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Final > Liver > Flashcards

Liver Flashcards

1
Q

Liver functions 7

A

Metabolism, detox, bile synth, ammonia to urea, storage, Blood cell breakdown, blood clotting, conjugation of bil

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2
Q

Kupffer cells are responsible for

A

Phagocytosis in the liver

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3
Q

Bilirubin

and unconjugated vs conjugated

A

A pigment from the breakdown of Hemoglobin.
Unconjugated- Lipid soluble Initial waste product, travels from bloodstream to liver via albumin.
Conjugated-Converted from unconjugated in the liver. It is water soluble and is turned into bile and is ultimately excreted.

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4
Q

Normal Lab values for Bilirubin total direct and indirect

A

Total- 0.2-1.2mg/dl
Direct-0.1-0.3mg/dl
Indirect-0.1-1.1mg/dl

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5
Q

Direct is
and indirect is
and when they are elevated it is a sign of?

A

Conjugated
uncongugated
Liver dysfunction

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6
Q

What does it mean when there is an increase in direct bilirubin lab?
Indirect?

A

Direct-usually from blockage, indirect-hemolytic

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7
Q

normal protein level in the blood?
normal albumin level in the blood?
and what does liver damage do to these?
and when is that seen?

A

albumin- 3.5-5 g/dl
total 6.4-8.3 g/dl
low levels
not seen until there is mod-severe damage

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8
Q

What is ammonia?
normal level?
Increased level shows, leads to blank and blank.

A

Toxic product of protein breakdown and is turned into urea and excreted through the kidneys.
15-45mcg/dl
shows liver dysfunction, leads to neuro problems and hepatic encephalopathy.

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9
Q

PT is normal value? what happens in liver dysfunction?

A

Prothrombin time 11-16 seconds and time increases with dysfunction.

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10
Q

INR normal range is blank based on blank and increases can?

A

2-3 PT indicate liver dysfunction.

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11
Q

What do liver enzymes do when there is liver failure?

A

They increase

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12
Q

ALP range

A

38-126 u/l

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13
Q

AST range

A

10-30

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14
Q

ALT range

A

10-40

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15
Q

GGT

A

0-30

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16
Q

Normal cholesterol value and what happens with liver dysfunction?

A

less than 200mg/dl it is high

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17
Q

Jaundice is and one sign that is not yellowing

A

A build up of bilirubin in the body clay colored stools

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18
Q

What is hepatitis and 6 causes

A

Hepatic inflammation. Virus, alcohol, medications, chemicals, autoimmune diseases, and metabolic problems.

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19
Q

Patho of viral Hep

A

Hepatocytes are targeted directly by virus or by the cell mediated response.

20
Q

one thing to know about the Manifestations of acute hep

A

many people do not have s/s

21
Q

Manifestations of HEP 5

A

Loss of smell, skin rash, flu like symptoms, right upper quad pain, pruritus

22
Q

Pruritus

A

Itching from the build up of bile salts beneath the skin

23
Q

Three stages of viral hep

A

prodromal
icteric
posticteric (convalescence)

24
Q

Prodromal hep 3 things

A

Loss of smell/cigs taste bad, megalies/ max infectivity

25
Q

icteric stage 2 things

A

Jaundice/pruritus

26
Q

Posticteric stage name and

A

convalescence- fatigue, splenomegaly might subside,

27
Q 
Hep A
how do you get it?
How do you prevent it?
one more thing?
Therapy?
A 
I Ate it
food, milk,water from f-o
Vaccine
no chronic 
None but can use immunoglob
28
Q 
Hep B 
how do you get it?
How do you prevent it?
one more thing?
Therapy?
A

Blood or Body fluids
vaccine hand washing avoid fluids
Usually recover

29
Q 
Hep C 
how do you get it?
How do you prevent it?
one more thing?
Therapy?
A

sex and blood and drugs
screening decrease risky behaviors
currently no vaccine
antivirals that block protein for replication

30
Q

Hep C blank progresses to blank

most common cause of 3

A

Chronic infection progresses to liver disease

Most common cause of cirrohisis and cancer and liver transplants

31
Q

Hep c screening

A

people born between 1945 and 1965

and those who received blood products before 1992

32
Q

two things to remember about HIV and the liver

A

HIV meds are hepatotoxic and Hep C and HIV are a terrible combo,

33
Q 
Hep D
how do you get it?
How do you prevent it?
one more thing?
Therapy?
A

from Hep b
Prevent B
No vaccines
Antiviral or interferon

34
Q

Hep E

How do you get it?

A

Everywhere but here

/Contaminated water fecal oral

35
Q

when do liver enzymes return to normal?

A

Post ic stage

36
Q

Complications of hep 4

A

Cancer, cirrhosis, chronic hep, acute liver fail

37
Q

Nutrition for Hep

A

high cal not high fat small frequent meals,

38
Q

Hep b vaccine time

A

At birth, one month and s months

39
Q

Hep a Vaccine time

A

1 year

40
Q

What is metabolic syndrome 4 and what does it have to do with the liver?

A

Obesity, diabetes, hyperlipedema, HTN also the risk factors for NAFLD

41
Q

how do you treat NAFLD?

A

Reduce modifable factors

42
Q

Acute liver failure

A

Severe impairment of liver function associated with hepatic encephalopathy

43
Q

What causes acute liver failure? 6

A

Acetaminophen and alcohol, TB, Sulfa, NSAIDS , HBV

44
Q

time acute liver fail

A

8-26 weeks

45
Q

S/S of ALF and what is the first one? 6

A

First-Change in mentation, jaundice, coagulation, encephalopathy, elevated bilirubin and enzymes.

46
Q

what can alf lead to 6

A

Cerebral edema, renal failure, hypoglycemia, metabolic acidosis, sepsis, mod

47
Q

What are we watching out for with ALF? 2

A

renal and cerebral function

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