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Endoscopy Nurses - GENCA > Chapter 19 - Liver > Flashcards

Chapter 19 - Liver Flashcards

1
Q

The liver is divided into a right and a left lobe by the ____ ligament.

A

falciform

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2
Q

What is the portal triad?

A

hepatic artery, portal vein, & a bile duct

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3
Q

What are sinusoids?

A

Irregular tubular space for the passage of blood (in the liver, spleen & bone marrow)

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4
Q

____ cells are phagocytic cells (ability to ingest foreign particles), that removes amino acids, old erythtocytes, bacteria and disease (harmful substances) from the blood that flows through the sinusoids.

A

Kupffer cells

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5
Q

What are the 5 main functions of the liver?

A
  1. 💧Bile formation
  2. 🍞 Metabolism of carbohydrates, proteins, fats and steroids
  3. 🩸Substances necessary for coagulation & anticoagulation
  4. ☠ Detoxification of foreign & toxic substances
  5. 💊Vitamin storage
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6
Q

What are the two proteins used for clotting is produced by the liver?

A

prothrombin & fibrinogen

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7
Q

What are the 3 major causes of cirrhosis?

A
  1. Alcohol
  2. Immune related diseases of the bile duct eg. primary sclerosing cholangistis
  3. Hepatic necrosis from Hepatitis, infection, metabolic liver disease, exposure to hepatotoxins or industrial chemicals
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8
Q

What are some complications of cirrhosis?

A
  1. Portal HTN
  2. Varices with GI Bleed
  3. Ascites
  4. Hepatic encephalopathy
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9
Q

What is the best way to assess portal hypertension in a pt with cirrhosis?

A

Measuring the Portal vein pressure gradient (PVPG) (an invasive procedure)

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10
Q

How can portal hypertension be treated?

A
  1. Radiological procedure/surgery with the use of shunts to divert blood flow around the liver and away from small blood vessels to avoid backflow
  2. Octreotide causes vasoconstriction thus leading to reduced portal blood flow
  3. Beta blockers reduces cardiac output
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11
Q

Patients with hepatic encephalopathy is the accumulation of ___ in the brain that usually is metabolized by the liver into urea but cannot due to blockage.

A

ammonia

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12
Q

What is portal hypertension?

A

When liver blockage leads to increased portal vein resistance and backflow, portal vein pressure increases.

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13
Q

What is cirrhosis?

A

Death of liver cells and irreversible scarring of the liver.

This leads to impaired blood flow and ultimately to hepatic insufficiency in carrying out essential functions such as detoxifying harmful substances, purifying blood and manufacturing vital nutrients.

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14
Q

Hepatitis is the inflammation of the liver. What is the most common type of Hepatitis?

A

Hepatitis A virus (HAV)

Spread by the fecal-oral route either through oral-anal sexual practices or by contaminated food, water or shellfish.

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15
Q

What is fulminant hepatic failure?

A

Massive liver cell death within 2 months of hepatitis.

Transplantation may be necessary.

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16
Q

What is Budd-Chiari syndrome? (BCS)

A

Rare condition characterized by an obstruction of the hepatic venous outflow.

17
Q

What is Wilson’s disease?

A

Rare disorder characterized by defective excretion of copper into bile leading to excessive amounts accumulated in the brain, liver, kidney and cornea.

👁👁 Rusty brown ring pigment around eyes called a Katser-Fleischer ring

18
Q

What is porphyria?

A

Hereditary or acquired enzyme defect in which the biosynthesis (production) of heme in either the bone marrow or liver leads to overproduction of porphyrins.

This can lead to chronic skin lesions, increased hair growth, mild liver disease and lack of neuropsychatric manifestations.

19
Q

What is hemochromatosis?

A

Iron overload syndromes

3 🐈tegories:

  1. Hereditary
  2. Secondary iron overload
  3. Miscellaneous
20
Q

What is the most common cause of liver disease in children?

A

Alpha1-antitrypsin (AAT) deficiency

21
Q

What is Gilbert syndrome?

A

Common and benign congenital disorder more frequent in male where there is mild fluctuating increase in bilirubin.

Hence the name Gilbert 😉 with the b for bilirubin.

22
Q

In the liver, Bile is secreted by:

a. sinusoids
b. hepatocytes
c. Glisson’s capsule
d. Kupffer cells

A

b. Hepatocytes

23
Q

Carbohydrates are metabolized into ___.

A

glycogen

24
Q

Most patients with HBV is treated with

A

rest from strenuous physical activity

25
Q

Ascites may be controlled by

A

dietary restrictions, diuretics and bed rest

26
Q

Most common risk factors for non-alcoholic steatohepatitis (NASH) (advanced form of non-alcoholic fatty liver disease (NAFLD)) are:

A

Obesity, T2DM, and hyperlipidema

Endoscopy Nurses - GENCA (7 decks)

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