Hepatic Disorders Flashcards
What are 5 symptoms of liver disease?
- Jaundice
- Ascites
- Portal HTN
- Esophageal Varices
- Hepatic encephalopathy
What levels increase in jaundice?
Bilirubin
What are 3 causes of jaundice?
- Impaired liver uptake
-impaired conjugation - impaired excretion into biliary system
What type of Jaundice is caused by an increase in destruction of RBCs?
Hemolytic Jaundice
What lab values will increase in hemolytic anemia?
- fecal and urine urobilinogen levels
- too much UNCONGUGATED bilirubin
What type of jaundice is where damaged liver cells are unable to clear bilirubin from the blood?
Hepatocellular Jaundice
What are some causes of hepatocellular jaundice?
- hepatitis, Epstein Barr virus, medications, toxins, or ETOH
What lab values are increased in hepatocellular jaundice?
- increased serum bilirubin, urine urobilinogen, AST, ALT
What type of symptoms will you see in hepatocellular anemia?
- lack of appetite, nausea, malaise, fatigue, weakness, wt loss
What are some s/s of Obstructive Jaundice?
- intense itching, dyspepsia, intolerance to fatty foods
What labs increase in obstructive jaundice?
increased bilirubin, alkaline phosphatase, AST, ALT, and GGT.
What might the urine and poop look like in obstructive jaundice?
- urine –> deep orange and foamy
- Feces –> light/ clay colored stool
What are some medications that can cause obstructive jaundice?
- phenothiazines, sulfylureas, TCAs
What 2 things can portal hypertension lead to?
ascites and esophageal varices
What is portal hypertension?
Occurs when pressure increases in the portal vein r/t obstructed blood flow.
What 3 things is ascites related to?
- portal HTN
- increased capillary pressure
-obstructed venous blood flow
What are some clinical manifestations of ascites?
- increased abdomen girth
-rapid weight gain - SOB
-Distended veins visible on abdomen
What are 3 ways to diagnose Ascites?
- percussion (Dullness over ascites & tympany over intestines)
- Bulging flanks when supine
-Fluid wave
What diet will a person with ascites be on?
Low Na diet
What drugs will a person with ascites be on?
- spironolactone
-furosemide
-IV albumin/other colloid
What is the goal of ascites?
to achieve a negative Na balance –> excrete more than you take in
What is a procedure we can do for ascites?
Paracentesis
What is the surgery if a person keeps coming in with recurrent ascites?
TIPS (Transjugular Intrahepatic portosystemic shunt)
should a person with ascites be on bedrest?
YES!! UPRIGHT POSTURE
What are some education we can give to patients with Ascites?
- AVOID ALL ETOH, low Na diet, medications, daily weight, skin care
