Liver Nemecek

Question 1

What are 3 things that are included in a physical assessment of liver disease?

Answer 1

1. Jaundice
2. Ascites
3. Hepatic encephalopathy

Question 2

Yellowing of the skin, starting with the eyes

Answer 2

Jaundice

Question 3

Large volume of fluid in peritoneal cavity

Answer 3

Ascites

Question 4

When patients present with altered mental status, it could be caused by what?

Answer 4

Hepatic encephalopathy

Question 5

What AST:ALT ratio is suggestive of alcohol related liver disease?

Answer 5

3:1

Question 6

What AST:ALT ratio is highly suggestive to Wilson’s disease?

Answer 6

> 10:1

Question 7

If LFTs are >1000 U/L what could it mean?

Answer 7

Viral hepatitis, ischemic liver injury or drug induced liver injury

Question 8

What are the 3 synthetic functions of the liver?

Answer 8

1. INR
2. Albumin
3. Bilirubin

Question 9

What synthetic function is impacted by nutrition and medications?

Answer 9

INR

Question 10

What synthetic function is impacted by nutrition, protein stores and protein clearance?

Answer 10

Albumin

Question 11

What synthetic function is impacted by hemolysis?

Answer 11

Bilirubin

Question 12

If there’s a high unconjugation of bilirubin, what does this mean for the liver?

Answer 12

The liver isn’t working

Question 13

What does it mean if there is a high amount of conjugated bilirubin?

Answer 13

Means there’s an issue with the biliary tract

Question 14

What does it mean if both conjugated and unconjugated bilirubin is elevated?

Answer 14

1. Alcohol induced liver disease
   OR
2. Toxic liver failure

Question 15

What can be elevated in liver disease but is not specific?

Answer 15

Alkaline phosphatase

Question 16

What is used to predict one and two year survival?

Answer 16

Child-Pugh score

Question 17

What is the equation for modified discriminate function score?

Answer 17

4.6 *(PT prolongation) + serum bili/ 17.1

Question 18

What MDS score shows there is sever alcoholic hepatitis?

Answer 18

> 32

Question 19

1 point for Albumin range

Answer 19

> 3.5

Question 20

2 points for Albumin range

Answer 20

2.8-3.5

Question 21

3 points for Albumin range

Answer 21

<2.8

Question 22

1 point for bilirubin range

Answer 22

<2

Question 23

2 points for bilirubin range

Answer 23

2-3

Question 24

3 points for bilirubin range

Answer 24

> 3

Question 25

1 point for INR range

Answer 25

<1.7

Question 26

2 points for INR range

Answer 26

1.7-2.3

Question 27

3 points for INR range

Answer 27

> 2.3