Hepatobiliary 2

Question 1

The bile that enters the duodenum is a mixture of both kinds of what?

Answer 1

concentrated and dilute hepatic bile

Question 2

What is cholestasis?

Answer 2

A “back up in plumbing” when bile secretion is suppressed and backs up into systemic circulation

Question 3

What can cause cholestasis?

Answer 3

Intrahepatic:

• cirrhosis
• primary sclerosing cholangitis

Extrahepatic:

• stones
• neoplasms

Question 4

What is a common symptom of cholestasis?

Answer 4

Itching (increased concentrations of bile acids in plasma)

Question 5

What is acute Cholecystitis?

Answer 5

Inflammation of gallbladder associated with obstruction of ducts from stones, causing a chemical irritation from concentrated bile

Gallbladder distention due to congestion

Question 6

What is cholelithiasis? What causes it?

Answer 6

gallstones;

too much cholesterol and too little bile salts leads to bile stasis

Question 7

Most likely causes of gallstones:

Answer 7

• Pregnancy
• malnutrition
• rapid weight loss
• long periods of inactivity
• obesity
• women with multiple pregnancies
• oral contraceptives

Question 8

When are gallstones symptomatic?

Answer 8

When bile flow is obstructed

Question 9

Where can gallstones refer pain to?

Answer 9

• right upper abdomen
• back above waist
• right shoulder
• right scapula
• midscapular region

Question 10

How is hepatitis detected?

Answer 10

viral antigens and antibodies to antigens

Question 11

How does liver injury occur in viral hepatitis? (2 ways)

Answer 11

1. ) Direct cellular damage

2. ) Activation of host immune response

Question 12

Manifestations of hepatitis:

Answer 12

1. ) Asymptomatic infection
2. ) acute hepatitis
3. ) carrier without disease
4. ) carrier with chronic or asymptomatic disease
5. ) chronic hepatitis with or without cirrhosis
6. ) fulminate with rapid onset of liver failure

Question 13

Acute hepatitis (A) usually lasts 2-3 weeks with a totally recovery:

Answer 13

9 weeks

Question 14

Chronic hepatitis (C) is more than 3-6 months duration and is the chief reason for what?

Answer 14

Liver transplant (often reinfected, but progresses slower)

Question 15

Pancreatitis is a release of enzymes into pancreas or surrounding tissues as a result of:

Answer 15

obstruction, cystic fibrosis, alcohol abuse, or abdominal/surgical trauma

Question 16

What relieves pancreatitis pain and why?

Answer 16

Leaning forward; takes impingement off celiac plexus

Question 17

How to treat pancreatitis:

Answer 17

NPO = nothing by mouth
NGT = nasogastric tube for gastric decompression and evacuation of secretions
TPN = total parenteral nutrition "tube feeding" simple carbs, fats, proteins, into circulation

Question 18

Treatment of chronic pancreatitis:

Answer 18

low fat diet, enzymes, surgery to relieve obstruction

Question 19

Liver cancer has a strong link to:

Answer 19

Hep B and cirrhosis

Question 20

Liver cancer is usually advanced when diagnosed; this means that…

Answer 20

metastatic tumors from liver travel to other organs commonly

Question 21

Risk factors for pancreatic cancer:

Answer 21

• being african american
• smoking
• high caloric intake
• high fats
• diabetes
• genetics

Question 22

Why does alcohol damage liver?

Answer 22

consumption produces “acetaldehyde” which is a toxic metabolite which damages the liver

Question 23

Is fatty liver reversible?

Answer 23

yes! (associated with bingeing, even in healthy people)

Question 24

What is alcoholic hepatitis?

Answer 24

inflammation and necrosis of liver cells (always serious, can be fatal)

Question 25

What is cirrhosis?

Answer 25

functional liver tissue replaced by fibrous tissue; disruption of flow of blood and bile through liver, this leads to a loss of cells and then failure!

Question 26

Most significant impacts of liver failure:

Answer 26

1. ) elevated ammonia levels hurting cognition
2. ) increased bleeding due to insufficient clotting factors
3. ) glucose dysregulation