Consequences of Hepatobiliary disturbances

Question 1

Consequences of hepatobiliary disturbances

Answer 1

jaundice
malabsorption
disordered hepatic metabolism

Question 2

Yellowish discoloration of skin and deep tissues from high levels of bilirubin in the blood

Answer 2

jaundice

Question 3

Serum bilirubin levels when jaundice becomes evident

Answer 3

above 2-2.5

Question 4

Four major causes of jaundice

Answer 4

excessive destruction of RBCs
impaired uptake of bilirubin by the liver cells
decreased conjugation of bilirubin
obstruction of bile flow in the canaliculi of the hepatic lobules or intrahepatic or extrahepatic bile ducts

Question 5

Three categories of jaundice

Answer 5

prehepatic
intrahepatic
posthepatic

Question 6

Jaundice due to excessive hemolysis of RBCs

Answer 6

prehepatic jaundice

sickle cell anemia, thalassemia, glucose-6 phospate dehydrogenase deficiency are other causes

Question 7

Symptoms of prehepatic jaundice

Answer 7

mild jaundice
unconjugated bilirubin elevated
stools normal in color
no bilirubin in urine

Question 8

Jaundice due to dysfunction of the liver’s ability to conjugate bilirubin for elimination

Answer 8

Intrahepatic or hepatocellular jaundice

Question 9

Common causes of intrahepatic jaundice

Answer 9

hepatitis

cirrhosis

Question 10

Lack of enzymes required at birth causing impaired uptake and conjugation of bilirubin

Answer 10

neonatal jaundice

Question 11

What happens to conjugated and unconjugated bilirubin in intrahepatic jaundice?

Answer 11

both are elevated because all phases of bilirubin metabolism is interfered
urine is also dark and slight elevation ALP

Question 12

Jaundice due to obstructed bile flow through the bile ducts (from liver to intestine)

Answer 12

posthepatic or cholestatic jaundice

Question 13

Common causes of posthepatic jaundice

Answer 13

gallstones blocking common bile duct
pancreatitis
pancreatic cancer

Question 14

signs/symptoms of posthepatic jaundice

Answer 14

elevated conjugated bilirubin levels
stools clay colored because lack of bilirubin in bile
dark urine
ALP markedly elevated
pruritis preceding jaundice

Question 15

Labs used to assess injury to liver cells

Answer 15

Serum liver enzymes
ALT (liver specific)
AST

Question 16

Labs that provide information related to the liver’s synthetic cpacity

Answer 16

Serum albumin

Blood clotting factors (PT)

Question 17

Labs used as measures of hepatic excretory function

Answer 17

Serum bilirubin
Serum GGT
Alkaline phosphatase (ALP)

Question 18

Why liver dysfunction may be associated with coagulation problems?

Answer 18

Decrease absorption of vitamin K which is important for synthesis of clotting factors

Question 19

What maybe malabsorbed r/t liver dysfunction?

Answer 19

fats (r/t decrease bile and phospholipids)

fat soluble vitamins: A,D,E,K

Question 20

Evidence of disordered hepatic metabolism from liver dysfunction

Answer 20

Fluid imbalances-edema-from decrease albumin
Encephalophathy or coma-build up of ammonia
Gynecomastaisa-decrease biotransformation and failure to metabolize estrogens

Question 21

Involves converting lipid-soluble substances like steroid hormones into more water-soluble ones for kidney excretion

Answer 21

biotransformation

Question 22

Pathologic condition of impaired bile formation and bile flow leading to accumulation of bile pigment in liver

Answer 22

cholestasis

Question 23

Most common presenting symptom of persons with cholestasis

Answer 23

pruritus