Chapter 14 Flashcards
liver -located in \_\_\_\_\_\_\_ quadrant -\_\_\_\_ of total body weight -receives \_\_% of cardiac output and has greatest \_\_\_\_\_ reserve -suspended by \_\_\_\_\_\_\_\_\_ -can lacerate liver in deceleration trauma function -\_\_\_\_\_\_\_ blood - removes damaged or aged \_\_\_\_\_\_\_ -stores \_\_\_\_\_ and agents for metabolism
upper right 2.5% 25% ligamentum teres detoxifies
lab findings in pts with liver disease Liver Function Test (LFT): serum transaminases (\_\_\_\_ and \_\_\_\_) \_\_\_\_\_\_\_ -\_\_\_\_\_ rise in blood -\_\_\_\_\_ levels increase in blood -\_\_\_\_\_\_\_\_ increase in blood
ALT AST elevated NH3 bilirubin alkaline phosphatase (ALP)
injury to solid organs
- dense and less strongly held together
- specific organs
- ______: pain referred to left shoulder
- ________: pain radiates to back
- ________: pain radiates from flank to groin and hematuria
- _______- pain referred to the right shoulder
spleen
pancreas
kidneys
liver
refers to yellow discoloration of the skin, sclaerae and tissues caused by ________.
it is most often associated w ________, ______ disease, _______ obstruction, or _______ anemia
- pre-hepatic (________) (_______ bilirubin)
- hepatic (________/________ bilirubin)
- post hepatic (_______) (______ bilirubin)
jaundice hyperbilirubinemia hepatocellular biliary hemolytic hemolytic unconjugated conjugated/unconjugated obstructive conjugated
autosomal dominant defect with bilirubin
prehepatic jaundice
gilbert’s disease
Hepatitis B partifcles are known as _____ particules
-three types: HBsAg (____ Antigen), HbcAg (_____ antigen), and HBeAg (_____ antigen)
pathological changes due to infection
1) reversible changes: hepatocytes have _____ nuclei and _______ membrane
2) irreversible changs: ______ hepatocytes will ___ nuclei and have round cytoplasmic fragments known as _________ bodies (_________ fragments)
3) inflammatory changes: hepatocytes are _______ due to inflammatory process and the dead cells are engulfed by macrophages via phagocytosis
Dane surface core extra normal well defined necrotic lose coulclinman's eosinophilic damaged
only infects persons with acute or chronic ____ infection. transmitted by __________
-delta virus is unable to produce its own virus coat and uses ______ produced by HBV
hepatitis D
HBV
sharing needles
HbsAg
oral fecal method of transmission
no prevention of disease after exposure
no immunization available
hep E
HGV does not lead to chronic hepatitis and has no known relationship to hepatocellular carcinoma
hep G
refers to a group of structural and functional changes in the liver resulting from excessive alcohol consumption
divided in three stages of progression:
___________: accumulation of fat in hepatocytes. resolves with abstinence
__________: causes degenerative changes and necrosis of liver cells. ________ (metabolite of alcohol) mediates damage. characterized by _____ of hepatocytes with formation of ______ bodies (intra cytoplasmic esoinophilic hyaline bodies), _____ and ____ inflammation. ______ and elevated liver enzymes (___>___)
________: most advanced, fatty liver may become ____, ______, irregular nodularity with ____ appearance and ____ of liver with loss of hepatic architecture
alcoholic liver disease alcoholic fatty liver alcoholic hepatitis acetaldehyde swelling MAllory necrosis acute hepatomegaly AST ALT alcoholic cirrhosis brown, shrunken, hobnail fibrosis
fatty change, hepatitis and or cirrhosis that develop without exposure to alcohol, associated with ______
lab diagonosis: ___>___
non alcoholic liver disease
obseity
ALT
AST
descriptive term for chronic liver disease characterized by generalized disorganization of hepatic architecture with _____ and _____ formation. ______ cell damage, ________activity, and generalized ______. classification can be morphologic, on the basis of nodule size (_______, ________, and mixed _________ forms.) in all forms there is an increased risk of ____________ carcinoma
causes include: a) prolonged ______ intake, _____, ______ agents
b) viral ________, _____ obstruction and ________
c) _____ disease
liver cirrhosis scarring nodule liver regnerative fibrosis micronodular, macronodular mixed macro-micronodular hepatocellular alcohol, drugs, chemical hepatitis, biliary, hemochromatosis Wilson's
biliary cirrhosis
primary: ________ disease, in ____ (40+), unknown cause, _______ antibody is present
secondary: obstruction of _____ extra hepatic _____ ducts by _____. ______ liver
- lab findings: ________, increase in ____ and ______
treatment: treat _____ cause
autoimmune women anti-mitochondrial large bile gallstone yellow-green hypercholsetrolemia ALP, bilirubin primary
excess body iron leading to deposition in tissues and organ damage. due to autosomal _______ (___ gene in chromosome 6) defect in iron absorption (______) or chronic transfusions (____)
1st degree: triad of _______, ______, and increased skin ________, giving rise to the older term _____ diabetes. pigment cirrhosis marked increase in serum iron and modest reduction in total _______ capacity (TIBC, transferrin)
2nd degree: most often associated w a combination of ineffective ______ and multiple ______, such as occurs in __________ major
treatment: weekly ____ and low ___ diet
hemochromatosis recessive Hfe primary secondary cirrhosis diabetes mellitus pigmentation bronze iron binding erythropoeisis transfusions thalassemia major phlebotmy, iron
most common cause of neonatal liver failure and the leading indication for liver transplantation in ____. characterized by progressive iron deposition during ____ period, predominantly targeting the ____, ____, ___, and ____ and ____ glands but sparing the ________ system
- associated w a high recurrence rate in subsequent pregnancies, a pattern that cannot be explained by genetic inheritance but is consistent with an alloimmune pathogeneis
- ______ MRI has become the standard noninvasive diagnostic procedure
- the presence of ________ in the biopsy specimens of affected organs has become the standard in establishing the diagnosis
treatment: therapy includes treatment for liver Failure with antioxidant cocktails including vitamin __, N-acetylcystine , prostaglandins and ______), fresh frozen ____, and cryoprecipitate
infusions of intravenous ________ and exchange _____ have also been suggested
-exchange transfusion is performed to remove any maternal _________ remaining in the fetal circulationn and ___ is administered to displace specific reactive ___ antibodies that are bound to target antigens and to bind with circulating complement
neonatal hemochromatosis infants fetal liver, pancreas, heart, thyroid, salivary glands reticuloendothelial system gradient-echo iron deposits vitamin E, N-acetylcysteine, prostaglandins, selenium plasma cryoprecipitate immune globin (IVIG) transfusion alloantibodies IgG
