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Fa: Coexisting 2 > 3. Liver > Flashcards

3. Liver Flashcards

1
Q

largest internal organ

A

liver

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2
Q

liver weight

A

1.5 kg

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3
Q

liver location

A

upper right quadrant

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4
Q

liver segments

A

8

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5
Q

liver CO

A

25%

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6
Q

blood flow to liver

A

portal vein - 75%
hepatic artery - 25%

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7
Q

O2 delivery to liver is through

A

50% portal vein
50% hepatic artery

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8
Q

hepatic artery and portal venous flow

A

inverse relationship

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9
Q

what modulates portal venous flow

A

arterial tone of splanchnic vessels

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10
Q

major function of liver

A

filter and transform substances in blood

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11
Q

portosystemic shunts

A

arise in portal HTN and allow blood flow to bypass liver

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12
Q

liver disease incr risk of

A

bleeding
thrombosis

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13
Q

markers for hepatocellular injury

A

AST
ALT
ALP
bilirubin
albimin

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14
Q

where is albumin synthesized

A

liver

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15
Q

which hepatitis causes chronic complications

A

Hep B
Hep C

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16
Q

most common viral hepatitis causes neede for liver transplant

A

HCV

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17
Q

HCV genotype 1 treatment

A

12 weeks of
sofosbuvir
velpatasvir

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18
Q

main reason for liver transplant

A

ALD
or NAFLD

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19
Q

signs during early ALD

A

none

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20
Q

ALD treatment

A

alcohol abstinence
liver failyre management

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21
Q

NAFLD

A

excessive fat accumulation without clear cause of alcohol use

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22
Q

NAFLD associated with

A

obesity
insulin resistance
T2D
metabolic syndrome

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23
Q

NAFLD diagnosis

A

imaging
biopsy

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24
Q

NAFLD treatment

A

weight loss
exercise

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25
which pt population is most affected by autoimmune hepatitis?
women
26
autoimmune hepatits
inflammatory diseas of liver autoantibodies hypergammaglobulinemia
27
autoimmune hepatitis labs
AST/ALT 10-20x normal
28
autoimmune hepatitis treatment
steroids
29
most common cause of drug induced liver injury
acetamiophen
30
acetominophen toxic overdose reversal
N-Acetycysteine
31
wilsons disease
impaired copper metabolism
32
a-antitrypsin deficiency
transplant is cure COPD emphysema
33
hemochromatosis
excess iron that leads to multiorgan dysfunction
34
ALF timeline
severe hepatic injury in less than 26 weeks
35
ALF S+S
incr AST/ALT altered mental status coag abnomalties jaundice nasuea RUQ pain encepalopathy
36
ALF causes
acetominophen drugs viral
37
ALF treatment
treat underlying cause supportive transplant
38
final stage of chronic liver disease
cirrhosis
39
cirrhosis
replacement of normal liver pernchyma with scar tissue
40
cirrhosis S+S
jaundice ascites bruising encephalopathy variceal hemorrhage
41
what causes encepalopathy
ammonia
42
cirrhosis labd
incr ALT/AST inc bilirubin incr ALP incr PT/INR
43
gold standard for cirrhosis diagnosis
liver biopsy
44
portal HTN
incr vascular resistance in portal venous system
45
HPVG
difference between hepatic venous pressure and hepatic wedge pressure
46
normal HPVG
1-5 mmHg
47
elevated portal HTN HPVG
> 10 mmHg
48
variceal rupture HPVG
> 12 mmHg
49
most common complication of cirrhosis
acites
50
acites management
low salt diet diuretics paracentesis TIPS
51
what presents in 50% of cirrhosis pts
gastroesophageal varices
52
most lethal complication of cirrhosis
variceal hemorrhage
53
what HPVG lead to variceal rupture
> 12 mmHg
54
varices treatment
nonselective beta blocker (propranolol) variceal banding
55
hepatic encephalopathy treatment
lactulose rifaximin
56
hepatorenal syndrom
decr renal blood flow splanchnic artery vasodilation
57
hepatorenal treatment
midodrine ocreotide albumin hemodialysis
58
hepatopulmonary syndrome triad
chronic liver disease (portal HTN) hypoxemia PaO2 < 70 mmHg intrapulmonary vasodilation
59
HPS is a state of
V/Q mismatch due to HPV inhibition
60
HPS treatment
transpant
61
portopulmonary hypertension
pulmonary HTN portal HTN systemic vasodilation with local production of pulm vasoconstrictors
62
PPHTN diagnosis
MAP > 25 mmHg at rest
63
PPHTN treatment
pulmonary vasodilators - PDE inhibitors - NO - prostacyclin - endothelin
64
CI to elective surgery
acute hepatitis ALF severe chronic liver disease
65
score to stratify risk in liver pts
child-pugh MELD
66
liver pts are at incr risk of _____ on induction
aspiration hypotension hypoxemia
67
which muscle relaxants dont require hepatic metabolism
sux cisatracurium
68
TIPS indication
portal HTN
69
TIPS
connects portal vein and hepatic vein
70
TIPS outcome
reduces portosystemic pressure gradient - decr engorged vein bleeding - decr ascites
71
TIPS CI
HF severe tricuspid regurge severe pulm HTN
72
TIPS may worsen
hepatic encepalopathy
73
how much of the liver can be removed and it will still regenerate
75%
74
can you due an epidural for liver transplant
not -really CI for hematoma risk
75
median time to transplant
11 months
76
5 year transplant survival rate
50-60%
77
preanhepatic stage
liver dissected until only attached to IVC and portal vein
78
anhepatic stage
portal vein clamped IVC clamped donor liver anastamosed to supra and infrahepatic vena cava portal vein attached
79
neohepatic phase
hypotension hepatic artery anastamosis bile duct attached
80
MR for liver transplant
cisatracurium
81
preanhepatic effects
hypovolemia blood loss
82
anhepatic effects
decr venous return decr preload hypocalcium acidosis air embolism
83
neohepatic effects
incr K+ incr preload decr SVR hypothermia hyperfibrinolysis
84
postreperfusion syndrom
hypotension pulm HTN
85
cholecystitis
inflammation of gall bladder bile elimination is blocked
86
cholelithiasis
hardening of bile into stones
87
choledocholithiasis
gallstones obstruct common bile duct
88
what can cause sphincter of odi spasm
opiates (morphine)
89
relax sphincter of odi spasm
glucagon naloxone nitrates

Fa: Coexisting 2 (7 decks)

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