Liver

Question 1

Liver functions 7

Answer 1

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

Question 2

Kupffer cells are responsible for

Answer 2

Phagocytosis in the liver

Question 3

Bilirubin

and unconjugated vs conjugated

Answer 3

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.

Question 4

Normal Lab values for Bilirubin total direct and indirect

Answer 4

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

Question 5

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

Answer 5

Conjugated
uncongugated
Liver dysfunction

Question 6

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

Answer 6

Direct-usually from blockage, indirect-hemolytic

Question 7

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?

Answer 7

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

Question 8

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

Answer 8

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.

Question 9

PT is normal value? what happens in liver dysfunction?

Answer 9

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

Question 10

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

Answer 10

2-3 PT indicate liver dysfunction.

Question 11

What do liver enzymes do when there is liver failure?

Answer 11

They increase

Question 12

ALP range

Answer 12

38-126 u/l

Question 13

AST range

Answer 13

10-30

Question 14

ALT range

Answer 14

10-40

Question 15

GGT

Answer 15

0-30

Question 16

Normal cholesterol value and what happens with liver dysfunction?

Answer 16

less than 200mg/dl it is high

Question 17

Jaundice is and one sign that is not yellowing

Answer 17

A build up of bilirubin in the body clay colored stools

Question 18

What is hepatitis and 6 causes

Answer 18

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

Question 19

Patho of viral Hep

Answer 19

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

Question 20

one thing to know about the Manifestations of acute hep

Answer 20

many people do not have s/s

Question 21

Manifestations of HEP 5

Answer 21

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

Question 22

Pruritus

Answer 22

Itching from the build up of bile salts beneath the skin

Question 23

Three stages of viral hep

Answer 23

prodromal
icteric
posticteric (convalescence)

Question 24

Prodromal hep 3 things

Answer 24

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

Question 25

icteric stage 2 things

Answer 25

Jaundice/pruritus

Question 26

Posticteric stage name and

Answer 26

convalescence- fatigue, splenomegaly might subside,

Question 27

``` Hep A how do you get it? How do you prevent it? one more thing? Therapy? ```

Answer 27

``` I Ate it food, milk,water from f-o Vaccine no chronic None but can use immunoglob ```

Question 28

``` Hep B how do you get it? How do you prevent it? one more thing? Therapy? ```

Answer 28

Blood or Body fluids vaccine hand washing avoid fluids Usually recover

Question 29

``` Hep C how do you get it? How do you prevent it? one more thing? Therapy? ```

Answer 29

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

Question 30

Hep C blank progresses to blank | most common cause of 3

Answer 30

Chronic infection progresses to liver disease | Most common cause of cirrohisis and cancer and liver transplants

Question 31

Hep c screening

Answer 31

people born between 1945 and 1965 | and those who received blood products before 1992

Question 32

two things to remember about HIV and the liver

Answer 32

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

Question 33

``` Hep D how do you get it? How do you prevent it? one more thing? Therapy? ```

Answer 33

from Hep b Prevent B No vaccines Antiviral or interferon

Question 34

Hep E | How do you get it?

Answer 34

Everywhere but here | /Contaminated water fecal oral

Question 35

when do liver enzymes return to normal?

Answer 35

Post ic stage

Question 36

Complications of hep 4

Answer 36

Cancer, cirrhosis, chronic hep, acute liver fail

Question 37

Nutrition for Hep

Answer 37

high cal not high fat small frequent meals,

Question 38

Hep b vaccine time

Answer 38

At birth, one month and s months

Question 39

Hep a Vaccine time

Answer 39

1 year

Question 40

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

Answer 40

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

Question 41

how do you treat NAFLD?

Answer 41

Reduce modifable factors

Question 42

Acute liver failure

Answer 42

Severe impairment of liver function associated with hepatic encephalopathy

Question 43

What causes acute liver failure? 6

Answer 43

Acetaminophen and alcohol, TB, Sulfa, NSAIDS , HBV

Question 44

time acute liver fail

Answer 44

8-26 weeks

Question 45

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

Answer 45

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

Question 46

what can alf lead to 6

Answer 46

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

Question 47

What are we watching out for with ALF? 2

Answer 47

renal and cerebral function