated direct bilirubin

Question 43

Therapeutic interventions for gallbladder disorder

Answer 43

Analgesics Bile acid sequestriants Antiemetics NPO Low-fat diet

Question 44

Cholelithiasis treatment

Answer 44

Cholecystectomy Laparoscopic surgery most common Traditional surgery, T tube Medication to dissolve stones