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adult health > liver, gallbladder, pancreas > Flashcards

liver, gallbladder, pancreas Flashcards

1
Q

functions of liver include:

A

glucose metabolism, ammonia conversion, protein metabolism, fat metabolism, vitamin & iron storage, bile formation, bilirubin excretion, drug metabolism

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2
Q
  • acute/chronic cirrhosis of liver
  • infection (hepatitis)
  • fatty liver disease
  • s/s: jaundice, portal HTN
A

hepatic dysfunction

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3
Q
  • ascites
  • hepatic encephalopathy or coma
  • nutritional deficiencies
  • esophageal varices
    results from…
A

untreated portal HTN

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4
Q

systemic viral infection that causes necrosis & inflammation liver cells

A

viral hepatitis

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5
Q

pt experiences flu-like symptoms (n/v, generalized weakness, anorexia)

A

preicteric stage

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6
Q

symptoms worsen to dark urine, clay colored stools, jaundice, RUQ tenderness, increased AST/ALT

A

icteric stage

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7
Q

recovery; decreased jaundice, livery enzymes start to return to normal, urine/stool color starts to normalize

A

posticteric stage

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8
Q

fecal-oral transmission

A

Hep A, E

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9
Q

blood/bodily fluids transmission

A

Hep B,C, D

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10
Q

T/F: you can only get Hep D from already having Hep B

A

T

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11
Q

chronic condition caused by extensive scarring of liver due to necrosis or chronic inflammation

A

cirrhosis

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12
Q

s/s:
- hepatomegaly
- portal obstruction
- ascites
- esophageal varices
- hepatic encephalopathy
- vit deficient anemia
- jaundice

A

cirrhosis

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13
Q

body cannot clear normal levels bilirubin

A

hepatocellular jaundice

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14
Q

blockage/occlusion of bile duct leading to jaundice

A

obstructive jaundice

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15
Q

s/s:
- n/v
- wt loss
- mild or severely ill
- malaise, fatigue, weakness
- headache, chills, fever, infection

A

hepatocellular jaundice

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16
Q

s/s:
- dark orange-brown urine, clay colored stools
- dyspepsia & intolerance to fats, impaired digestion
- pruritus
- yellow skin, sclera, mucous membranes of mouth

A

obstructive jaundice

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17
Q

T/F: jaundice cannot be reversed

A

F

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18
Q

persistent increase in pressure in portal vein; complication of cirrhosis

A

portal HTN

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19
Q

diagnosis of portal HTN

A

hepatic venous pressure gradient

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20
Q

Increased pressure in portal system makes body compensate & send blood to other areas, when blood gets into other areas those vessels aren’t as big as portal vein, stretch to provide better flow, stretch makes them leak, cause them to spill proteins into blood (fluid/electrolytes follow) into abdomen

A

ascites

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21
Q

s/s:
- edema
- hypervolemia (wt gain, crackles on auscultation, tachycardia, hypotension, shallow & rapid resp, SOB)
- increased abdominal girth
- absent bowel sounds

A

ascites

22
Q

diuretic to treat ascites

A

spironolactone

23
Q

nutritional therapy ascites

A

small frequent meals, vit supplementation, fluid restriction, low Na

24
Q

fragile, thin-walled distended esophageal veins

A

esophageal varices

25
Q

s/s:
- melena
- altered mental status
- may be in shock (losing blood)
- bleeding

A

esophageal varices

26
Q

tx shock from esophageal varices

A
  1. restore volume (IV, volume expanders)
  2. replace electrolytes
  3. blood & blood products
    admin vasopressin, nitroglycerin, octeotide
27
Q

in treatment of shock, reduces bleeding

A

octeotide

28
Q

neuropsychic manifestation of liver damage due to high levels ammonia

A

hepatic encephalopathy

29
Q

s/s:
- altered mental status
- mood changes
- motor disturbances
- hyperreflexive DTRs (early stages), flaccid (later)
- apraxia, asterixis, fetor hepaticus

A

hepatic encephalopathy

30
Q

stage I, cannot construct simple things

A

apraxia

31
Q

stage II, liver flap (involuntary flexion/extension of hands due to buildup ammonia)

A

asterixis

32
Q

bad breath from accumulation digestive by-products

A

fetor hepaticus

33
Q

med tx hepatic encephalopathy

A

lactulose

34
Q

oral/rectal, goal to have 2-3 BM/day, promoters BM

A

lactulose

35
Q

gallbladder functions:

A

bile storage, release bile into intestine to emulsify fats

36
Q

pancreas function

A

exocrine (digesteve enzymes), endocrine (insulin, glucagon somatostatin)

37
Q

inflammation of gallbladder

A

cholecystitis

38
Q

s/s:
- guarding, rigidity, rebound tenderness
- murphy’s sign
- epigastric pain radiating to R shoulder
- n/v, indigestion
- tachycardia

A

cholecystitis

39
Q

chronic cause of cholecystitis

A

insufficient bowel emptying (bile too thick)

40
Q

pain on deep inspiration when palpating subcostal margin

A

murphy’s sign

41
Q

cholelithiasis

A

gallstones

42
Q

s/s:
- pain & biliary colic
- positive murphy’s sign
- jaundice, pruritus
- changes in urine/stool color
- vit deficiency (fat-soluble)

A

cholelithiasis

43
Q

after an ERCP, what reflexes must return?

A

cough & gag

44
Q
  • relief of pruritus
  • binds bile salts in intestine increasing fecal excretion
  • taste may deter pt –> mix w/ pulpy fruit juice
  • can lead to constipation & impaction, obstruction
A

cholestyramine (questran)

45
Q

what position should a pt be post-op for laparoscopic cholecystectommy?

A

low/semifowler

46
Q

autodigestion of the pancreas

A

acute pancreatitis

47
Q

enlargement of the pancreas due to inflammation/edema in acute pancreatitis

A

interstitial edematous

48
Q

tissue necrosis, can be more widespread in acute pancreatitis

A

necrotizing

49
Q

s/s:
- Abdominal pain  sudden onset, rigid, board-like abdomen, LUQ radiating to back
- n/v, fever
- jaundice
- tachycardia, hypotension
- respdistress
- cullen’s sign
- turner’s sign

A

acute pancreatitis

50
Q

bruising around umbilicus

A

cullen’s sign

51
Q

ecchymosis on flanks

A

turner’s sign

adult health (10 decks)

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