Liver

Question 1

Results from abnormally high concentration of the pigment bilirubin in the blood.

NORMAL concentration: 0.2-1.3mg/dl

If serum level 2.5mg/dl, jaundice is
visible.

Answer 1

Bilirubin

Question 2

circulates freely in blood until

reaches

Answer 2

Conjugated direct Bilirubin

Question 3

binds with protein in blood

Answer 3

Unconjugated(indirect) bilirubin

Question 4

Excess destroyed RBCs

Elevated unconjugated bilirubin in bloodstream

Answer 4

Hemolytic jaundice

Question 5

Caused by liver disease

Elevated conjugated and unconjugated bilirubin levels

Answer 5

Hepatocellular jaundice

Question 6

Caused by block in passage of bile between liver and
intestinal tract.
Elevated conjugated bilirubin levels

Answer 6

Obstructive jaundice

Question 7

Lack of appetite
Nausea
Weight loss
Malaise
Fatigue
Weakness
Headache
Chills
Fever, if infectious in origin

Answer 7

S/S of heptacellulor jaundice

Question 8

Dark orange-brown urine
Light clay-colored stools
Dyspepsia
Intolerance of fats
Impaired digestion
Pruritus

Answer 8

S/S obstructive jaundice

Question 9

Causes Ascites and esophageal varices

Answer 9

Portal hypertension

Question 10

Avoid: smoked, cured, salted, canned foods, cold cuts, ham, frankfuters, sausage, sardines, caviar, anchovies, frozen dinners, canned soups, salted nuts
Diuretics- Spirolactone K + sparing
Bed rest
Administration of salt-poor albumin
Paracentesis
Transjugular intrahepatic portosystemic shunt
(TIPS)

Answer 10

Treatment of ascites

Question 11

Normal LOC
Lethargy
Euphoria
Reversal of day-night sleep patterns
Asterixis
Impaired writing and ability to draw line figures
Normal EEG

Answer 11

Stage 1 hepatic encephalopathy

Question 12

Increased drowsiness
Disorientation
Inappropriate behavior
Labile mood
Agitation
Asterixis
Fetor hepaticus
Abnormal EEG with generalized slowing

Answer 12

Stage 2 hepatic encephalopathy

Question 13

Stuporous
Difficult to arouse
Sleeps most of the time
Marked confusion
Incoherent speech
Asterixis
Increased deep tendon reflexes
Rigidity of extremities
EEG markedly abnormal

Answer 13

Stage 3 hepatic encephalopathy

Question 14

COMATOSE
May not respond to painful stimuli
ABSENCE of Asterixis
ABSENCE of Deep Tendon Reflexes
Flaccidity of extremities
EEG markedly abnormal

Answer 14

Stage 4 hepatic encephalopathy

Question 15

Steady decrease in size and weight of liver
Decreased blood flow
Rescued drug metabolism
Slow clearance of hepatitis B surface antigen
Decline in drug clearance
Decreased gallbladder contraction after meal
Atypical presentation of biliary disease
Increased prevalence of gallstones

Answer 15

Age related changes of hepatic system