13 - Liver and Pancreas Dysfunction (part 2)

Question 1

Liver is unable to detoxify toxic byproducts of metabolism. Ammonia is the major etiologic factor of encephalopathy. Major S/S is asterixis (liver flap), which is flapping tremor of the hands.

Answer 1

Hepatic Encephalopathy

Question 2

Large ecchymosis appearing in the flanks as a result of pancreatitis.

a. ) Grey Turner’s Sign
b. ) Cullen’s Sign

Answer 2

Grey Turner’s Sign

Question 3

Increased pressure through portal venous system because of a blockage. Obstructed blood flow through damaged liver. Causes GI bleeding (black tarry stool and hematemesis), encephalopathy, coagulopathy, and ascites.

Answer 3

Portal Hypertension

Question 4

Systemic, viral infection that causes necrosis and inflammation of liver cells. Altered liver function.

Answer 4

Viral Hepatitis

Question 5

Autodigestion of the pancreas by pancreatic enzymes. Cellular destruction and organ damage. The pancreas eats itself.

Answer 5

Pancreatitis

Question 6

Onset is abrupt. Early symptoms include fever, chills, rash, arthralgia, pruritus, and anorexia. Late symptoms include Jaundice, dark urine, and an enlarged/tender liver. Treatment includes short course of high-dose corticosteroids, rest, small/frequent meals, a low protein, fat, and high carbohydrate diet. IV fluid containing dextrose as needed.

Answer 6

Drug Induced Hepatitis

Question 7

One of the main S/S of pancreatitis is pain.

1.) Which specific type of pain?

(3 parts to answer)

Answer 7

Mid epigastric pain, radiating to the midback.

Pain does not decrease even with vomiting.

Rebound tenderness

Question 8

What type of diet do you want patients with pancreatitis to have?

Answer 8

Low fat, protein, and high carbohydrate diet.

Question 9

Backup of venous blood flow from portal HTN. Failure to metabolize aldosterone. Accumulation of albumin-rich fluid.

Answer 9

Ascites

Question 10

What are the three main lab values looked at when diagnosing pancreatitis?

Answer 10

Lipase, Amylase, & BMP.

C-reactive protein is elevated

Question 11

Ecchymosis in the umbilical area as a result of pancreatitis.

a. ) Grey Turner’s Sign
b. ) Cullen’s Sign

Answer 11

Cullen’s Sign

Question 12

Resembles viral hepatitis, but is caused by exposure to toxic chemicals (medications, botanicals, alcohol, and/or industrial chemicals). Treatment includes removal of the causative agent. S/S include anorexia, N/V, Jaundice, and hepatomegaly. There are no effective antidotes, and a delay in treatment can result in increased severity.

Answer 12

Toxic Hepatitis