cirrhosis + cholecystitis

Question 1

What is cirrhosis?

Answer 1

End-stage liver disease with extensive degeneration, fibrosis, and regenerative nodules due to liver’s attempt to repair itself.

Question 2

What are common causes of cirrhosis?

Answer 2

Chronic HCV infection, NASH, alcohol-induced liver disease, malnutrition, malabsorption, extreme dieting, obesity.

Question 3

What is cardiac cirrhosis?

Answer 3

Liver problems from long-standing, severe right-sided heart failure, leading to hepatic venous congestion, liver damage, necrosis, and fibrosis.

Question 4

How does cirrhosis affect liver function?

Answer 4

Poor liver regeneration, hypoxia, and malnutrition lead to decreased liver function.

Question 5

What are early symptoms of cirrhosis?

Answer 5

Fatigue, enlarged liver.

Question 6

What are late symptoms of cirrhosis?

Answer 6

Jaundice, spider angiomas, palmar erythema, thrombocytopenia, leukopenia, anemia, coagulation issues, endocrine dysfunction, peripheral neuropathy (in alcohol-related cirrhosis).

Question 7

What causes jaundice in cirrhosis?

Answer 7

The liver’s inability to conjugate and excrete bilirubin into the intestines.

Question 8

What are the skin manifestations of cirrhosis?

Answer 8

Spider angiomas (dilated blood vessels on face/upper body) and palmar erythema (red palms that blanch with pressure).

Question 9

Why do cirrhosis patients develop endocrine problems?

Answer 9

Damaged liver cannot metabolize steroid hormones, leading to increased estrogen levels.

Question 10

What are endocrine-related symptoms in men?

Answer 10

Gynecomastia, testicular atrophy, loss of body hair, impotence, loss of libido.

Question 11

What are endocrine-related symptoms in women?

Answer 11

Amenorrhea (younger women), vaginal bleeding (older women).

Question 12

What electrolyte imbalance occurs in cirrhosis?

Answer 12

Hyperaldosteronism → sodium & water retention, potassium loss.

Question 13

What are key nursing interventions for cirrhosis?

Answer 13

Rest, B-complex vitamins, avoiding alcohol, minimizing NSAIDs, aspirin, and acetaminophen.

Question 14

What dietary restriction is recommended for ascites?

Answer 14

Low-sodium diet.

Question 15

What treatments are used for ascites?

Answer 15

Diuretics, paracentesis (if severe and unresponsive to diuretics).

Question 16

Why should cirrhosis patients avoid hepatotoxic drugs?

Answer 16

The diseased liver cannot effectively metabolize these drugs.

Question 17

Why should patients with esophageal or gastric varices avoid NSAIDs?

Answer 17

To prevent bleeding.

Question 18

What actions can increase variceal hemorrhage risk?

Answer 18

Straining at stool, coughing, sneezing, retching, and vomiting.

Question 19

What medical treatments are used for esophageal and gastric varices?

Answer 19

Endoscopic band ligation, sclerotherapy, balloon tamponade, TIPS (peritoneovenous shunt).

Question 20

What is the gold standard for diagnosing cirrhosis?

Answer 20

Liver biopsy (percutaneous needle).

Question 21

What are key diagnostic tests for cirrhosis?

Answer 21

Liver function tests, serum albumin, electrolytes, PT time, CBC, liver ultrasound (FibroScan), endoscopy, CT scan, MRI.

Question 22

How do liver enzyme levels change in cirrhosis?

Answer 22

Initially high (due to inflammation), but may normalize in end-stage disease due to hepatocyte death.

Question 23

What medications are prescribed for cirrhosis?

Answer 23

Nonselective β-blockers (propranolol), octreotide, vasopressin.

Question 24

What drug therapies are used for hepatic encephalopathy?

Answer 24

Rifaximin (antibiotic), lactulose.

Question 25

What is cholecystitis?

Answer 25

Inflammation of the gallbladder wall, usually due to gallstones.

Question 26

Who is more commonly affected by cholecystitis?

Answer 26

Women.

Question 27

What is acalculous cholecystitis?

Answer 27

Cholecystitis without gallstones, often in critically ill or immobile patients.

Question 28

What conditions are associated with acalculous cholecystitis?

Answer 28

Prolonged immobility, fasting, prolonged parenteral nutrition (PN), diabetes, bile stasis.

Question 29

What is biliary colic?

Answer 29

Severe pain due to gallstone obstruction or movement through ducts, causing spasms.

Question 30

What symptoms are associated with biliary colic?

Answer 30

Excruciating pain, tachycardia, diaphoresis, prostration, RUQ tenderness.

Question 31

When does pain typically occur in cholecystitis?

Answer 31

3-6 hours after a high-fat meal or when lying down.

Question 32

What happens if the common bile duct is obstructed?

Answer 32

No bilirubin reaches the intestines, leading to dark amber or brown urine.

Question 33

What are general symptoms of cholecystitis?

Answer 33

Indigestion, moderate to severe pain, fever, chills, jaundice.

Question 34

Where can pain be referred in cholecystitis?

Answer 34

Right shoulder and scapula.

Question 35

What are additional symptoms of cholecystitis?

Answer 35

Nausea, vomiting, restlessness, diaphoresis, RUQ/epigastric tenderness, abdominal rigidity.

Question 36

What are key nursing interventions for conservative therapy for cholecystitis?

Answer 36

IV fluids, NPO with NG tube, low-fat diet progression, antiemetics, analgesics, fat-soluble vitamins, anticholinergics, antibiotics (if infection is present).

Question 37

What are medical procedures for cholecystitis?

Answer 37

Transhepatic biliary catheter, ERCP with sphincterotomy, extracorporeal shock-wave lithotripsy (ESWL).

Question 38

What is the surgical treatment for cholecystitis?

Answer 38

Laparoscopic or open cholecystectomy.

Question 39

What is extracorporeal shock-wave lithotripsy (ESWL)?

Answer 39

A non-invasive treatment used when endoscopic methods cannot remove gallstones.

Question 40

What diagnostic tests are used for cholecystitis?

Answer 40

Ultrasound, ERCP (to visualize gallbladder, cystic duct, hepatic duct, and bile duct).

Question 41

What lab findings are common in cholecystitis?

Answer 41

Increased WBC count (inflammation), elevated ALT, AST, alkaline phosphatase, and bilirubin levels.

Question 42

What medications are prescribed for cholecystitis?

Answer 42

Analgesics, anticholinergics, fat-soluble vitamins (A, D, E, K), bile salts, morphine (pain management).