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PHCP 2 > Liver Cirrhosis, Hepatitis, Pancreatitis > Flashcards

Liver Cirrhosis, Hepatitis, Pancreatitis Flashcards

1
Q

only organ that can regenerate once damaged

A

Liver

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2
Q

Chronic and irreversible liver disease due to exposure to hepatotoxic substances leading to inflammation and abnormal collagen formation/secretion

A

Cirrhosis

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3
Q

Portal triad

A

bile duct (BD)
portal vein (PV)
hepatic artery (HA)

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4
Q

Flapping tremor

A

Asterixis

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5
Q

an abnormal connection between the portal vascular system and systemic circulation

A

Portosystemic shunt

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6
Q

Enlargement of spleen due to back flow of blood

A

Congestive splenomegaly

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7
Q

increased estrogen can cause ________, _________, _________

A

Gynecomastia, spider angiomata, palmar erythema

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8
Q

Accumulation of fluid in peritoneal cavity

A

Ascites

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9
Q

Hypoalbuminemia may lead to

A

Edema

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10
Q

Unconjugated bilirubin will result to

A

Jaundice

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11
Q

once the liver is damaged, the production of clotting factors will be affected, leading to

A

Bleeding

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12
Q

Removing excess fluid in the abdomen

A

Paracentesis

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13
Q

Mainstay primary prophylaxis for variceal bleeding

A

Beta adrenergic blockers

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14
Q

NONSELECTIVE B-Blocker should be used

A

propranolol or nadolol

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15
Q

Decrease splanchnic arterial blood flow with a subsequent decrease in portal inflow

A

Somatostatin and Octreotide

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16
Q

TIPS

A

Transjugular intrahepatic portosystemic shunt

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17
Q

decrease water retention with ascites

A

Furosemide and Spironolactone

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18
Q

Bacterial Peritonitis

A

Broad-Spectrum antibiotics

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19
Q

This can cause fulminant hepatitis (cirrhosis).

A

Hepatitis E

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20
Q

HAV family

A

Picornaviridae (RNA)

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21
Q

Not sexually transmitted

A

HEPATITIS A

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22
Q

ONLY HEPATITIS THAT CAN BE CURED

A

HEPATITIS A

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23
Q

does not cause chronic hepatitis

A

HEPATITIS A

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24
Q

Has the largest potential among hepatitis virus to cause epidemic

A

HEPATITIS A

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25
Q

Most common transmission of HAV

A

fecal-oral route

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26
Q

Spread by ingestion of contaminated water and food

A

HEPATITIS A

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27
Q

Yellowing of eyes in jaundice

A

Icteric sclera

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28
Q

Joint pain

A

Arthralgia

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29
Q

Uncommon sequelae of acute infection

A

RELAPSING

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30
Q

Smokers lose their taste of tobacco

A

PRODROME

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31
Q

Dark urine

A

ICTERIC PHASE

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32
Q

decrease in bile flow due to impaired secretion by hepatocytes

A

Cholestasis

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33
Q

may shorten the period of cholestasis

A

Corticosteroids and Ursodeoxycholic acid

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34
Q

DOC for gallstones

A

Ursodeoxycholic acid

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35
Q

used for pre- and post exposure prophylaxis, and offers passive immunity

A

Immunoglobulin

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36
Q

Vaccines for HAV

A

Havrix and Vaqta

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37
Q

Mean incubation period of HAV

A

2 - 4 weeks

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38
Q

Commonly transmitted via body fluids such as blood, semen and vaginal secretion

A

HBV

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39
Q

HBV family

A

Hepadnaviridae

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40
Q

Can produce fulminant hepatitis with massive liver necrosis

A

HBV

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41
Q

Asymptomatic carrier

A

HBV

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42
Q

__________ transmission is the primary mechanism for HBV infection

A

Sexual

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43
Q

_________ was the most prevalent identifiable risk factor for HBV

A

International travel

44
Q

surface antigen of the DNA virus

A

HBsAg

45
Q

core antigen (no envelope*)

A

HBcAg

46
Q

secreted by the precore

A

HBeAg

47
Q

Extracellular form of HBcAg

A

HBeAg

48
Q

HBV enters a 4- to 10-week incubation period

A

Initial or acute phase

49
Q

Marks a decrease in HBV DNA levels with ongoing secretion of HBeAg.

A

immunoactive phase

50
Q

HBeAg is replaced by Anti-HBeAg

A

Seroconversion phase

51
Q

most prominent surface antigen and is detectable at the onset of clinical symptoms

A

HBsAg

52
Q

High levels of antibodies are detectable during acute infections.

A

IgManti-HBcAg

53
Q

If there is an infection and if it is proliferating, there should be _______

A

HBcAg

54
Q

Patients who respond to vaccines will have ______ only.

A

anti-HBsAg

55
Q

HBV vaccines

A

Recombivax HB and Engerix-B

56
Q

combination vaccine for HAV and HBV in adults

A

Twinrix

57
Q

HBV vaccine used for children

A

Comvax and Pediarix

58
Q

T/F: HBV infections are not curable

A

T

59
Q

First-line therapy options for HBV

A

○ interferon (IFN)-α2b
○ Lamivudine–also used for HIV, pregnant women
○ Telbivudine
○ Adefovir
○ Entecavir
○ Pegylated IFN-α2a

60
Q

most common blood-borne pathogen

A

HCV

61
Q

approximately five times as common as HIV

A

HCV

62
Q

caused by an RNA virus from the flaviviridae

A

HCV

63
Q

single largest risk factor for HCV infection is

A

injection drug use

64
Q

Vast majority of cases are chronic hepatitis.

A

HCV

65
Q

detected 1-2 weeks of exposure

A

HCV

66
Q

No vaccine

A

HCV

67
Q

inhibiting key viral enzyme, NS3/4A serine protease

A

BOSEPREVIR

68
Q

Must be administered together with PGN-INF alpha and ribavirin

A

BOSEPREVIR

69
Q

Inhibits HCV NS3/4A protease needed for proteolytic cleavage

A

TELAPREVIR

70
Q

Specifically intended for patients with compensated liver disease such as cirrhosis

A

TELAPREVIR

71
Q

DOCfor thrombocytopenia

A

Eltrombopag

72
Q

Stimulates bone marrow platelet production to provide stable platelet counts toallow therapy with interferons

A

Eltrombopag

73
Q

Antiviral nucleoside analogue

A

Ribavirin

74
Q

Not effective when given alone

A

Ribavirin

75
Q

Mean incubation period of HBV

A

1-4 months

76
Q

Digests proteins

A

Trypsin & Chymotrypsin

77
Q

Digests Carbohydrates

A

Amylase

78
Q

helps indigestion

A

exocrine function

79
Q

regulates blood sugar such as insulin and glucagon

A

endocrine function

80
Q

inflammatory disorder of the pancreas characterized by upper abdominal pain and pancreatic enzyme elevations

A

Acute pancreatitis

81
Q

progressive disease characterized by long-standing pancreatic inflammation

A

Chronic pancreatitis

82
Q

account for most cases in the United States

A

Gallstones and alcohol abuse

83
Q

used in cancer chemotherapy, particularly breast cancer

A

Tamoxifen

84
Q

type of platinum compound that is also used as an anticancer

A

Oxaliplatin

85
Q

SIRS

A

systemic inflammatory response syndrome

86
Q

increased intestinal permeability and translocation of colonic bacteria

A

Pancreatic infection

87
Q

I GET SMASHED

A

● Idiopathic
● Gallstones
● Ethanol
● Trauma
● Steroids
● Mumps
● Autoimmune
● Scorpion sting
● Hyperlipidemia / Hypercalcemia
● Endoscopic Retrograde Cholangiopancreatography (ERCP)
● Drugs

88
Q

ERCP

A

Endoscopic Retrograde Cholangiopancreatography

89
Q

lactated Ringer’s at an initial rate of

A

5 to 10mL/kg/hour

90
Q

crystalloids at a rate of

A

250 to 500 mL/hour

91
Q

_______ analgesics are used to control abdominal pain

A

Parenteral opioid

92
Q

considered in patients with necrosis who deteriorate or fail to improve within 7 to 10 days

A

Empiric antimicrobial therapy

93
Q

Imipenem-Cilastatin: now replaced by

A

Meropenem

94
Q

Imipenem should not be given alone because it would cause

A

seizure

95
Q

accounts for about two-thirds of cases in Western society

A

Chronic ethanol consumption

96
Q

Excessive fat in stool

A

steatorrhea

97
Q

a late manifestation commonly associated with pancreatic calcification

A

Pancreatic diabetes

98
Q

Nitrogenous substance in the stool

A

Azotorrhea

99
Q

recommended for patients who cannot consume adequate calories, have continued weight loss, experience complications, or require surgery

A

Enteral nutrition via a feeding tube

100
Q

Pain management should begin with weak opioid analgesics

A

tramadol, codeine

101
Q

Administration of _____________ prior to meals may decrease postprandial pain

A

short-acting analgesics

102
Q

should be considered for patients with steatorrhea who are unable to gain weight

A

Supplementation withmedium-chain triglycerides

103
Q

Adjuvant agents should be added if patients have inadequate relief from opioids alone.

A

Pregabalin (75 mg twice daily initially; maximum 300 mg twice daily)

104
Q

The enzyme dose required to minimize malabsorption is ___________ units of lipase administered with each meal.

A

30,000 to 50,000

105
Q

The dose may be increased to a maximum of ______ units per meal.

A

90,000

PHCP 2 (5 decks)

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