Hepatic Disorders Flashcards

1
Q

What are 5 symptoms of liver disease?

A
  1. Jaundice
  2. Ascites
  3. Portal HTN
  4. Esophageal Varices
  5. Hepatic encephalopathy
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2
Q

What levels increase in jaundice?

A

Bilirubin

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3
Q

What are 3 causes of jaundice?

A
  • Impaired liver uptake
    -impaired conjugation
  • impaired excretion into biliary system
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4
Q

What type of Jaundice is caused by an increase in destruction of RBCs?

A

Hemolytic Jaundice

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5
Q

What lab values will increase in hemolytic anemia?

A
  • fecal and urine urobilinogen levels
  • too much UNCONGUGATED bilirubin
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6
Q

What type of jaundice is where damaged liver cells are unable to clear bilirubin from the blood?

A

Hepatocellular Jaundice

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7
Q

What are some causes of hepatocellular jaundice?

A
  • hepatitis, Epstein Barr virus, medications, toxins, or ETOH
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8
Q

What lab values are increased in hepatocellular jaundice?

A
  • increased serum bilirubin, urine urobilinogen, AST, ALT
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9
Q

What type of symptoms will you see in hepatocellular anemia?

A
  • lack of appetite, nausea, malaise, fatigue, weakness, wt loss
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10
Q

What are some s/s of Obstructive Jaundice?

A
  • intense itching, dyspepsia, intolerance to fatty foods
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11
Q

What labs increase in obstructive jaundice?

A

increased bilirubin, alkaline phosphatase, AST, ALT, and GGT.

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12
Q

What might the urine and poop look like in obstructive jaundice?

A
  • urine –> deep orange and foamy
  • Feces –> light/ clay colored stool
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13
Q

What are some medications that can cause obstructive jaundice?

A
  • phenothiazines, sulfylureas, TCAs
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14
Q

What 2 things can portal hypertension lead to?

A

ascites and esophageal varices

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15
Q

What is portal hypertension?

A

Occurs when pressure increases in the portal vein r/t obstructed blood flow.

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16
Q

What 3 things is ascites related to?

A
  • portal HTN
  • increased capillary pressure
    -obstructed venous blood flow
17
Q

What are some clinical manifestations of ascites?

A
  • increased abdomen girth
    -rapid weight gain
  • SOB
    -Distended veins visible on abdomen
18
Q

What are 3 ways to diagnose Ascites?

A
  • percussion (Dullness over ascites & tympany over intestines)
  • Bulging flanks when supine
    -Fluid wave
19
Q

What diet will a person with ascites be on?

A

Low Na diet

20
Q

What drugs will a person with ascites be on?

A
  • spironolactone
    -furosemide
    -IV albumin/other colloid
21
Q

What is the goal of ascites?

A

to achieve a negative Na balance –> excrete more than you take in

22
Q

What is a procedure we can do for ascites?

A

Paracentesis

23
Q

What is the surgery if a person keeps coming in with recurrent ascites?

A

TIPS (Transjugular Intrahepatic portosystemic shunt)

24
Q

should a person with ascites be on bedrest?

A

YES!! UPRIGHT POSTURE

25
Q

What are some education we can give to patients with Ascites?

A
  • AVOID ALL ETOH, low Na diet, medications, daily weight, skin care