Chapter 43 ppnts and highlights

Question 1

Risk factors for dumping syndrome?

Answer 1

-obesity,
-Hx gastric bypass surgery
-obesity

Question 2

Hepatotoxic Medications?

Answer 2

-Acetominophine
-Ketoconazole
-NSAIDS
-TB drugs (Isoniazid)
-Valproic acid

Question 3

Palpating a hard liver is an indication of liver ____

Answer 3

cirrhosis

Question 4

Palpating a soft but tender liver is an indication of __

Answer 4

hepatitis

Question 5

What would a liver function study (labs) show if a patient is experiencing liver dysfunction?

Answer 5

-elevated AST/ALT, LDH
-serum proteins would be nml to low
-urine: may be orange in appearance, because of elevated serum and urine bilirubin
-elevated PT/INR due to liver not storing Vitamin K properly
-increased alkaline phosphatase
-increased ammonia
-increased lipids

Question 6

What enzyme is most related to liver function?

Answer 6

-ALT

Question 7

What labs are related to gall bladder and would be elevated in the case of dysfunction?

Answer 7

-GGT, GGTP

Question 8

Name a few gerontologic changes and considerations with hepatic function.

Answer 8

Atypical clinical presentation of biliary disease Decreases in the following:
*Clearance of hepatitis B surface antigen
*Drug metabolism and clearance capabilities *Intestinal and portal vein blood flow *Gallbladder contraction after a meal
*Rate of replacement and or repair of liver cells after injury
*Size and weight of the liver, particularly in women
*Increased prevalence of gallstones due to the increase in cholesterol secretion in bile
*More rapid progression of hepatitis C infection and lower response rate to therapy
*More severe complications of biliary tract disease