GIT EMERGENCIES Flashcards
this is also known as hepatic failure
liver cirrhosis
a condition in which the liver fails to fulfill its
functions or is unable to meet the demands placed upon it
liver cirrhosis
s/sx in liver cirrhosis related to glycogen storage and production
hypoglycemia
s/sx in liver cirrhosis related to protein synthesis
edema/ascites
why does low protein manifests as edema?
because albumin exerts OP that pulls the water in to prevent leakage of fluid outside the cell
most abundant protein in body
albumin
s/sx in liver cirrhosis related to synthesis of globulins
immunocompromised
why does low globulin synthesis contributes to px w/ liver cirrhosis to be immunocompromised?
because globulin produces antibodies
s/sx in liver cirrhosis related to synthesis of CF
bleeding tendencies
s/sx in liver cirrhosis related to bile secretion
jaundice, pruritus
why is bile increased in liver cirrhosis?
because bile can’t flow outside properly due to scarring of the liver leading to buildup in the liver
s/sx in liver cirrhosis related to conversion of ammonia to urea
hepatic encephalopathy
hallmark of hepatic encephalopathy
asterixis
what is asterixis?
flapping tremor of the hand
why is jaundice present in liver cirrhosis?
there is buildup of bilirubin in the liver
why is pruritus present in liver cirrhosis?
there is buildup of bile salts in the liver
components of bile
bilirubin
bile salts
water
cholesterol
s/sx in liver cirrhosis related to storage of vitamins and minerals
low vit. and minerals/avitaminemia
s/sx in liver cirrhosis related to metabolism of estrogen
gynecomastia
testes atrophy
hair loss
causes of ascites in liver failure
low OP
high HP - due to portal HTN
why is there easy bleeding/bruising in liver cirrhosis?
no synthesis of CF
esophageal varices is due to
portal HTN
dilated submucosal distal esophageal veins connecting the portal and systemic circulations
esophageal varices
complication of esophageal varices
bleeding - BV are very fragile and thin
why does neovascularization happens?
to redirect congested blood in the liver
spider angioma is due to
neovascularization
fragile, thin-walled, distended esophageal veins that become irritated and rupture
bleeding esophageal varices
why does blood in upper GIT becomes black when pooped out?
blood is being digested and contact with HCL acid makes it black
first line treatment for esophageal varices
vasopressin
why is vasopressin the first line treatment for esophageal varices?
it makes the BV constrict hence stopping the bleeding
2 balloon tamponades to prevent rupture of esophageal varices
sengstaken blakemore tube
minnesota tubes
this is essential in the bedside of pt w/ balloon tamponade in case of respiratory emergencies
scissor
first line to correct bleeding
IV fluid replacement
blood transfusion will only be allowed in esophageal varices if pt has hemoglobin of?
7 g/dl
prophylactic antibiotic for esophageal varices
iv ceftriaxone
oral norfloxacin
why do we administer beta blockers for pt w/ esophageal varices?
to correct portal hypertension
NSBB that is increasingly used that has a greater portal pressure reducing effect than propranolol
carvedilol
why is lactulose being given to patients with hepatic encephalopathy?
lactulose binds with ammonia to facilitate excretion
why is neomycin being given to patients with hepatic encephalopathy?
to kill the bacteria in the colon that acts up on protein to convert it to ammonia
end-stage of liver cirrhosis
hepatic encephalopathy
