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Med Surg > Hepatic/Biliary > Flashcards

Hepatic/Biliary Flashcards

1
Q

lab test used to monitor hepatitis, cirrhosis, or treatments that can be harmful to the liver

A

ALT

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2
Q

lab value that shows damage to any tissue with high metabolic activity such as the heart, liver, or kidneys

A

AST

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3
Q

lab values that indicate biliary cholestasis (gallstones) or alcohol abuse

A

GGT and GGTP

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4
Q

4 things albumin is low in

A

cirrhosis
ascites
chronic hepatitis
poor nutrition

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5
Q

lab test that is similar to albumin but shows up faster for acute malnutrition

A

pre-albumin

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6
Q

lab value that is elevated in liver disease and does not respond to vitamin K in the presence of severe liver damage

A

prothrombin time

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7
Q

ammonia levels _____ in liver disease and cause changes in mental status

A

increase

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8
Q

3 lab values that will be increased in a biliary obstruction

A

HDL
LDL
cholesterol

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9
Q

most common complication of liver biopsy

A

peritonitis

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10
Q

jaundice occurs when bilirubin levels are greater than ___ mg/dL

A

2

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11
Q

_______ jaundice is caused by the inability of damaged liver cells to clear normal amounts of bilirubin from the blood

A

hepatocellular

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12
Q

_______ jaundice is caused obstruction of the bile duct, an inflammatory process, or an enlarged organ

A

obstructive

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13
Q

_______ jaundice is caused by increased destruction of RBC more than the deliver can handle

A

hemolytic

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14
Q

ascites is affected by the movement of _______ from the serum into the peritoneal cavity

A

albumin

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15
Q

removal of fluid from the abdomen from a small hole puncture

A

paracentesis

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16
Q

surgery to treat ascites that inserts a stent to act as a shunt between the portal circulation and the hepatic vein

A

TIPS

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17
Q

vitamin ____ deficiency leads to eye and skin changes, night blindness

A

A

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18
Q

______ deficiency leads to Wernickes-Korasakoff psychosis, beriberi, and polyneuritis

A

thiamine

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19
Q

______ deficiency leads to lesions in the skin and mucous membranes

A

riboflavin

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20
Q

_______ deficiency leads to lesion in the skin and mucous membranes and neurologic changes

A

pyridoxine

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21
Q

vitamin ____ deficiency leads to scurvy (hemorrhagic disease)

A

C

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22
Q

vitamin ___ deficiency can leads to bleeding and low platelets

A

K

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23
Q

_____ ____ deficiency can lead to macrocytic anemia

A

folic acid

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24
Q

_____ liver tumors typically occur in women taking oral contraceptives

A

benign

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25
Q

4 things that cause primary liver tumors

A

chronic liver disease
hep C
hep B
cirrhosis

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26
Q

_____ ____ is elevated in primary liver cancer

A

alpha fetoprotein

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27
Q

______ _____ is elevated in cancers of the GI tract

A

carcinoembryonic agent (CEA)

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28
Q

the ____ score is used to determine allocation of the liver

A

MELD

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29
Q

the ______ functions as a storage depot for bile

A

gallbladder

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30
Q

pancreatic enzyme that digests carbs

A

amylase

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31
Q

pancreatic enzyme that digests protein

A

trypsin

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32
Q

pancreatic enzyme that digests fat

A

lipase

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33
Q

patient must be ____ before ultrasonography

A

NPO

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34
Q

____ scan is when IV dye is given to track flow through biliary tract

A

HIDA

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35
Q

older people are more likely to develope _______

A

gallstones

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36
Q

older people have atypical ______ disease presentation

A

gallbladder

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37
Q

obstructive jaundice causes dark _____ to _____ urine and _____ colored stools

A

orange to brown, clay

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38
Q

obstructed blood floe through the liver results in ______ _____

A

portal hypertension

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39
Q

2 things portal hypertension can lead to

A

ascites
esophageal varices

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40
Q

1st choice diuretic for ascites

A

aldosterone

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41
Q

2nd choice diuretic for ascites

A

lasix

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42
Q

diuretic NOT to give with ascites because it can cause hepatic encephalopathy

A

Diamox

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43
Q

procedure for ascites where they insert a needle and draw out the fluid

A

paracentesis

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44
Q

treatment for ascites that pulls blood from abdomen back into vascular system

A

peritoneovenous shunt

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45
Q

2 things to avoid with ascites

A

NSAIDs and alcohol

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46
Q

esophageal varices develop when blood flow to the _____ is blocked

A

liver

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47
Q

esophageal varices are the most significant source of bleeding in ______

A

cirrhosis

48
Q

emergency vasoconstrictor given to treat esophageal varices

A

vasopressin

49
Q

3 medications for esophageal varices

A

octreotide (sandostatin)
beta-blockers
nitrates

50
Q

give vitamin ___ to treat esophageal varices

A

K

51
Q

3 things to avoid with esophageal varices

A

alcohol
NSAIDs
salicylates

52
Q

hepatic encephalopathy is caused by increased _____

A

ammonia

53
Q

3 symptoms othered than AMS for hepatic encephalopathy

A

asterixis
constructional apraxia
fector hepaticus

54
Q

inability to sustain posture and involuntary movements

A

asterixis

55
Q

inability to draw out what someone tells you or shows you

A

constructional apraxia

56
Q

sweet smelling poop seen in complete liver failure

A

fector hepaticus

57
Q

medication that causes excretion of ammonia in poop

A

Lactulose (cephulac)

58
Q

3 medications used for hepatic hydrocepaholpathy

A

lactulose (cephulac)
IV glucose
antibiotics

59
Q

Hep A transmission route

A

fecal-oral route or sex

60
Q

vaccine is available for both Hep ___ and ___

A

A and B

61
Q

Hep A recovery

A

mild to full

62
Q

Hep B transmission route

A

blood and fluids

63
Q

Hep B can be acute or chronic, but is mostly _____

A

chronic

64
Q

Hep B symptoms usually don’t appear until __ to ___ months after infection

A

1 to 4

65
Q

3 things Hep B increases risk for

A

chronic hepatitis
cirrhosis
cancer

66
Q

Hep C transmission route

A

blood and sex

67
Q

there is a potential cure for Hep __

A

C

68
Q

Hep __ occurs in some cases of Hep B

A

D

69
Q

patients with Hep D are more likely to develop ______ _____ ______

A

fulminant liver failure

70
Q

to be diagnosed with Hep D patients have to have interferon A for ____ ____

A

one year

71
Q

Hep E transmission route

A

fecal-oral

72
Q

Nonviral hepatitis is _____ induced

A

drug

73
Q

number 1 cause of nonviral hepatitis

A

tylenol

74
Q

with nonviral hepatitis avoid ___ ____ ____ because it causes you to bleed more

A

st. johns wart

75
Q

3 types of toxic hepatitis

A

alcohol
medicinal
chemical

76
Q

toxic hepatitis can lead to _____ ______ ___

A

fulminant liver failure

77
Q

sudden and severely impaired liver function

A

fulminate liver failure

78
Q

medication that can cause liver failure

A

tylenol

79
Q

chemical that can cause liver failure

A

carbon tetrachloride

80
Q

metabolic disturbance that can cause liver failure

A

Wisons disease

81
Q

structural change that can cause liver failure

A

Budd-Chiari syndrome

82
Q

antidote for tylenol

A

N-acetylcysteine

83
Q

antidote for mushrooms

A

PCN

84
Q

treatment where stuff is filtered out fo the blood in liver failure

A

plasmapahresis

85
Q

alcoholic cirrhosis is scarring around the ____ ____

A

portal area

86
Q

biliary cirrhosis is scarring around the ____ _____

A

bile ducts

87
Q

patients with cirrhosis should have _____ calorie diets with low ____

A

high, sodium

88
Q

_______ cholecystitis occurs because there is a stone obstructing bile flow

A

calculous

89
Q

_______ cholecystitis occurs because of inflammation after trauma or surgery

A

acalculous

90
Q

3 antibiotics given with cholecystitis

A

penicillins
cephalosporins
metronidazole

91
Q

patients with cholecystitis should have a diet high in _____ and low in _____

A

protein, fat

92
Q

the gallbladder is the storage place for _____

A

bile

93
Q

the gallbladder metabolizes _____

A

fat

94
Q

pill taken that can replaces exocrine pancreas functions

A

pancrease

95
Q

inflammation of the gallbladder

A

cholecystitis

96
Q

gallbladder stones

A

cholelithiasis

97
Q

slowing or stalling of bile through gallbladder

A

cholestasis

98
Q

type of gallbladder stones that are more common

A

cholesterol gallstones

99
Q

5 F’s risk factors for cholelithiasis

A

fair
fat
female
fertile
familial

100
Q

vitamins that will be low in cholelithiasis

A

A, D, K, E

101
Q

if you think your patient has gallbladder problems do not give _____ because it causes constriction and more pain

A

morphine

102
Q

medications that dissolve gallstones

A

ursodeoxycholic acid
chenodiol

103
Q

procedure that breaks up stones

A

lithotripsy

104
Q

most common cause of acute pancreatitis is _____ of the pancreas

A

autodigestion

105
Q

acute pancreatitis pain is unrelieved by _____

A

antacids

106
Q

acute pancreatitis can cause decreased _______

A

perstalsis

107
Q

acute pancreatitis will cause ecchymosis around the _____ and _____

A

flank and umbilicus

108
Q

someone who has acute pancreatitis will show signs of _____

A

shock

109
Q

in acute pancreatitis, _____ and ____ will be 3x the normal limit

A

amylase, lipase

110
Q

amylase and lipase will be elevated within the first ____ hours of symptoms and then decrease after ___ to ___ hours

A

24, 48-72

111
Q

electrolyte that will be low in acute pancreatitis

A

calcium

112
Q

with paracentesis, in acute pancreatitis it may show presence of _____ _____

A

pancreatic enzymes

113
Q

someone with acute pancreatitis should have ______ feeding as soon as possible

A

enteral

114
Q

acute pancreatitis will cause hyperglycemia, so you must give _____

A

insulin

115
Q

2 things acute pancreatitis patients cannot have

A

alcohol and caffeine

116
Q

2 most common causes of chronic pancreatitis

A

smoking and alcohol use

117
Q

gastric bypass that bypasses the pancreas and is used in patients with chronic pancreatitis

A

Roux-en-Y

Med Surg (10 decks)

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