Liver, Gallbladder, Pancreas Flashcards
elevated AST, ALT, or LDH suggest disease of what part of the liver
parenchyma
caval obstruction of the liver can lead to what
pedal edema
esophageal varices and splenomegaly can be seen due to liver dz due to what
portal HTN
why do liver patient’s not clot well
prothrombin is made by the liver and the liver is damaged
INR above 1 means what in terms of clottin
slow clot and bleeding too much
INR less than 1 means what
blood is too thick and clot too much
why is circulating plasma protein decr in liver patients
liver makes the plasma proteins
what happens when plasma protein is decreased in liver patients?
lots of edema in tissue space (anasarca)
what is anasarca and who is it commonly seen in
generalized edema. seen in liver patients
what is ascites and who is it seen in
hepatic enlargement due to accumulation of fluid in the peritoneal cavity
what is acites due to (4 reasons)
- Abdominal organs weeping plasma
- Compression of hepatic lymphatic vessels weeping fluid
- Hypoalbuminemia (albumin helps hold fluid into the vessels and this is gone in liver pateints)
- Sodium/H20 retention due to decreased renal circulation
jaudice/icterus in liver patient’s is caused by what
elevated plasma bilirubin (bilirubin cannot become conjugated so it cannot be made water soluble bc the liver is where it is conjugaged with glucoronic acid)
why is breast enlargement seen in liver dz
liver is not able to metabolize estrogen
high MELD score = highest chance for mortiality than a low MELD
yes
causes of liver disease
- Autoimmune (hepatitis)
- Infections
- Toxic damage (drug or alcohol use)
- Neoplasia
route of transmission for Hep A
oral-fecal
serological blood marker for Hep A
IgM antibodies
is there a vaccine for hep a
yes
does hep a often cause long term damage to liver
no
route of transmission for hep b
needles, oral-fecal, STD, dental or medical procedure, childbirth
is hep b a rna or dna virus
dna
HAA is associated with what type of hepatitis
hep b
Austrialian antigen is associatedd with what hepatitis
hep b
do most people with hep b recover
yes
90% completely recover
10% have chronic, progressive hepatitis and cirrhosis
is there a hep b vaccine
yes
route of transmission for hep c
STD, tattoos, childbrith, blood transfusion
is there a vaccine for hep c
NO
does hep c cause long term damage
yes.
50% develop chronic hepatitis
20% develop cirrhosis and/or hepatocellular carcinoma
what is the route of transmission for hep d
STD, needles, oral-fecal, dental and medical procedure (like hep b)
which heptatis only occurs as a simulatenous infection with HBV
HDV
true or false: hep b with hep d has the highest overall mortality rate of all acute viral infections
true
route of transmission for hep E
oral fecal transmission
does hep e have a vaccine
yes
hep e is not very deadly and not seen much in the US but is dangerous for who
those who are pregnant
causes of Non-alcohiolic fatty liver disasee
- DM
- Obesity
- Elevated Cholesterol and Trigs
Sclerosing Cholangitis is what
autoimmune causing the ducts to scar and things to back up into the liver
Cirrhosis of the liver is marked with what
Ascites
does Prothrombin time and the INR incr or decr with ESLD
increases, so someone does not clot as easily and bleeds easily
why are low levels of platelets seen with ESLD
bc there are low levels of Cytokine Thrombopoientin which is prodcued by the liver and stimulates the production of plateletes
why does the pH drop and metabolic acidosis occur during ESLD
failure to detoxify NH3 into urea in the liver, so NH3 is converted to NH4+ which throws and extra H+ ion into the bloostream which can lead to acidosis
is arterial or venous blood usually more acidic
venous blood (venous blood has a lower pH)
pH below what level is metabolic acidosis
7.35
two compensatory mechanisms for metabolic acidosis
- incr resp rate
2. renal compensation
stages of hepatoceullular encephaloapthy
1 = personality changes 2 = muscle involvement 3 = violence 4 = hepatic coma
The Glasgow Come scale is on a scale of 3-15 based on 3 things
- Best eye response
- Best verbal response
- Best motor response
Acute pancreatitis refers pain where usually
the back
main cause of acute pancreatitis
overuse of alcohol
prolonged cases of acute pancreatits can result in what
auto-digestion of pancreas
chronic pancreatitis can come from what
- acute pancreatitis
2. chronic alcohol abuse
what can cause chronic pancreatitis in kids
cystic fibrosis (gradual replacement of functional tissue occurs
pancreatic neoplasia most often occurs in what type of people
those who are black males
Cholesithiasis (Gall Stones) most often occurs in who
females 40-50 years old
6 F’s for Gall Stones
- Fair
- Fat
- Female
- Fertile
- Flatulent
- Forty
what causes gall stones
precipitation of cholesterol and bile pigments. stasis of bile occurs
sign and sx of gall stones
pain in the upper right quadrant. May radiate in the mid upper back and shoulder
Does pain get worse or better when you eat with Gall Stones
worse (feel better before you eat)
