Dr. Wilson Liver Lecture

Question 1

hepatic encephalopathy is an example of a _________ problem

Answer 1

biochemical

Question 2

________ problems are usually due to hydrostatic pressure

Answer 2

mechanical

Question 3

what is steotosis?

Answer 3

fat cells that displace normal cells

Question 4

the occurrence of confusion, altered level of consciousness, and coma as a result of liver failure

Answer 4

hepatic encephalopathy

Question 5

2 intrahepatic and extrahepatic vasodilators in portal HTN

Answer 5

NO, carbon monoxide

Question 6

increase in dilation of abdominal vessels

Answer 6

portal HTN gastropathy (PHG)

Question 7

3 extrahepatic vasodilators

Answer 7

1. glucagon
2. bile acids
3. prostaglandins

Question 8

2 mechanical treatments of portal HTN

Answer 8

endoscopic therapy

TIPS (shunt within liver)

Question 9

2 pharmacologic treamtents of portal HTN

Answer 9

beta blockers

somatostatin derivatives

Question 10

3 things to avoid if you have portal HTN

Answer 10

1. salt
2. excessive fluids
3. aggressive exss

Question 11

what is a protein that is concentrated in the fluid build up in ascites?

Answer 11

albumin

Question 12

two steps to hepatorenal syndrome

Answer 12

1. arterial under filling

2. renal constriction

Question 13

type 1 hepatorenal syndrome is an ______________ situation

Answer 13

emergent

Question 14

how to cure HR syndrome?

Answer 14

liver transplant

Question 15

bilirubin

Answer 15

breakdown of heme

Question 16

jaundice is a disorder of __________

Answer 16

metabolism/excretion

Question 17

what causes the cognitive symptoms in hepatic encephalopathy?

Answer 17

ammonia - liver can’t break down and it crosses the blood-brain barrier

Question 18

we want to restrict a HE pt’s ______

Answer 18

protein

Question 19

normal liver size

Answer 19

1.5 kg

Question 20

won’t take a liver for transplant if it has more than ______ percent fat

Answer 20

30

Question 21

HVPG

Answer 21

hepatic venous pressure gradient

Question 22

if HVPG is greater than _____, portal HTN is present

Answer 22

15 mmhg

Question 23

what happens to the vessels in the liver when there is increased portal pressure?

Answer 23

they constrict

Question 24

normal pressure in liver

Answer 24

8 mmhg

Question 25

for a pt with ascites, they should not consume more than _______ mg of Na/day

Answer 25

300-500

Question 26

increased pressure in the liver causes (2)

Answer 26

DILATION IN VESSELS OUTSIDE LIVER

1. engorged spleen
2. esophagus varices

Question 27

beta blockers help to ____________

Answer 27

vasodilate

Question 28

hydrothorax

Answer 28

water in chest from ascites

Question 29

treatment of _______ and _______ is very similar

Answer 29

ascites and edema

Question 30

what position increases kidney function?

Answer 30

supine

Question 31

which type of hepatorenal syndrome patients can get dialysis?

Answer 31

1

Question 32

bilirubin leads to…

Answer 32

cirrhosis

Question 33

when is bilirubin clinically apparent?

Answer 33

serum is about 3 mg/dl