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NUR 326 (Patho 1) > Liver (Exam 2) > Flashcards

Liver (Exam 2) Flashcards

1
Q

Major Functions of the LIver

A

Metabolism and storage of fat-CHO-vitamins-minerals

Blood volume reservoir - Distended/compresses to alter circulation blood volume

-Filters blood

-Blood clotting factors

-Drug metabolism and detoxification

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2
Q

Portal Circulation

A

The portal circulatory system brings blood to the liver from the stomach, intestines, spleen, and pancreas

Blood enters through the portal vein

the absorbed products of digestion come directly to the liver and are sent to the lobules

This is the first pass effects

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3
Q

Major Liver Enzymes

A

ALT
AST
Alk Phos

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4
Q

Does ALT, AST, and ALK Phos increase or decrease with liver problems

A

Increase

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5
Q

Does serum Ammonia increase or decrease with liver failure

A

Increase because the liver breaks ammonia down

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6
Q

Does serum protein and albumin increase or decrease with liver failure

A

Decrease because the liver helps produce these

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7
Q

Does prothrombin time increase or decrease with liver problems

A

Increases

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8
Q

Jaundice (icterus): Caused by

A

Increased levels of bilirubin in the bloodstream

usually causes problems and is noticeable with total bilirubin is greater than 2-2.5mg/dl

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9
Q

How to determine cause of jaundice

A

Look at conjugated versus unconjugated to determine possible cause

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10
Q

3 classifications of Jaundice

A

Hemolytic
Hepatocellular
Obstructive

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11
Q

Hemolytic Jaundice

A

Increased breakdown of RBC’s

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12
Q

Hepatocellular Jaundice

A

Liver unable to take up bilirubin from blood or unable to conjugate it

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13
Q

Obstructive Jaundice

A

Decrease or obstructed flow of bile

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14
Q

Bilirubin

A

By product of heme breakdown –> mainly hemoglobin

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15
Q

Conjugated Bilirubin

A

Direct

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16
Q

Unconjugated Bilirubin

A

Indirect

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17
Q

Elevations of INDIRECT bilirubin

A

bilirubin overproduction or impaired liver functioning

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18
Q

Elevations of DIRECT bilirubin

A

Liver working, but cant get the bilirubin out. Obstruction / gall stone

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19
Q

Jaundice Clinical Manifestations

A

Dark amber urine

Elevated liver enzymes

Normal / clay stools

Pruritus

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20
Q

Viral Hepatitis

A

Systemic virus that mainly affects the liver. Inflammation

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21
Q

Various strains of hepatits

A

A B C

other virus that can cause hepatitis –> epstein-barr and cytomegalovirus

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22
Q

Hepatitis (not viral) can also come from

A

Alc abuse - Drugs - Chemicals - Bacteria

23
Q

What viral hepatitis is most dangerous in pregnancy

A

Hepatits E

24
Q

Viral Hepatitis: Pathogenesis

A

Viral Infection

Immune response: Inflammatory mediators

Lysis of infected cells

Edema swelling of tissue

Tissue hypoxia

Hepatocyte death

25
Q

Stages of Viral Hepatitis

A

Prodromal

Icteric

Recovery

26
Q

Viral Hepatitis: Prodromal stage

A

2 weeks after exposure

Fatigue, anorexia, malaysia, nausea, vomiting, HA, hyperalgesia, cough, low grade fever

High transmissible

27
Q

Viral Hepatitis: Icteric stage

A

Beings with jaundice

Jaundice - Dark urine - Clay stools

Liver enlarged and may be painful to palpate

Abdominal pain persists or increases in severity

28
Q

Viral Hepatitis: Recovery

A

Resolution of jaundice

6-8 weeks after exposure, symptoms diminish

Liver remains enlarged / tender

29
Q

Do symptoms always occur with hepatitis?

A

No

30
Q

Viral Hepatits: Complications

A

Most patients recover completely with no complications

-Chronic hepatits
-Liver cirrhosis
-Liver cancer
-Fulminant viral hepatitis - acute liver failure

31
Q

HEP A

A

-Food borne illness related to unsafe food handling

32
Q

HEP A transmission

A

Fecal oral, parental, sexual

33
Q

HEP A: S/S

A

Acute onset with fever. Usually mild severity

34
Q

Does HEP A cause chronic hepatitis?

A

NO

35
Q

HEP A prevention

A

Hand hygiene and Hep A vaccine

36
Q

HEP B

A

IV drug use or sexual contact

common within substance use community

37
Q

HEP B: Presentation

A

Insidious with long incubation period

38
Q

Can HEP B cause chronic hepatitis?

A

Yes my be prolonged

39
Q

HEP B: prevention

A

Vaccine, safe sex, and hygiene

All children and health care have to get HEP B vaccine

40
Q

HEP C common causes

A

IV drug use and unsafe sex

Mother to fetal and medical mishapes

41
Q

HEP C: presentation

A

Insidious onset with mild to severe symptoms

42
Q

can HEP C lead to chronic hepatits

A

Yes, 80% do

43
Q

HEP C prevention

A

Screening for blood - Hygiene - NO vaccine

44
Q

HEP C can lead to

A

Hepatocellular carcinoma

Now there are new drugs that prevent that

45
Q

HEP A vaccines

A

-2 doses 6 months apart

All children beginning at 12 months

Special high risk populations: Travel -Health care - Handle food

46
Q

HEP B vaccines

A

3 doses at least 4 months apart

All infants beginning as newborns

47
Q

HEP C vaccines

A

none

48
Q

Two classes of drugs that are use for chronic HBV

A

Interferons

Nucleoside analogs

49
Q

Treatment for HBV is only for

A

High risk patients:

Increase AST levels
Hepatic inflammation
Advanced fibrosis

50
Q

Disadvantages of HBV treatment

A

Prolonged therapy

Costs and Adverse effects

High relapse

51
Q

HCV treatment thoughts

A

Treatment is only recommended for patients with chronic disease

However, this through is changing with the introduction of newer, very effective drugs

52
Q

HCV treatment

A

Direct-acting antiviral therapy and

interferon-based regimen

some require treatment along with nucleoside analogue medication as well

53
Q

Any patient with hepatitis can or cant take tylenol?

A

Can but it has to be less than 2 grams per day

NUR 326 (Patho 1) (27 decks)

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