Exam 1 thera hepatic

Question 1

Non specific symptoms

Answer 1

Anorexia
Nausea and vomiting
Fatigue
Mental confusion

Question 2

Late disease symptoms

Answer 2

Jaudince
Dark urine
ascites
peripheral edema

Question 3

Hepatocellular injury

Answer 3

Injury to the liver cells

Question 4

Cholestatic injury

Answer 4

Damage to the billiary tract

Question 5

Hepatobiliary

Answer 5

damage to the hepatocytes and the biliary tract

Question 6

Aminotransferases ALT and AST
represent what?
What are they?

Answer 6

Hepatocellular injury
They are intracellular enzyme inside of the cell

Question 7

Aminotransferases ALT and AST reference value?

Answer 7

<35 units/L

Question 8

AST is in the

Answer 8

Liver, muscle, brain, kidney and red cells

Question 9

ALT is in the

Answer 9

Mainly in the liver, muscled and kidney

Question 10

Ischemic injury

Answer 10

Less blood flow to the liver

Question 11

Liver cirrhosis Compensated cirrhosis

Answer 11

The liver has some function
The liver can metabolize at some extent

Question 12

Liver cirrhosis decompensated cirrhosis

Answer 12

The liver loss the ability to metabolize
-Can see ALT and AST in normal level because it needs cell to cause the damage and the cell that are damage are replace by scar tissue

Question 13

AST / ALT and alcoholism

Answer 13

-AST to ALT ratio is greater than 2
-When the pt is chronic alcoholic user see elevated AST
-because the AST is in the mitochondria and when the mitochondria is damage is going to release the AST
-Also because the pt has poor diet and doesn’t have Vitamin B6 that is needed for ALT activit

Question 14

Lactate Dehydrogenase LDH what does it represents?

Answer 14

Hepatocellular injury
-Is in the liver, RBC, kidney, heart, skeletal muscle, brain and lungs
-It shows a injury but need isoenzymes to determine where the injury is at

Question 15

Alkaline Phosphatase ALP what does it represents?

Answer 15

Cholestatic injury
-It shows injury to the liver and to the bone

Question 16

What does it means to have high ALP?

Answer 16

It indicates that the billie cannot be excreted because the biliary tract is occluted and the billie will get back up
As a result it stimulated the release of ALP
Pregnant woman and childrens have high ALP

Question 17

Gamma-Glutamyl transferase GGT represents what?

Answer 17

Cholestatic injury
-Is mainly in the liver, biliary tract and pancreas
If high GGT represents chronic alcohol use
-Can increase by enzyme inducers

Question 18

Bilirubin is made how?

Answer 18

Breakdown of RBC the bilirubin is going to be conjugated to albumin but when it gets to the liver is not going to be conjugated by albumin it will get conjugated by the liver

Question 19

Bilirubin reference number

Answer 19

1

Question 20

Pt with hepatitis A shows high what?

Answer 20

High AST, High ALT and high bilirubin

Question 21

Hyperbilirubinemia

Answer 21

High levels of bilirubin greater than 2 will show symptoms of jaundice and ictus (itchy)

Question 22

Conjugated bilirubin = direct

Conjugated bilirubin reference value

Answer 22

0-0.2mg/dl

Question 23

If conjugated bilirubin is high what does it means?

Answer 23

Indicates there is a liver injury
Get dark urine because the conjugated bilirubin is not being excreted because of hepatobiliary injury and the conjugated bilirubin will go throw blood circulation and then back to urine

Question 24

Unconjugated bilirubin reference value?

Answer 24

0.2-0.9

Question 25

What does high unconjugated bilirubin reflects?

Answer 25

It shows that the pt has anemia, receives blood transfusion or also a genetic disorder

Question 26

Pt with Hepatitis A has high what?

Answer 26

High ALT
High AST
High bilirubin

Question 27

Albumin reference

Answer 27

3.5-5

Question 28

Low Albumin

Answer 28

-It represents the liver function
-Because albumin is made by the liver so if the pt has low albumin the liver is not working well
-Also if the pt has low protein intake the albumin will be low
-Over hydration
-If low albumin the fluids start leaking so get edema
-Nephrotic syndrome- edema, weight gain and protein in urine

Question 29

High albumin

Answer 29

Dehydration and steroids

Question 30

Prothrombim time (PT)

Answer 30

-It shows the liver function because factor VII is made by the liver
-Is how fast blood clots can form in a result of a injury
-If high PT –>increases the risk of bleeding and 80% of the liver is not working

Question 31

INR reference value

Answer 31

1

if high INR pt is bleeding

Question 32

Pt on warfarin INR

Answer 32

2.5-3.5

Question 33

Ammonia

Answer 33

-Ammonia is metabolized by the liver and excreted by the kidneys
-If high ammonia indicates the liver is not working well and is not metabolizing properly

Question 34

Ammonia reference value

Answer 34

40-80mcg