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Patho1 > Liver > Flashcards

Liver Flashcards

1
Q

what are the 5 major functions of the liver?

A
  1. metabolism and storage of fats, carbs, proteins, vitamins, and minerals
  2. blood volume reservoir
  3. blood filter
  4. blood clotting factors (prothrombin and fibrinogen)
  5. drug metabolism and detox
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2
Q

what is the portal circulatory system?

A

vessels that bring blood from the stomach, intestines, spleen, and pancreas to the liver

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3
Q

what is the name of the vessel that brings the blood into the liver?

A

the portal vein

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4
Q

what levels will the nurse need to monitor with a patient with liver problems?

A

bilirubin, serum ammonia, serum protein, serum albumin, and PT

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5
Q

how will the serum ammonia level change with decreased liver functioning?

A

increase

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6
Q

how will the serum protein level change with decreased liver functioning?

A

decreased

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7
Q

how will the serum albumin level change with decreased liver functioning?

A

decreased

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8
Q

how will the PT level change with decreased liver functioning?

A

increased (LONGER TO CLOT)

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9
Q

what causes jaundice?

A

increased bilirubin levels in the bloodstream (usually greater than 2 - 2.5 mg/dL)

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10
Q

bilirubin is the byproduct of the breakdown of what?

A

hemoglobin

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11
Q

conjugated bilirubin is also called:

A

direct bilirubin

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12
Q

unconjugated bilirubin is also called:

A

indirect bilirubin

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13
Q

if conjugated bilirubin is elevated - what does that mean about the liver?

A

means the liver is working but there is something causing the bilirubin not be to able to get out - like a bile duct obstruction or gallstones

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14
Q

if unconjugated bilirubin is elevated - what does this mean about the liver?

A

means that there is either impaired liver function or an overproduction of bilirubin

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15
Q

jaundice causes what type of discoloration of the skin?

A

yellow

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16
Q

are liver enzymes elevated or depleted in the presence of jaundice?

A

elevated

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17
Q

what is viral hepatitis?

A

systemic virus that mainly affects the liver and causes inflammation

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18
Q

what are 2 other types of viruses (besides the hepatitis viruses) that lead to hepatitis

A

epstein barr, cytomegalovirus

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19
Q

what are other causes (non-viral) of hepatitis?

A

alcohol abuse, drugs, chemicals, and bacteria

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20
Q

what causes hepatocyte death in the case of hepatitis?

A

an infection causes an immune and inflammatory response which leads to lysing of the infected cells causing edema and tissue hypoxia which leads to the hepatocyte death

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21
Q

what are the 3 stages of hepatitis?

A

prodromal
icteric
recovery

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22
Q

what are the clinical manifestations of the prodromal stage of hepatitis?

A

fatigue, anorexia, malaise, n/v, headache, cough, hyperalgesia, low grade fever

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23
Q

the prodromal stage of hepatitis begins __________ after exposure

A

2 weeks

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24
Q

during what stage of hepatitis will the patient begin experiencing jaundice and an enlarged liver?

A

icteric

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25
Q

what are the clinical manifestations of the icteric stage of hepatitis?

A

jaundice, dark urine, liver enlargement, painful palpation of the liver, fatigue, abdominal pain

26
Q

what are the transmission routes of hepatitis A?

A

fecal-oral, parenteral, sexual

27
Q

what is the onset of hepatitis A like?

A

acute with a fever

28
Q

does hepatitis A lead to chronic hepatitis?

A

no

29
Q

what age groups does hepatitis A usually affect?

A

children and adults

30
Q

what is the prevention of hepatitis A?

A

hand hygiene and hepatitis A vaccine

31
Q

what is the transmission of hepatitis B?

A

parenteral or sexual

32
Q

what is the onset of hepatitis B?

A

insidious, slow

33
Q

does hepatitis B lead to chronic hepatitis?

A

yes

34
Q

what is the incubation period of hepatitis B? (relative)

A

long

35
Q

what is the age range of those affected with hepatitis B?

A

any

36
Q

what is the prevention of hepatitis B?

A

hepatitis B vaccine and safe sex / hygiene

37
Q

what is the transmission of hepatitis C?

A

parental, sexual

38
Q

what is the onset of hepatitis C?

A

insidious, slow

39
Q

can hepatitis C develop into chronic hepatitis?

A

yes (80%)

40
Q

what types of hepatitis have vaccines?

A

A and B

41
Q

how many doses does the hepatitis B vaccine have?

A

3

42
Q

when does the vaccine for hepatitis B begin?

A

Infant

43
Q

how many doses does the hepatitis B vaccine have?

A

3

44
Q

when does the vaccine for hepatitis B start?

A

infant

45
Q

what is cirrhosis?

A

irreversible, inflammatory, fibrotic liver disease

46
Q

what are the causes of cirrhosis?

A

hepatitis B and C
excessive alcohol intake
idiopasthic
non-alcoholic fatty liver disease

47
Q

when the liver is at the fatty liver stage can the damage be reversed?

A

yes

48
Q

what is alcoholic steatohepatitis?

A

a precursor to cirrhosis, includes inflammation and degeneration of hepatocytes
Begins irreversible damage

49
Q

is alcohol cirrhosis reversible?

A

no

50
Q

what are the early clinical manifestations of liver cirrhosis?

A

-N/V
-anorexia
-flatulence
-change in bowel habits
-fever
-weight loss
-palpable liver

51
Q

what are the late clinical manifestations of liver cirrhosis?

A

-jaundice
-peripheral edema
-decreased albumin
-ascites
-vascular lesions
-anemia / bleeding
-endocrine problems (women = amenorrhea)
-esophageal varices
-anorectal varices
-encephalopathy

52
Q

what is the primary factor associated with encephalopathy r/t cirrhosis

A

ammonia

53
Q

what does portal hypertension lead to?

A

varices and ascities

54
Q

what is the treatment for portal hypertension?

A

liver transplant

55
Q

what is the main concern with the development of portal hypertension?

A

development of varices that can then burst and cause internal bleeding

56
Q

what is acute liver failure?

A

separate liver failure not caused by cirrhosis or other types of liver disease

57
Q

what is the most common cause of acute liver failure?

A

acetaminophen overdose

58
Q

what is the antidote to acetaminophen overdose?

A

acetylcysteine

59
Q

how long after viral hepatitis or metabolic liver disease can acute liver failure happen?

A

6-8 weeks after

60
Q

how long after an acetaminophen overdose can acute liver failure happen?

A

5 days - 8 weeks

61
Q
A

Patho1 (22 decks)

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