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Understanding Human Disease Exam 3 > Chapter 14 > Flashcards

Chapter 14 Flashcards

1
Q

liver functions

A
  • metabolism (CHO, protein, fat)
  • synthesis of bile
  • detox
  • storage (vitamin B12/fat soluble vitamins)
  • synthesis plasma proteins and clotting factors
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2
Q

livers function in clearing waste products

A
  • drug and hormone metabolism (detox/inactivation)
  • cytochrome p450 enzymes
  • synthesis of urea (takes away nitrogen)
  • removal of bilirubin
  • alcohol metabolism
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3
Q

what organ is the only organ that can remove heme waste products?

A

liver

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4
Q

bilirubin metabolism

A
  1. liver conjugates bilirubin (makes more soluble)
  2. secreted in bile
  3. also eliminated in urine
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5
Q

jaundice

A

accumulation of bilirubin in blood, often symptomatic of liver/gallbladder problem

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6
Q

biliary colic (signs and symptoms)

A

severe right upper quadrant and side pain caused by obstruction of biliary ductal system by stones

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7
Q

what is another sign/symptom of liver problems?

A

unintentional weight loss (could indicate pancreatic problem also)

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8
Q

steatorrhea (signs and symptoms)

A

passage of smelly, greasy stools that float in water, indicative of malabsorption of fats

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9
Q

hepatomegaly (signs and symptoms)

A

increase in size of liver, prominent in alcoholic fatty liver and metastatic disease

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10
Q

liver enzyme test

A

look for aspartate amiotransferase (AST), alanine aminotransferase (ALT), and alkaline phosphatase (AP) in blood, not normally there if liver is functioning normally

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11
Q

liver albumin test

A

check to see how much albumin is in the blood, too little could indicate a problem

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12
Q

hepatitis

A

inflammation of the liver due to virus

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13
Q

viral hepatitis is distinguished by..

A
  • mode of transmission
  • carrier state
  • chronic
  • vaccine
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14
Q

hepatitis A is also known as..

A

HAV

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15
Q

how is hepatitis A transmitted?

A

primarily fecal-oral, mucosal secretions

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16
Q

abrupt symptoms of hepatitis A

A
  • fever, nausea, vomiting, and loss of appetite
  • enlarged, tender liver and dark urine
  • serum AST strikingly elevated
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17
Q

where is hepatitis A more common?

A

developing nations, ~10,000 new cases/year in U.S.

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18
Q

treatment for hepatitis A

A

nothing specific, rest

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19
Q

do a lot of people die from hepatitis A?

A

no, rare

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20
Q

is there a vaccine for hepatitis A?

A

yes

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21
Q

hepatitis B is also known as..

A

HBV

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22
Q

hepatitis B can..

A

cause acute illness that manifests with fever, malaise, and jaundice

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23
Q

can an individual infected with hepatitis B become an asymptomatic carrier?

A

yes, can also develop chronic hepatitis and eventually cirrhosis

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24
Q

how is hepatitis B transmitted?

A

contact with infected blood, body fluids, shared needles, fetus in utero or during vaginal delivery

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25
Q

can hepatitis A become chronic?

A

no

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26
Q

is there a vaccine available for hepatitis B?

A

yes

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27
Q

is hepatitis B acute or chronic?

A

both

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28
Q

how is hepatitis C spread?

A

primarily by blood to blood contact

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29
Q

____ of hepatitis C cases result in chronic hepatitis

A

80%

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30
Q

risk factors for hepatitis C

A
  • contact with blood at work
  • unprotected sex (less common than B)
  • blood transfusion
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31
Q

is there a vaccine for hepatitis C?

A

no

32
Q

treatment for hepatitis C

A

direct-acting antiviral (DAA) drugs
- introduced in 2011
- 12 weeks of treatment (expensive)

33
Q

___ of HBV cases are resolved

A

90%

34
Q

fulminant liver failure

A

liver fails acutely

35
Q

cirrhosis

A

describes end stage of most serious chronic types of liver disease

36
Q

hepatitis D

A
  • depends on hepatitis B for replication
  • have to be infected with HBV to get hepatitis D
37
Q

hepatitis E

A
  • fecal-oral transmission
  • developing countries
  • mild and self limiting
  • epidemic in India
38
Q

why are pharmaceutical drugs been linked to liver injury?

A
  • blood runs through liver with drugs in blood stream
  • tylenol is toxic
39
Q

chemical injury to the liver can be predictable or..

A

idiosyncratic: can tell how damaging doses of medicine will be

40
Q

patients with severe acute or chronic liver disease are more susceptible to..

A

toxic hepatic injury

41
Q

example of toxic drug to liver

A

acetaminophen
- choice for people attempting suicide
- most common drug accidentally ingested in large doses by children
- large doses lead to production of metabolic by-product highly toxic to hepatocytes

42
Q

fatty liver disease

A

fat accumulates in hepatocytes secondary to injury (hepatic steatosis, yellow and swollen)

43
Q

most common causes of fatty liver disease

A

alcohol and obesity

44
Q

is fatty liver disease reversible?

A

impaired liver function but injury is reversible

45
Q

what can fatty liver disease lead to?

A

steatohepatitis: inflammation of the liver

46
Q

is fatty liver disease symptomatic or asymptomatic?

A

asymptomatic

47
Q

cholelithiasis

A

gallstones in the gallbladder or biliary tree (usually multiple)

48
Q

is cholelithiasis common?

A

yes, ~1 million new cases/year in U.S.

49
Q

what do cholelithiasis look like?

A
  • hard, pebble like deposits
  • cholesterol
  • pigmented (comes from bilirubin
50
Q

risk factors for gallstones

A
  • increase with age
  • women more than men
  • obesity
  • family history
51
Q

symptoms of cholelithiasis

A
  • usually no symptoms until they begin to move; mid-size stones are the worst
  • painful cramps in RUQ (often after meals, especially high in fat)
  • nausea/vomiting
52
Q

complications of gallstones

A
  • cholecystitis: inflammation of gallbladder because of gallstone
  • pancreatitis: inflammation to the pancreas due to blockages
  • perforation
  • biliary obstruction (jaundice)
  • infection (peritonitis
  • gallbladder cancer
53
Q

2 types of liver neoplasms

A
  • primary: hepatocellular carcinoma, most often due to chronic hepatitis
  • metastatic: most liver neoplasm has metastasized to liver from somewhere else (colon, lung, stomach, breast)
54
Q

what does the prognosis look like for liver cancer?

A

poor

55
Q

acute liver failure

A
  • results from massive death of hepatocytes
  • most common causes: viral hepatitis and drug reactions
  • can be fatal
56
Q

cirrhosis is characterized by..

A

fibrosis

57
Q

causes of cirrhosis

A
  • chronic hepatitis
  • chronic alcohol consumption
  • biliary obstruction
  • cryptogenic: having liver failure but unknown why
58
Q

cirrhosis treatment

A

liver transplant

59
Q

complications of cirrhosis

A
  • portal hypertension
  • passive congestion and enlargement of spleen
  • hyperammonemia and hepatic encephalopathy (liver failure leading to brain issues)
60
Q

clinical features of cirrhosis

A
  • failure to metabolize estrogen and ammonia (breast development ini males)
  • protein synthesis failure (decrease clotting. edema)
  • excretory failure
61
Q

hepatic encephalopathy

A

deterioration of brain function characterized by impaired consciousness, confusion, disorientation, and eventually coma

62
Q

hepatic encephalopathy is from..

A

accumulation of toxic substances in the blood that are normally detoxified and excreted by the liver

63
Q

alcoholic liver disease

A

refers to a group of structural and functional changes in the liver resulting from excessive alcohol consumption

64
Q

what does severity depend on for alcoholic liver disease?

A

amount and duration of alcohol consumption

65
Q

what are the 3 stages of progression for alcoholic liver disease?

A
  • alcoholic fatty liver
  • alcoholic hepatitis
  • alcoholic cirrhosis
66
Q

how does cystic fibrosis effect the pancreas?

A
  • pancreas disfigured and destroyed by mucus plug
  • patient suffers repeated bouts of pancreatitis
  • damage to pancreas is irreversible
67
Q

pancreatitis

A

inflammation and autodigestion of pancreas by pancreatic digestive juices

68
Q

manifestations of pancreatitis

A
  • severe upper abdominal pain
  • anorexia
  • malabsorption
  • hemorrhagic pancreatitis (surgical emergency, progess to shock)
69
Q

diagnosis of pancreatitis

A

amylase and lipase is elevated in the blood, normally not found

70
Q

acute pancreatitis

A
  • reversible inflammation
  • rapid onset of symptoms
71
Q

causes of acute pancreatitis

A
  • chronic alcohol abuse causes 2/3 cases
  • half of patients have gallstones
72
Q

chronic pancreatitis

A

irreversible, caused by repeated bouts of acute pancreatitis, chronic alcohol abuse cases 2/3 cases, half of patients have gallstones

73
Q

conditions causing chronic injury to pancreas

A
  • cystic fibrosis
  • acute pancreatitis
  • repeated attacks of gallstone pancreatitis
  • obstruction of pancreatic ducts by disease
74
Q

symptoms of chronic pancreatitis

A
  • malabsorption
  • steatorrhea
  • hemorrhage
75
Q

complications of chronic pancreatitis

A

diabetes

76
Q

diagnosis of chronic pancreatitis

A

enzyme leakage in the blood

77
Q

treatment of chronic pancreatitis

A

limit activity of gland, total parenteral nutrition, nutrients come into the blood

Understanding Human Disease Exam 3 (5 decks)

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