lewis ch 43 liver, biliary tract and pancreas problems

Question 1

causes hepatitis (6)

Answer 1

• viral (most common)
• alcohol
• meds
• chemicals
• autoimmune diseases
• metabolic problems

Question 2

types viral hepatitis (5)

Answer 2

A
B
C
D
E

Question 3

transmission hep a

Answer 3

fecal oral

Question 4

transmission hep b (3)

Answer 4

• percutaneous or mucosal exposure to blood/blood products
• sexual contact
• perinatal transmission

Question 5

how long are hep b carriers infectious

Answer 5

for life

Question 6

transmission hep c (3)

Answer 6

• percutaneous or mucosal exposure to blood/blood products
• high risk sexual contact
• perinatal contact

Question 7

what type hepatitis must precede hep d

Answer 7

hep b

Question 8

transmission hep e (2)

Answer 8

• fecal oral

- contaminated water

Question 9

people at risk for hep b (6)

Answer 9

• men who have sex with men
• household contact o chronically infected
• patients on hemodialysis
• health care and public safety workers
• IV drug users
• recipients of blood products

Question 10

people at risk for hep c (4)

Answer 10

• IV drug use
• unprotected sex
• occupational exposure
• blood transfusions before 1992 (highest risk)

Question 11

what type hepatitis is most common cause of liver disease and liver failure, and is most common reason for liver transplant in US

Answer 11

hep c

Question 12

a chronic degenerative disease of the liver where the lobes are covered with fibrous tissue, the parenchyma degenerate and the lobules are infiltrated with fat

Answer 12

cirrhosis

Question 13

S+S chronic hepatitis (4)

Answer 13

• lower extremity edema
• asterixis (liver flap)
• bleeding abnormalities
• jaundice

Question 14

how long can the acute phase of hepatitis last (maximal infectivity)

Answer 14

1-6 months

Question 15

S+S acute hepatitis (5)

Answer 15

• N/V
• RUQ pain
• reduced sense of smell and taste
• distaste for cigarettes
• flu like symptoms

Question 16

3 classifications jaundice

Answer 16

• hemolytic jaundice
• hepatocellular jaundice
• obstructive jaundice

Question 17

causes of hemolytic jaundice (3)

Answer 17

• blood transfusion reactions
• hemolytic anemia
• sickle cell crisis

Question 18

causes hepatocellular jaundice (3)

Answer 18

• cirrhosis
• hepatitis
• liver cancer

Question 19

causes obstructive jaundice (4)

Answer 19

• cirrhosis
• hepatitis
• liver cancer
• common bile duct obstruction

Question 20

what is common in acute phase in hep a

Answer 20

itching with jaundice

Question 21

icteric

Answer 21

jaundice

Question 22

anicteric

Answer 22

without jaundice

Question 23

2 major problems in convalescent phase of hepatitis

Answer 23

malaise

easy fatigability

Question 24

5 complications hepatitis

Answer 24

• acute liver failure
• chronic hepatitis
• cirrhosis
• portal hypertension
• liver cancer

Question 25

risk factors cirrhosis (4)

Answer 25

• male gender
• alcohol use
• concomitant fatty liver disease
• excess iron deposition in liver

Question 26

later S+S cirrhosis (7)

Answer 26

• jaundice
• changes in mental responsiveness
• spider angiomas
• anemia, coagulation disorders
• hemorrhoids
• edema
• peripheral neuropathy

Question 27

what hyperosmotic laxative can be given to remove ammonia from the body during hepatic encephalopathy

Answer 27

lactulose

Question 28

S+S hepatic encephalopathy (4)

Answer 28

• decreased LOC
• neuromuscular disturbances
• asterixis (liver flap)
• hyperreflexia

Question 29

Accumulation of excess fluid in peritoneal cavity

Answer 29

ascites

Question 30

what causes ascites (2)

Answer 30

• reduced protein levels in blood

- reduced plasma oncotic pressure

Question 31

what type of drug can be used to treat hepatitis (blocks activity of polymerase enzyme)

Answer 31

antiviral drugs

Question 32

what type of drug can be used to reduce viral load

Answer 32

nucleoside and nucleotide analogs

Question 33

5 examples nucleoside and nucleotide analogs

Answer 33

• lamivudine (epivir)
• adefovir (hepsera)
• entecavir (baraclude)
• telbivudine (tyseka)
• tenoovir (viread)

Question 34

4 drugs given as antiviral drug therapy for hep b

Answer 34

lamivudine
tenofovir
telbivudine
alfa-interferon

Question 35

adverse effects interferon drug therapy hep b (2)

Answer 35

• flu like symptoms

- depression

Question 36

4 drugs used for treatment of hep c

Answer 36

• interferon
• ribavirin
• simeprevir
• sofosbuvir

Question 37

end stage of liver disease, extensive degeneration and destruction of liver cells

Answer 37

cirrhosis

Question 38

2 most common causes cirrhosis

Answer 38

• chronic hep c

- alcohol induced liver disease

Question 39

6 complications of cirrhosis

Answer 39

• portal hypertension
• esophageal and gastric varices
• peripheral edema
• abdominal ascites
• hepatic encephalopathy
• hepatorenal syndrome

Question 40

obstruction of blood flow in and out of liver, increased pressure in liver

Answer 40

portal hypertension

Question 41

complex of tortuous, enlarged veins that are fragile and do not tolerate high pressure, result from portal hypertension, can bleed easily, life threatening **

Answer 41

esophageal and gastric varices

Question 42

accumulation of serous fluid in peritoneal or abdominal cavity

Answer 42

ascites

Question 43

factors that contribute to ascites (5)

Answer 43

• decreased serum colloidal oncotic pressure
• hyperaldosteronism
• impaired water excretion
• increased flow hepatic lymph
• portal hypertension

Question 44

drug therapies for hepatic encephalopathy (4)

Answer 44

• vancomycin
• lactulose
• cathartics
• enemas

Question 45

musty sweet odor of breath associated with hepatic encephalopathy

Answer 45

fetor hepaticus

Question 46

normal bilirubin range

Answer 46

0-1 mg/dL

Question 47

normal protein level range

Answer 47

6-8.5 gm/dL

Question 48

normal albumin level range

Answer 48

3.5-5 gm/dL

Question 49

normal globulin level range

Answer 49

2-3.5 gm/dL

Question 50

2 options drug therapy for esophageal or gastric varices (vasoconstrictors)

Answer 50

• octreotide

- vasopressin