Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

24 Physical & Health Assessment > Hepatic Diseases (Exam III) > Flashcards

Hepatic Diseases (Exam III) Flashcards

1
Q

How much blood is contained in the liver at any given time?

A

1L

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

What positioning is often necessary to gain access to liver? (imaging, biopsy, etc.)

A

Trendelenburg

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

How much bile is produced by the gallbladder daily?

A

500mls

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

What is the consequence of not having a gallbladder?

A

Digestion problems

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

What patient populations most often have their gallbladder removed?

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

What anatomical feature divides the left and right lobes of the liver?

A

Falciform Ligament

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

What reasons would one have for doing an open cholecystectomy vs a laparoscopic cholecystectomy?

A
  • Necrotic gallbladder
  • Surgeon practice (lol)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What is the most serious source of local bleeding encountered in cholecystectomies?

A

Cystic Artery

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

What are common s/s of gallbladder disease?

A
  • Murphy’s sign
  • RUQ pain
  • ↑WBCs
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

T/F. Most of the liver’s blood flow comes from the hepatic artery.

A

False. Most of the liver’s blood flow comes from the portal vein.

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

What is Bud-Chiari syndrome?

What are the s/s?

A

Obstruction of the venous outflow of the liver.

  • ABD pain
  • Ascites
  • Hepatomegaly
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What is a normal portal vein pressure?

A

7-10 mmHg

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

What pressure is seen with portal vein hypertension?

A

> 20-30 mmHg

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

What is a normal pressure in the venous sinusoids?

A

0 mmHg

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

What pressure is seen in the venous sinusoids of a portal hypertension patient?

A

5 mmHg

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

How is hepatic artery perfusion pressure calcuated?

A

HAPP = MAP - HVP

HAPP = hepatic artery perfusion pressure
HVP = Hepatic vein pressure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What blood coagulation factors are dependent on vitamin K for synthesis?

A

2, 7, 9, 10

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What is the name of factor two?

A

Prothrombin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What clotting factors are produced by the liver?

A

needs work

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What is the name of factor 3?

A

Tissue thromboplastin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What is the name of factor 8?

A

vWf (von Willebrand factor)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What is the name of factor 4?

A

Calcium

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What drug is given intra-operatively that “opens up” the gallbladder?

A

Glucagon

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What conditions/drugs/positions/etc increase hepatic blood flow?

A
  • Eating
  • Glucagon
  • β-agonists
  • Recumbent position
  • Acute hepatitis
  • Hypercapnia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
What conditions/drugs/etc decrease hepatic blood flow?
- Anesthetics - Surgical trauma - α-agonists - β-blockers - PEEP - Vasopressin boluses - Cirrhosis - Hypocapnia
26
This molecule is a degradation product of Hgb.
Bilirubin
27
What are normal bilirubin levels?
< 1mg/dL
28
At what bilirubin level would one see scleral icterus?
3 mg/dL
29
At what bilirubin level would one see jaundice?
>4 mg/dL
30
The liver aminotransferases are primarily involved in what?
Gluconeogenesis
31
If AST/ALT are both elevated and there is a ratio of < 1 then what is indicated?
Non-alcoholic liver disease
32
If AST/ALT are both elevated and there is a ratio of 2-4 then what is indicated?
Alcoholic liver disease
33
If AST/ALT are both elevated and there is a ratio of >4 then what is indicated?
Wilson's disease
34
What is Wilson's disease?
Inherited disorder where your body accumulates copper (especially in the liver).
35
When is alkaline phosphatase elevated?
When bile-salt induced liver damage has occurred.
36
Which liver transaminase is more specific to the liver?
ALT (alanine transaminase)
37
Which liver transaminase is found in mitochondria **and** the cytosol?
AST (aspartate transaminase)
38
Which of the liver transaminases has a longer half-life?
**AST (36hrs)** ALT (18hrs)
39
What would be considered a minor increase in AST & ALT? What would be indicated by this?
**< 100 IU** - Hep B & C - Non-alcoholic disease - Fatty liver
40
What would be considered a moderate increase in AST & ALT? What would be indicated by this?
**100 - 300 IU** - Alcoholic hepatitis - Autoimmune hepatitis - Acute viral hepatitis
41
What would be considered a marked/severe increase in AST & ALT? What would be indicated by this?
**> 300 IU** - Drugs - Acute viral hepatitis - Ischemia - Extrahepatic cholestasis
42
AST/ALT ratio of greater than ___ is suggestive of cirrhosis or alcoholic liver disease.
2
43
What are normal AST values? ALT?
AST = 10 - 40 IU/L ALT = 10 - 50 IU/L
44
What is a normal prothrombin time?
12 - 14 seconds
45
What liver lab is sensitive for acute injury?
PT (prothrombin time)
46
What liver lab is not sensitive for acute injury?
Albumin
47
How long could it take to go from jaundice to 80-90% loss of liver function?
4 weeks
48
What are the four grades of encephalopathy?
1. Behavioral changes, minimal LOC changes. 2. Disorientation, drowsiness, inappropriate behavior. 3. Marked confusion, incoherence, somnolent. 4. Comatose.
49
What are the s/s of hepatorenal syndrome?
- H₂O retention - Azotemia - ↓ Na⁺ - Oliguria
50
What pharmacokinetic changes in liver patients necessitate decreases in drug dosing?
- ↑ VD - ↓ plasma-protein binding - ↓ drug clearance
51
How is Hepatitis A spread?
Fecal matter contact w/ food and water.
52
What are the s/s of Hep A?
Asymptomatic to full liver failure
53
How is Hep A treated?
Pooled gamma globulin
54
What is the leading cause of liver cancer?
Hepatitis B
55
How is Hepatitis B spread?
- Sex - Blood
56
Who most often develops chronic infection from hepatitis B?
Children
57
What is the treatment for Hep B?
Hepatitis B immunoglobulin
58
What is the leading cause for liver transplantation?
Hepatitis C
59
How is Hepatitis C spread?
- Sex - Blood - Parenteral drug use
60
How is Heptatitis C treated?
- Sofosbuvir - Interferon w/ ribavirin - other antivirals
61
Hepatitis D occurs in conjuction with what?
Hepatitis B
62
How is Hepatitis E spread?
- Oral/Fecal
63
What treatments exist for Hepatitis E?
NO treatments, usually self-limiting
64
What is the most common cause of acute liver failure in the US?
Acetaminophen
65
How is acetaminophen-induced acute liver failure treated?
N-acetylcysteine within 8 hours
66
What compound(s) of halothane metabolism contributes to hepatocellular injury?
- **TFA (trifluroacetic acid)** - Fluoride
67
Summarize all the hepatitis pathologies. *This card is just here so I can consistently look at the graphic*.
68
What is the MELD score?
**Model for End-Stage Liver Disease** Score (predicts mortality based on symptomology).
69
A MELD score of > 40 means what?
100% mortality in the hospitalized patient.
70
A MELD score < 10 is indicative of what for a preoperative patient?
Safe to undergo elective surgery.
71
A MELD score 10-15 is indicative of what for a preoperative patient?
Needs optimization to undergo elective surgery.
72
A MELD score >15 is indicative of what for a preoperative patient?
Elective surgery is contraindicated.
73
What are the coagulative effects of cirrhosis?
Hemostasis → clotting
74
What are the cardiac effects of cirrhosis?
- Portal HTN - ↓ circulating volume
75
What are the renal effects of cirrhosis?
- Hepatorenal Syndrome - ↑ H₂O and Na⁺ retention
76
What are the pulmonary effects of cirrhosis?
Chronic Lung Disease and SOB from fluid retention and ascites.
77
Why does hepatic encephalopathy occur?
Accumulation of ammonia
78
What is an overall summary of cirrhosis? *This card is just so I can look at the graphic*.
79
What is the goal Hgb for acute variceal bleeding?
Hgb = 8 mg/dL
80
What volatile is best for liver surgeries?
Sevoflurane
81
What result does hypocapnia have on hepatic blood flow? Hypercapnia?
↓ PaCO₂ = ↓ HBF ↑ PaCO₂ = ↑ HBF
82
What portion of the clotting cascade does warfarin affect? What test measures warfarin effect?
- **W**arfarin - **E**xtrinsic pathway - **P**rothrombin - **T**ime

24 Physical & Health Assessment (33 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions