liver, gallbladder, pancreas

Question 1

functions of liver include:

Answer 1

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

Question 2

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

Answer 2

hepatic dysfunction

Question 3

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

Answer 3

untreated portal HTN

Question 4

systemic viral infection that causes necrosis & inflammation liver cells

Answer 4

viral hepatitis

Question 5

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

Answer 5

preicteric stage

Question 6

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

Answer 6

icteric stage

Question 7

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

Answer 7

posticteric stage

Question 8

fecal-oral transmission

Answer 8

Hep A, E

Question 9

blood/bodily fluids transmission

Answer 9

Hep B,C, D

Question 10

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

Answer 10

T

Question 11

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

Answer 11

cirrhosis

Question 12

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

Answer 12

cirrhosis

Question 13

body cannot clear normal levels bilirubin

Answer 13

hepatocellular jaundice

Question 14

blockage/occlusion of bile duct leading to jaundice

Answer 14

obstructive jaundice

Question 15

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

Answer 15

hepatocellular jaundice

Question 16

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

Answer 16

obstructive jaundice

Question 17

T/F: jaundice cannot be reversed

Answer 17

F

Question 18

persistent increase in pressure in portal vein; complication of cirrhosis

Answer 18

portal HTN

Question 19

diagnosis of portal HTN

Answer 19

hepatic venous pressure gradient

Question 20

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

Answer 20

ascites

Question 21

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

Answer 21

ascites

Question 22

diuretic to treat ascites

Answer 22

spironolactone

Question 23

nutritional therapy ascites

Answer 23

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

Question 24

fragile, thin-walled distended esophageal veins

Answer 24

esophageal varices

Question 25

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

Answer 25

esophageal varices

Question 26

tx shock from esophageal varices

Answer 26

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

Question 27

in treatment of shock, reduces bleeding

Answer 27

octeotide

Question 28

neuropsychic manifestation of liver damage due to high levels ammonia

Answer 28

hepatic encephalopathy

Question 29

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

Answer 29

hepatic encephalopathy

Question 30

stage I, cannot construct simple things

Answer 30

apraxia

Question 31

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

Answer 31

asterixis

Question 32

bad breath from accumulation digestive by-products

Answer 32

fetor hepaticus

Question 33

med tx hepatic encephalopathy

Answer 33

lactulose

Question 34

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

Answer 34

lactulose

Question 35

gallbladder functions:

Answer 35

bile storage, release bile into intestine to emulsify fats

Question 36

pancreas function

Answer 36

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

Question 37

inflammation of gallbladder

Answer 37

cholecystitis

Question 38

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

Answer 38

cholecystitis

Question 39

chronic cause of cholecystitis

Answer 39

insufficient bowel emptying (bile too thick)

Question 40

pain on deep inspiration when palpating subcostal margin

Answer 40

murphy's sign

Question 41

cholelithiasis

Answer 41

gallstones

Question 42

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

Answer 42

cholelithiasis

Question 43

after an ERCP, what reflexes must return?

Answer 43

cough & gag

Question 44

- 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

Answer 44

cholestyramine (questran)

Question 45

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

Answer 45

low/semifowler

Question 46

autodigestion of the pancreas

Answer 46

acute pancreatitis

Question 47

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

Answer 47

interstitial edematous

Question 48

tissue necrosis, can be more widespread in acute pancreatitis

Answer 48

necrotizing

Question 49

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

Answer 49

acute pancreatitis

Question 50

bruising around umbilicus

Answer 50

cullen's sign

Question 51

ecchymosis on flanks

Answer 51

turner's sign