Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Starred Summer 2015 > Hepatic > Flashcards

Hepatic Flashcards

1
Q

What is the portal triad?

A

Hepatic artery, portal vein & bile duct

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What is the portal triad?

A

Hepatic artery, portal vein & bile duct

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Albumin level indicative of liver failure?

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Pentothal dose with liver failure

A

Reduced

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Acute liver disease & PT

A

> 14

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Steps involved in coagulation?

A

Adhesion of platelets to vascular wall (requires Factor VIII:vWF), activation of platelets (requires thrombin - IIa), aggregation of platelets (requires ADP & TXA2), & production of fibrin (requires extrinsic, intrinsic & final common pathway)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What produces VIII:vWF

A

Endothelial cells

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Cryoprecipitate contains what factors?

A

VIII, I & XIII - harvested from FFP

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What medications render COX nonfunctional?

A

NSAIDS/ASA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What medications prevent ADP induced platelet aggregation?

A

Ticlid, PLAVIX, integrilin, reapro, aggrastat

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What coagulation factors are not made in the liver?

A

III (tissue factor), IV (calcium), & VIII:vWF

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What factors are vitamin k dependent?

A

2, 7, 9 & 10

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What is platelet dysfunction from with liver disease?

A

Elevated pressure from portal hypertension sequesters platelets in spleen rendering them inactive & elevated fibrin degradation products

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What is platelet dysfunction from with liver disease?

A

Elevated pressure from portal hypertension sequesters platelets in spleen rendering them inactive & elevated fibrin degredation products

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Hepatic blood flow

A

Liver receives 25% of cardiac output – hepatic artery supplies 25-30% of blood & 45-50% of oxygen, portal vein supplies 70-75% of blood & 50-55% of oxygen

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Pentothal dose with liver failure

A

Reduced

17
Q

Acute liver disease & PT

A

> 14

18
Q

Steps involved in coagulation?

A

Adhesion of platelets to vascular wall (requires Factor VIII:vWF), activation of platelets (requires thrombin - IIa), aggregation of platelets (requires ADP & TXA2), & production of fibrin (requires extrinsic, intrinsic & final common pathway)

19
Q

What produces VIII:vWF

A

Endothelial cells

20
Q

Cryoprecipitate contains what factors?

A

VIII, I & XIII - harvested from FFP

21
Q

Post-hepatic dysfunction tests

A

High bili & increased alk phos – bile duct obstruction

22
Q

What medications prevent ADP induced platelet aggregation?

A

Ticlid, PLAVIX, integrilin, reapro, aggrastat

23
Q

Cholestatic Disease

A

Gall bladder disease - gall stone pancreatitis, rarely progresses to MODS

24
Q

What factors are vitamin k dependent?

A

2, 7, 9 & 10

25
Q

Coagulation cascade

A

Extrinsic: 3&7 (PT/INR), Intrinsic: VIII, IX, XI, XII (PTT), Common: X, V, II, I, XIII

26
Q

What is platelet dysfunction from with liver disease?

A

Elevated pressure from portal hypertension sequesters platelets in spleen rendering them inactive & elevated fibrin degredation products

27
Q

Drug metabolism & hepatic disease

A

Inability to metabolize drugs from decreased blood flow and inactivation of P450 increases half life, decreased cholinesterase will prolong succ, mivacurium & ester locals,

28
Q

Hepatic blood flow

A

Liver receives 25% of cardiac output – hepatic artery supplies 25-30% of blood & 45-50% of oxygen, portal vein supplies 70-75% of blood & 50-55% of oxygen

29
Q

Venous system of liver depends on what?

A

Cardiac output - flow is pressure dependent

30
Q

Reciprocal flow of hepatic system

A

If venous system decreases flow, arterial system can compensate, volatiles may decrease this & result in ischemia

31
Q

Things in anesthesia that may effect hepatic blood flow

A

Positive pressure ventilation decreases flow by increasing intrathoracic pressure, alpha stimulation causes constriction, regional >T10 decreases perfusion pressure

32
Q

Pre-Hepatic dysfunction tests

A

Bilirubin- elevated from hemolysis, reabsorption of hematoma, PRBC admin & surgery

33
Q

Intra-hepatic dysfunction tests

A

Reflects direct hepatocellular damage, results of toxic effects - aminotransferase spills into blood stream & AST/ALT will be elevated (though these can also be indicative of other organ function), use other tests with

34
Q

Post-hepatic dysfunction tests

A

High bili & increased alk phos – bile duct obstruction

35
Q

Parenchymal liver disease

A

Results in MODS, varices, etc (high pressure)- cirrhosis, will have high CO, low SVR, decreased FRC & renal perfusion, e-lyte issues, ascites, coagulopathies

36
Q

Cholestatic Disease

A

Gall bladder disease - gall stone pancreatitis, rarely progresses to MODS

37
Q

Coagulation issues & liver failure - treatment

A

Vitamin K, if unresponsive use FFP

38
Q

MAC for ETOH acute vs chronic

A

Acute intoxication - require less anesthesia (additive depressant), RSI. Chronic intoxication requires more anesthesia - cross tolerance and P450 system enhanced

Starred Summer 2015 (12 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions