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NURS 2514 > Week 3: accessory organs (PHYS) > Flashcards

Week 3: accessory organs (PHYS) Flashcards

1
Q

What does the hepatic portal vein do

A

its rich in nutrients from the intestine, it carries toxins for liver to filter (vein so it carries things UP from intestine)

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2
Q

what does the hepatic artery do

A

it carries oxygen rich blood from heart to liver

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3
Q

which macrophage cells live in the liver and clean the blood

A

Kupffer

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4
Q

how does the liver break down protein

A

the liver breaks protein down into Amino acids, which have nitrogen
its then turned into ammonia which is lowkey toxic so liver turns it into urea which gets transported to the kidneys and excreted into the urine

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5
Q

how is fat broken down in the liver

A

fatty things need bile to be absorbed, it then turns into fatty acids and glycerol

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6
Q

what is an important protein that the liver processes

A

albumin, this is the protein that maintains oncotic pressure and keeps equilibrium of water in interstitial fluid and plasma fluid

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7
Q

what would happen to drugs if there was low albumin in the blood

A

certain things like drugs, lipids and hormones are albumin bound so they need albumin to be transported around, if there was low albumin they would just float around and probably become toxic

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8
Q

how does the liver process oral medication

A

remember first pass metabolism

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9
Q

which hormones does the liver store and excrete

A

aldosterone, estrogen, testosterone

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10
Q

what is vitamin K, why is it important

A

its a very important clotting factor, its fat soluble so you need liver and bile to process and store it (bad liver= issues with clotting )

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11
Q

what even is bilirubin

A

macrophages in the spleen and liver break down old red blood cells, causing bilirubin as a byproduct
its also a key component of bile

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12
Q

what is the difference between conjugated and unconjugated bilirubin

A

conjugated (direct) is when bilirubin has been processed by the liver and is now water soluble
unconjugated is when bilirubin is fat soluble and has not been processed by the liver yet (also called indirect/free bilirubin)

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13
Q

what is sterocobilinogen

A

basically bilirubin that has been converted by bacteria and makes stool brown

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14
Q

what colour would stool be if there was an issue with the processing of billirubin

A

clay colour

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15
Q

what does bile do

A

basically gets rid of fat/fat soluble things and also gets rid of old red blood cells (important note for bilirubin and jaundice topics)

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16
Q

what is hyperbilirubinemia

A

jaundice

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17
Q

what’s pre hepatic jaundice

A

results from increase in bilirubin before reaching liver, it is an overproduction of unconjugated bilirubin so it actually has nothing to do with liver function, and more with increased load

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18
Q

what are the two main conditions that cause pre hepatic jaundice

A

babies with incompatible blood types to their mother (haemolytic jaundice of the newborn) and blood transfusion errors (wrong blood type

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19
Q

what is hepatic jaundice

A

liver dysfunction, results from livers inability to take up conjugate and excrete bilirubin

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20
Q

how does a diseased liver result in elevated conjugated and unconjugated jaundice

A
  1. hepatocytes struggle to conjugate bilirubin
  2. conjugated bilirubin will leak from cells and into circulation
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21
Q

what liver diseases will cause hepatic jaundice

A

hepatitis and cirrhosis

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22
Q

what will urine look like with hepatic jaundice

A

it will be dark in colour

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23
Q

what is the primary thing that causes posthepatic jaundice

A

failure of bile to reach the duodenum, usually from cholestasis (which is obstruction of bile flow to the liver)

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24
Q

what is an intrahepatic (inside the liver) cause of post hepatic jaundice

A

swelling or fibrosis of liver and bile ducts

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25
Q

what is an extra hepatic (outside the liver) cause of post hepatic jaundice

A

common bile duct stone, gall stone, pancreatic cancer

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26
Q

what is viral hepatitis

A

widespread inflammation and infection of the liver tissue, results in liver cell necrosis and inflammation which can obstruct the flow of bile

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27
Q

whats the difference between Hep A, B, and C (transmission)

A

A: fecal oral contamination (not v harmful)
B: blood, bodily fluids (unprotected sex), mother to child
C: Blood-Blood and sex (the worst one)

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28
Q

What are the three main clinical manifestations of viral hepatitis

A
  • upper right quadrant pain (liver enlargement due to inflammation
  • general symptoms like fatigue, arthralgia, malaise, anorexia, fever
  • jaundice: inflamation and necrosis changes the structure of the liver and can obstruct the flow of bile causing blockage
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29
Q

which type(s) of hepatitis can cause chronic infection

A

B and C

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30
Q

what is NAFLD and why is it bad

A

accumulation of fat in the liver cells that can turn into NASH which is bad and irreversible

31
Q

what happens to cause toxic and drug induced hepatitis

A
  • the liver filters substances
  • when the liver breaks down the toxins, it creates byproducts that can damage the liver
  • liver regenerates, but if it does to much of this it can cause scarring and inflammation
32
Q

describe liver cirrhosis and how it causes damage in the liver

A

basically the liver keeps taking hits, and its healing is disorganised causing liver regeneration that is different from its original liver structure. The liver then will get improper blood flow and become hypoxic and receive poor nutrition

33
Q

what is compensated liver cirrhosis

A

when the liver is diseased but can still preform essential function

34
Q

what is uncompensated liver cirrhosis

A

when liver dysfunction occurs and liver ends up failing

35
Q

what is portal hypertension

A

structural changes in the liver (due to liver cirrhosis) leads to compressed and damaged veins, which affects blood flow

the hepatic portal vein will get clogged and get all backed up

36
Q

how would portal hypertension show signs of bleeding and bruising

A

blood flows into the spleen causing splenomegaly, thrombocytopenia, and trapping of white blood cells

37
Q

what is varicose

A

the body reroutes veins around the liver so that vein doesn’t burst like a balloon

38
Q

where are the three common spots where varies are formed

A

esophagus, abdominal wall (gastric varices), and the rectum (hemmorrhodal varies)

39
Q

what are some bad things about varicose

A
  • there weak and rupture easily
  • they carry things in blood that aren’t filtered which is bad
40
Q

how would portal hypertension cause ascites

A

because it kicks in the RAAS which makes aldosterone

41
Q

why does liver cirrhosis cause ascites

A

low serum albumin from damaged liver will mean that there is less oncotic pressure, causing fluid shift into the interstitial space

42
Q

how does ascites and edema affect potassium

A

it causes hypokalaemia

43
Q

what is the highest risk varices

A

Rectum because it can cause life threatening GI bleed

44
Q

what is hepatic encephalopathy

A

Liver cirrhosis impacts the process of converting ammonia to urea, causes a build up in the blood which travels to brain

45
Q

how does liver cirrhosis cause ammonia build up

A
  1. ammonia rich blood is bypassing liver due to rerouting of veins
  2. dysfunctional hepatocytes cannot convert ammonia to urea
46
Q

what is fector hepaticus

A

bad breath from ammonia build up

47
Q

how would a bad liver cause hypercoaguability and anemia?

A
  • portal hypertension leads to splenomegaly (enlarged spleen), where WBC, WBC and platelets are trapped
    bad liver also has trouble producing vitamin K
48
Q

What is hepatorenal syndrome

A

sudden decrease in urinary output, increased usine osmolality (common cause of death)

49
Q

what is cholelithiasis/ calculi

A

gall bladder stones

50
Q

what causes calculi

A

too much cholesterol in the bile or too much billiruben

51
Q

what are the risk factors for calculi

A

4 F
female
fertile (had multiple kids)
forty
fat
anything in the body that changes how we metabolise cholesterol can cause stones

52
Q

what are the two types of acute cholecystitis

A

1) calculous: caused by stones
2) acauculous: caused by conditions where gal has trouble filling and emptying

53
Q

why would cholecystitis produce fatty stools

A

because there is no bile being produced to break down fat in diet

54
Q

where would pain be located in cholecystitis

A

upper right abdominal quadrant

55
Q

what type of jaundice would occur in acute cholecystitis

A

post-hepatic jaundice because no bile to get rid of excess billirubin

56
Q

what are the four pancreatic enzymes and their functions

A

trypsin: digestion of proteins
chymotrypsin: digestion of proteins
amylase: digestion of carbs
lipase: digestion of fats

57
Q

what is the protective mechanism of the pancreatic enzymes

A

they remain inactive until they reach the duodenum so that they don’t eat Pancras

58
Q

what is acute pancreatitis and how does it happen

A

it is acute inflammation of the pancreas, it is abnormal activation of the pancreatic enzymes which ends up in auto digestion of the Pancras

59
Q

what are the two most common causes of pancreatitis

A

gall bladder stones and alcohol use

60
Q

what is lipolysis

A

the enzyme lipase that causes fat necrosis of pancreatic cells

61
Q

what is proteolysis

A

break down of proteins that can lead to thrombosis and gangrene

62
Q

describe the clinical manifestations of acute pancreatitis

A

answer 5 if you have studied them

63
Q

what is splenomegaly

A

thick spleen

64
Q

what does a low INR indicate

A

the body takes less time to clot

65
Q

what is urobilinogen

A

bilirubin in the urine, gives it the yellow colour

66
Q

what is stercobilinogen

A

gives poop the brown colour, bilirubin being excreted through stool

67
Q

which type of jaundice is characterised by elevated unconjugated bilirubin

A

pre hepatic

68
Q

which type of jaundice is characterised by elevated conjugated and unconjugated bilirubin

A

hepatic jaundice

69
Q

which type of jaundice is characterised by elevated conjugated bilirubin

A

post hepatic jaundice

70
Q

what is an intrahepatic factors that causes post hepatic jaundice

A

swelling/blockage of liver and bile ducts

71
Q

what is an extrahepatic cause of post hepatic jaundice

A

common bile duct stones, gall stones, pancreatic cancer

72
Q

what are the main causes for ascites and edema in a liver cirrhosis patient

A

portal hypertension, low albumin, too much aldosterone

73
Q

you’re caring for a patient with pancreatitis and their blood work shows that they have increased serum lipase and amylase, what does this indicate?

A

that there is cell death causing the enzymes to leak from the organ (bad)

NURS 2514 (31 decks)

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