Chapter 28: Medical Nutrition Therapy for Hepatobiliary and Pancreatic Disorders

Question 1

bile

Answer 1

A thick, viscous fluid secreted from the liver, stored in the gallbladder, and released into the duodenum when fatty foods enter the duodenum. It emulsifies fats in the intestine and forms compounds with fatty acids to facilitate their absorption

Question 2

transamination

Answer 2

Transfer of an amino group from one compound to another

Question 3

oxidative deamination

Answer 3

Removal of an amino group from an amino acid or other compound

Question 4

detoxification

Answer 4

The process of removing toxic substances or qualities. The liver is responsible for detoxification of substances, including drugs and alcohol, toxins, pollutants, chemicals, pesticides and herbicides, bioactive compounds, and biological poisons

Question 5

Kupffer cells

Answer 5

Specialized macrophages located in the sinusoids. Kupffer cells use their phagocytic properties to remove bacteria and debris from the blood

Question 6

hepatitis

Answer 6

A widespread inflammation of the liver and is caused by various hepatitis viruses

Question 7

icteric phase

Answer 7

The third phase of hepatitis. In this phase jaundice appears and the nonspecific symptoms worsen and weight loss, dysgeusia, and pruritus may develop

Question 8

jaundice

Answer 8

A yellowing of the skin, mucous membranes, and the eyes

Question 9

nonalcoholic fatty liver disease (NAFLD)

Answer 9

A spectrum of liver diseases ranging from steatosis to steatohepatitis and cirrhosis. It involves the accumulation of fat droplets in the hepatocytes and can lead to inflammation, fibrosis, cirrhosis, and even hepatocellular carcinoma

Question 10

nonalcoholic steatohepatitis (NASH)

Answer 10

An inflammatory condition associated with hepatocyte injury with or without fibrous tissue in the liver

Question 11

alcoholic liver disease

Answer 11

One of the most common liver diseases in the United States. Forty percent of deaths from cirrhosis are attributed to alcohol

Question 12

hepatic steatosis aka fatty liver

Answer 12

Fatty infiltration of the liver caused by a culmination of metabolic disturbances. Hepatic steatosis is reversible with abstinence from alcohol

Question 13

ascites

Answer 13

Abdominal fluid retention

Question 14

encephalopathy

Answer 14

Mental impairment

Question 15

portal hypertension

Answer 15

Elevated blood pressure in the portal venous system caused by the obstruction of blood flow through the liver

Question 16

primary biliary cirrhosis (PBC)

Answer 16

A chronic cholestatic disease caused by progressive destruction of small and intermediate-sized intrahepatic bile ducts

Question 17

cholestasis

Answer 17

A blockage of bile flow

Question 18

primary sclerosing cholangitis (PSC)

Answer 18

Characterized by fibrosing inflammation of segments of intra- and extrahepatic bile ducts. This progressive disease can be characterized by three syndromes including cholestasis with biliary cirrhosis, recurrent cholangitis, and cholangiocarcinoma.

Question 19

cholangitis

Answer 19

Inflammation of the bile ducts

Question 20

hepatic osteodystrophy

Answer 20

May occur from vitamin D and calcium malabsorption, resulting in secondary hyperparathyroidism, osteomalacia, or rickets

Question 21

hemochromatosis

Answer 21

An inherited disease of iron overload usually associated with the gene HFE. Patients with hereditary hemochromatosis absorb and store excessive iron from the gut in the liver heart, pancreas, joints, and endocrine organs

Question 22

Wilson’s disease

Answer 22

An autosomal-recessive disorder associated with impaired biliary copper excretion. Copper accumulates in various tissues, including the liver, brain, cornea, and kidneys

Question 23

Kayser-Fleischer rings

Answer 23

Greenish-yellow pigmented rings encircling the cornea just within the corneoscleral margin, formed by copper deposits

Question 24

hepatic encephalopathy

Answer 24

A clinical syndrome characterized by impaired mentation, neuromuscular disturbances, and altered consciousness

Question 25

fulminant liver disease

Answer 25

Defined by the absence of preexisting liver disease and the rapid development of hepatic encephalopathy within 2 to 8 weeks of the onset of illness

Question 26

varices

Answer 26

Abnormal enlarged veins often caused by portal hypertension

Question 27

cirrhosis

Answer 27

A build up of scar tissue and fibrosis of the liver, has many clinical manifestations

Question 28

portal hypertension

Answer 28

Increases collateral blood flow and can result in swollen veins in the gastrointestinal tract

Question 29

paracentesis

Answer 29

A procedure to drain fluid

Question 30

hepatic encephalopathy

Answer 30

A syndrome characterized by impaired mentation, neuromuscular disturbances, and altered consciousness

Question 31

hepatic failure

Answer 31

AKA liver failure. When the liver cannot work properly

Question 32

portal systemic encephalopathy

Answer 32

Results in neuromuscular and behavioral alterations

Question 33

branched-chain amino acids (BCAA)

Answer 33

Amino acids with branched chains. These include valine, leucine, and isoleucine

Question 34

aromatic amino acids (AAAs)

Answer 34

Amino acids with an aromatic structure. These include tryptophan, phenylalanine, and tyrosine

Question 35

fasting hypoglycemia

Answer 35

Low blood glucose

Question 36

steatorrhea

Answer 36

The presence of fat in the stool

Question 37

hepatorenal syndrome

Answer 37

Renal failure associated with severe liver disease without intrinsic kidney abnormalities

Question 38

dry body weight

Answer 38

Weight without fluid retention

Question 39

Wernicke encephalopathy

Answer 39

A neurological disease characterized by three main clinical symptoms: confusion, the inability to coordinate voluntary movement (ataxia) and eye (ocular) abnormalities

Question 40

cholestasis

Answer 40

A condition in which little or no bile is secreted or the flow of bile into the digestive tract is obstructed

Question 41

calculi

Answer 41

Gallstones

Question 42

cholelithiasis

Answer 42

The formation of gallstones

Question 43

choledocholithiasis

Answer 43

Develops when gallstones slip into the bile ducts, producing obstruction, pain, and cramps

Question 44

cholecystitis

Answer 44

Inflammation of the gallbladder. May be chronic or acute. Usually caused by gallstones obstructing the bile ducts, leading to a backup of bile

Question 45

secondary biliary cirrhosis

Answer 45

Bile backup resulting in jaundice and liver damage

Question 46

cholecystectomy

Answer 46

Surgical removal of the gallbladder, especially if the stones are numerous, large, or calcified

Question 47

postcholecystectomy syndrome

Answer 47

After cholecystectomy, patients may experience symptoms of gastritis secondary to duodenogastric reflux of bile acids

Question 48

cholangitis

Answer 48

Inflammation of the bile ducts

Question 49

pancreatitis

Answer 49

Inflammation of the pancreas and is characterized by edema, cellular exudate, and fat necrosis

Question 50

pancreaticoduodenectomy aka Whipple procedure

Answer 50

A surgical procedure often used for pancreatic carcinoma. Distal segment of the stomach, the first and second portions of the duodenum, the head of the pancreas, the common bile duct, and the gallbladder are removed.

Question 51

pancreatic islet autotransplantation

Answer 51

Performed after total pancreatectomy in patients with severe and chronic pancreatitis that cannot be managed by other treatments. Islets are extracted and purified from the pancreas, then they are infused through a catheter into the liver. The goal is to give the body enough healthy islets to make insulin