Chapter 28: Medical Nutrition Therapy for Hepatobiliary and Pancreatic Disorders Flashcards
bile
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
transamination
Transfer of an amino group from one compound to another
oxidative deamination
Removal of an amino group from an amino acid or other compound
detoxification
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
Kupffer cells
Specialized macrophages located in the sinusoids. Kupffer cells use their phagocytic properties to remove bacteria and debris from the blood
hepatitis
A widespread inflammation of the liver and is caused by various hepatitis viruses
icteric phase
The third phase of hepatitis. In this phase jaundice appears and the nonspecific symptoms worsen and weight loss, dysgeusia, and pruritus may develop
jaundice
A yellowing of the skin, mucous membranes, and the eyes
nonalcoholic fatty liver disease (NAFLD)
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
nonalcoholic steatohepatitis (NASH)
An inflammatory condition associated with hepatocyte injury with or without fibrous tissue in the liver
alcoholic liver disease
One of the most common liver diseases in the United States. Forty percent of deaths from cirrhosis are attributed to alcohol
hepatic steatosis aka fatty liver
Fatty infiltration of the liver caused by a culmination of metabolic disturbances. Hepatic steatosis is reversible with abstinence from alcohol
ascites
Abdominal fluid retention
encephalopathy
Mental impairment
portal hypertension
Elevated blood pressure in the portal venous system caused by the obstruction of blood flow through the liver
primary biliary cirrhosis (PBC)
A chronic cholestatic disease caused by progressive destruction of small and intermediate-sized intrahepatic bile ducts
cholestasis
A blockage of bile flow
primary sclerosing cholangitis (PSC)
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.
cholangitis
Inflammation of the bile ducts
hepatic osteodystrophy
May occur from vitamin D and calcium malabsorption, resulting in secondary hyperparathyroidism, osteomalacia, or rickets
hemochromatosis
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
Wilson’s disease
An autosomal-recessive disorder associated with impaired biliary copper excretion. Copper accumulates in various tissues, including the liver, brain, cornea, and kidneys
Kayser-Fleischer rings
Greenish-yellow pigmented rings encircling the cornea just within the corneoscleral margin, formed by copper deposits
hepatic encephalopathy
A clinical syndrome characterized by impaired mentation, neuromuscular disturbances, and altered consciousness
fulminant liver disease
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
varices
Abnormal enlarged veins often caused by portal hypertension
cirrhosis
A build up of scar tissue and fibrosis of the liver, has many clinical manifestations
portal hypertension
Increases collateral blood flow and can result in swollen veins in the gastrointestinal tract
paracentesis
A procedure to drain fluid
hepatic encephalopathy
A syndrome characterized by impaired mentation, neuromuscular disturbances, and altered consciousness
hepatic failure
AKA liver failure. When the liver cannot work properly
portal systemic encephalopathy
Results in neuromuscular and behavioral alterations
branched-chain amino acids (BCAA)
Amino acids with branched chains. These include valine, leucine, and isoleucine
aromatic amino acids (AAAs)
Amino acids with an aromatic structure. These include tryptophan, phenylalanine, and tyrosine
fasting hypoglycemia
Low blood glucose
steatorrhea
The presence of fat in the stool
hepatorenal syndrome
Renal failure associated with severe liver disease without intrinsic kidney abnormalities
dry body weight
Weight without fluid retention
Wernicke encephalopathy
A neurological disease characterized by three main clinical symptoms: confusion, the inability to coordinate voluntary movement (ataxia) and eye (ocular) abnormalities
cholestasis
A condition in which little or no bile is secreted or the flow of bile into the digestive tract is obstructed
calculi
Gallstones
cholelithiasis
The formation of gallstones
choledocholithiasis
Develops when gallstones slip into the bile ducts, producing obstruction, pain, and cramps
cholecystitis
Inflammation of the gallbladder. May be chronic or acute. Usually caused by gallstones obstructing the bile ducts, leading to a backup of bile
secondary biliary cirrhosis
Bile backup resulting in jaundice and liver damage
cholecystectomy
Surgical removal of the gallbladder, especially if the stones are numerous, large, or calcified
postcholecystectomy syndrome
After cholecystectomy, patients may experience symptoms of gastritis secondary to duodenogastric reflux of bile acids
cholangitis
Inflammation of the bile ducts
pancreatitis
Inflammation of the pancreas and is characterized by edema, cellular exudate, and fat necrosis
pancreaticoduodenectomy aka Whipple procedure
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.
pancreatic islet autotransplantation
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
