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PathoPharm > lewis ch 43 liver, biliary tract and pancreas problems > Flashcards

lewis ch 43 liver, biliary tract and pancreas problems Flashcards

1
Q

causes hepatitis (6)

A
  • viral (most common)
  • alcohol
  • meds
  • chemicals
  • autoimmune diseases
  • metabolic problems
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2
Q

types viral hepatitis (5)

A 
A
B
C
D
E
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3
Q

transmission hep a

A

fecal oral

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4
Q

transmission hep b (3)

A
  • percutaneous or mucosal exposure to blood/blood products
  • sexual contact
  • perinatal transmission
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5
Q

how long are hep b carriers infectious

A

for life

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6
Q

transmission hep c (3)

A
  • percutaneous or mucosal exposure to blood/blood products
  • high risk sexual contact
  • perinatal contact
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7
Q

what type hepatitis must precede hep d

A

hep b

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8
Q

transmission hep e (2)

A
  • fecal oral

- contaminated water

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9
Q

people at risk for hep b (6)

A
  • 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
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10
Q

people at risk for hep c (4)

A
  • IV drug use
  • unprotected sex
  • occupational exposure
  • blood transfusions before 1992 (highest risk)
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11
Q

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

A

hep c

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12
Q

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

A

cirrhosis

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13
Q

S+S chronic hepatitis (4)

A
  • lower extremity edema
  • asterixis (liver flap)
  • bleeding abnormalities
  • jaundice
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14
Q

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

A

1-6 months

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15
Q

S+S acute hepatitis (5)

A
  • N/V
  • RUQ pain
  • reduced sense of smell and taste
  • distaste for cigarettes
  • flu like symptoms
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16
Q

3 classifications jaundice

A
  • hemolytic jaundice
  • hepatocellular jaundice
  • obstructive jaundice
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17
Q

causes of hemolytic jaundice (3)

A
  • blood transfusion reactions
  • hemolytic anemia
  • sickle cell crisis
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18
Q

causes hepatocellular jaundice (3)

A
  • cirrhosis
  • hepatitis
  • liver cancer
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19
Q

causes obstructive jaundice (4)

A
  • cirrhosis
  • hepatitis
  • liver cancer
  • common bile duct obstruction
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20
Q

what is common in acute phase in hep a

A

itching with jaundice

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21
Q

icteric

22
Q

anicteric

A

without jaundice

23
Q

2 major problems in convalescent phase of hepatitis

A

malaise

easy fatigability

24
Q

5 complications hepatitis

A
  • acute liver failure
  • chronic hepatitis
  • cirrhosis
  • portal hypertension
  • liver cancer
25
risk factors cirrhosis (4)
- male gender - alcohol use - concomitant fatty liver disease - excess iron deposition in liver
26
later S+S cirrhosis (7)
- jaundice - changes in mental responsiveness - spider angiomas - anemia, coagulation disorders - hemorrhoids - edema - peripheral neuropathy
27
what hyperosmotic laxative can be given to remove ammonia from the body during hepatic encephalopathy
lactulose
28
S+S hepatic encephalopathy (4)
- decreased LOC - neuromuscular disturbances - asterixis (liver flap) - hyperreflexia
29
Accumulation of excess fluid in peritoneal cavity
ascites
30
what causes ascites (2)
- reduced protein levels in blood | - reduced plasma oncotic pressure
31
what type of drug can be used to treat hepatitis (blocks activity of polymerase enzyme)
antiviral drugs
32
what type of drug can be used to reduce viral load
nucleoside and nucleotide analogs
33
5 examples nucleoside and nucleotide analogs
- lamivudine (epivir) - adefovir (hepsera) - entecavir (baraclude) - telbivudine (tyseka) - tenoovir (viread)
34
4 drugs given as antiviral drug therapy for hep b
lamivudine tenofovir telbivudine alfa-interferon
35
adverse effects interferon drug therapy hep b (2)
- flu like symptoms | - depression
36
4 drugs used for treatment of hep c
- interferon - ribavirin - simeprevir - sofosbuvir
37
end stage of liver disease, extensive degeneration and destruction of liver cells
cirrhosis
38
2 most common causes cirrhosis
- chronic hep c | - alcohol induced liver disease
39
6 complications of cirrhosis
- portal hypertension - esophageal and gastric varices - peripheral edema - abdominal ascites - hepatic encephalopathy - hepatorenal syndrome
40
obstruction of blood flow in and out of liver, increased pressure in liver
portal hypertension
41
complex of tortuous, enlarged veins that are fragile and do not tolerate high pressure, result from portal hypertension, can bleed easily, life threatening **
esophageal and gastric varices
42
accumulation of serous fluid in peritoneal or abdominal cavity
ascites
43
factors that contribute to ascites (5)
- decreased serum colloidal oncotic pressure - hyperaldosteronism - impaired water excretion - increased flow hepatic lymph - portal hypertension
44
drug therapies for hepatic encephalopathy (4)
- vancomycin - lactulose - cathartics - enemas
45
musty sweet odor of breath associated with hepatic encephalopathy
fetor hepaticus
46
normal bilirubin range
0-1 mg/dL
47
normal protein level range
6-8.5 gm/dL
48
normal albumin level range
3.5-5 gm/dL
49
normal globulin level range
2-3.5 gm/dL
50
2 options drug therapy for esophageal or gastric varices (vasoconstrictors)
- octreotide | - vasopressin

PathoPharm (42 decks)

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