Disorders of the liver Flashcards
Question 1 of 9
Can you select the correct characteristics for each of the following disorders? Drag and drop the characteristics that apply to the disorder to the box.
Cirrhosis and Liver Failure Elevated triglycerides and cholesterol Liver scarring Develops from hepatitis A infection Silent, gradual disease Portal hypertension Kayser-Fleischer rings of the cornea Widespread decrease in liver function parameters
Liver scarring
Wide spread decrease in liver function parameters
Portal hypertension
Silent, gradual disease
Cirrhosis is late stage fibrotic scarring of the liver. The scarring manifests as a result of damage to the liver. Liver function becomes impaired, as indicated by laboratory results. The disease is not rapid in onset and does not present with acute symptoms in the early stages. Portal hypertension often develops in response to cirrhosis, as the veins become blocked by the damaged liver. Hepatitis C, not hepatitis A, is more likely to cause cirrhosis.
Question 2 of 9
Can you select the correct characteristics for each of the following disorders? Drag and drop the characteristics that apply to the disorder to the box.
Hepatitis B Positive HBcAg Positive HBc Ig High urinary copper Transmitted by fecal-oral route Range of symptoms Vaccine available Dormant subclinical infection
Positive HBcAg
Positive HBc Ig
Vaccine available
Range of symptoms
Diagnosis of hepatitis B results from positive serology results for the antigen, including HBcAg, as well hepatitis B antibodies, HBc Ig. Hepatitis B presents with a range of symptoms. It is transmitted by blood and body fluids, not the fecal-oral route. A vaccine against hepatitis B is available.
Question 3 of 9
Can you select the correct characteristics for each of the following disorders? Drag and drop the characteristics that apply to the disorder to the box.
Wilson’s disease?
Masklike facies Low ceruloplasmin levels Kayser-Fleischer rings of the cornea Positive HCV RNA assay Elevated unconjugated bilirubin Copper accumulation High urinary copper
Masklike facies Low ceruloplasmin levels Kayser-Fleischer rings of the cornea Copper accumulation High urinary copper
Wilson’s disease is a rare genetic disorder that causes copper to accumulate in some tissues. Copper may begin to be excreted in the urine at a high level. Golden, brown discoloring of the eyes (Kayser-Fleischer rings) may be apparent and result from copper deposition. Ceruloplasmin levels are low, as copper incorporation onto this transport protein is abnormal. Neurological manifestations may develop in Wilson’s disease. One such example is masklike facies, in which the facial expression is flat, almost masklike.
Question 4 of 9
Can you select the correct characteristics for each of the following disorders? Drag and drop the characteristics that apply to the disorder to the box.
Alcoholic Liver Disease?
AST and ALT 2-7 times higher than normal Hyperpigmentation Elevated triglycerides and cholesterol Steatosis Elevated HBsAg Portal hypertension Hepatic encephalopathy
Elevated triglycerides and cholesterol
Steatosis
AST and ALT 2-7 times higher than normal
Hepatic encephalopathy
Alcoholic liver disease develops as a result of excessive alcohol consumption. As the liver processes alcohol, excessive consumption may lead to damage to the liver cells. Liver enzymes, such as AST and ALT may elevate in the serum, indicating damage to hepatocytes. Liver processing of lipids may be impaired resulting in elevated triglycerides and cholesterol. Steatosis, the accumulation of fat in liver cells, may also occur. With severe damage, the liver is no longer able to detoxify the blood. For example, ammonia levels may increase to the point that damage to the nervous system, including the brain, results. This is known as hepatic encephalopathy.
Question 5 of 9
Can you select the correct characteristics for each of the following disorders? Drag and drop the characteristics that apply to the disorder to the box.
Hepatitis C Positive HCV RNA assay Positive HBsAg Anti-HCV antibody Genotyping should be completed Fecal-oral transmission Vaccine is available Low ceruloplasmin Dormant infection; asymptomatic initially
Genotyping should be completed
Dormant infection; asymptomatic initially
Anti-HCV antibody
Positive HCV RNA assay
Hepatitis C is sometimes referred to as a “silent infection,” as few signs and symptoms may be present initially. Diagnosis is based on positive RNA assay results for the virus, as well as positive antibody results. Several genotypes exist for hepatitis C, and there is no vaccine currently available.
Question 6 of 9
Can you select the correct characteristics for each of the following disorders? Drag and drop the characteristics that apply to the disorder to the box.
Biliary Cirrhosis Elevated serum ferritin Medical emergency Increased IgM Increased ESR Xanthelasma Hepatic encephalopath Antimicrobial antibodies (AMAs)
Increased ESR
Xanthelasma
Antimicrobial antibodies (AMAs)
Increased IgM
Destruction of the bile ducts occurs in biliary cirrhosis. The primary form of biliary cirrhosis is considered an autoimmune disease. Thus, inflammatory mediators, such as ESR, and antibodies, such as IgM and AMAs, are elevated. Xanthelasma, which are yellow patches of cholesterol that develop near the eyes, may be present.
Question 7 of 9
Can you select the correct characteristics for each of the following disorders? Drag and drop the characteristics that apply to the disorder to the box.
Hepatitis A Fecal-oral transmission Anti-HAV antibodies Six different genotypes Hepatomegaly Antimicrobial antibodies (AMAs) RUQ tenderness
Fecal-ORAL TRANSMISSION
Anti-HAV antibodies
Hepatomegaly
RUQ tenderness
Hepatitis A is a viral form of hepatitis transmitted through the fecal-oral route. It can lead to typical signs of liver problems, including enlargement of the liver and tenderness in the right upper quadrant area. Infection with hepatitis A results in the formation of anti-HAV antibodies, which can be detected with a blood test.
Question 8 of 9
Can you select the correct characteristics for each of the following disorders? Drag and drop the characteristics that apply to the disorder to the box.
Crigler-Najjar Syndrome Genetic defect affecting bilirubin processing Liver scarring Steatosis RUQ tenderness Elevated unconjugated bilirubin Elevated total bilirubin Positive HCV RNA assay
Genetic defect affecting bilirubin processing
Elevated unconjugated bilirubin
Elevated total bilirubin
Crigler-Najjar syndrome is a rare genetic disorder in which the breakdown of bilirubin is compromised. Bilirubin builds up in the body leading to elevated levels of unconjugated bilirubin. Nonhemolytic jaundice develops.
Question 9 of 9
Can you select the correct characteristics for each of the following disorders? Drag and drop the characteristics that apply to the disorder to the box.
Hemochromatosis Hereditary forms Low ceruloplasmin Elevated serum iron Increased IgM Elevated serum ferritin Primary and secondary forms Silent, gradual disease
Hereditary forms
Elevated serum iron
Elevated serum ferritin
Primary and secondary forms
Hemochromatosis develops when too much iron is present in the blood. Most frequently, this is due to an inheritable genetic defect. The elevation in iron causes higher than normal ferritin and transferrin levels. Ceruloplasmin levels are related to copper levels, thus are not affected by hemochromatosis.
Question 1 of 5
The physical examination findings of a patient who has liver disease show dilated veins over the umbilical area of the abdomen. What is this finding called?
Caput medusa
Jaundice
Ascites
Icterus
Caput medusa
Which of the following may cause hyperbilirubinemia? Select all that apply.
Bile duct obstruction Increased red blood cell breakdown Injury to hepatocytes Lack of albumin synthesis Lack of prothrombin synthesis
Bile duct obstruction
Increased red blood cell breakdown
Injury to hepatocytes
Question 3 of 5
A nurse is caring for a patient diagnosed with portal hypertension. What development should the nurse be concerned about?
Increased risk for esophageal varices
Decreased detoxification of the blood
Increased blood clotting time
Decreased bile production
Increased risk for esophageal varices
Question 4 of 5
Which of the following are common signs of liver disorders? Select all that apply.
Hepatomegaly Jaundice Increased liver enzyme levels in blood Skin rash Fever
Jaundice
Increased liver enzyme levels in blood
Hepatomegaly
Question 5 of 5
Which form of hepatitis is primarily transmitted through the blood, often through IV drug use?
Hepatitis C
Hepatitis A
Hepatitis D
Hepatitis B
Hepatitis C
