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Liver Function > Liver Test Questions > Flashcards

Liver Test Questions Flashcards

1
Q

The majority of perfusion to the liver is delivered via the?

A

Hepatic Portal vein

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2
Q

The Hepatic portal Vein is the venous drainage for which four organs?

A

Stomach, esophagus, sm and lg intestines

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3
Q

What would happen if there was enough pressure in the hepatic portal vein?

A

Portal hypertension and could lead to an upper GI bleed

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4
Q

Where does the liver receive products of RBC breakdown from?

A

The spleen

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5
Q

The liver eliminates ammonia by converting it into?

A

BUN

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6
Q

Ammonia is the waste product of the break down in?

A

Protein

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7
Q

If there was a build up of ammonia, what medications would be normally see given to help the balance the lab value?

A

Lactalose
AND
antibiotics

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8
Q

Why would we see an antibiotic when ammonia gets too high?

A

An antibiotic will kill the gut flora, to control how much is being produced

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9
Q

What is Oncotic pressure?

A

Oncotic pressure, or colloid osmotic pressure, is a form of osmotic pressure exerted by proteins, notably albumin, in a blood vessel’s plasma (blood/liquid) that usually tends to pull water into the circulatory system.

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10
Q

What protein produced by the liver maintains oncotic pressure of our capillaries?

A

Albumin

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11
Q

What happens to oncotic pressure when a pt is in liver failure?

A

Liver produces albumin > LIVER FAILURE OCCURS > less albumin is being produced > decrease in oncotic pressure > ASCITES/ EDEMA

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12
Q

What does the spleen do?

A

Creates and releases platelets

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13
Q

Where is bile stored?

A

Gallbladder

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14
Q

What is iron used for?

A

to make Hgb or RBCS

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15
Q

Bile is needed for?

A

Fat absorption

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16
Q

Hepatic vein

A

nutrient and oxygen poor, takes blood back to right side of heart

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17
Q

portal vein

A

nutrient rich, takes from the spleen, stomach and sm and lg intestines. delivers the nutrients to the liver

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18
Q

proper hepatic

A

oxygen rich

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19
Q

What the fuck is a hepatic lobule?

A

Blood enters the lobules through branches of the portal vein and hepatic artery proper, then flows through sinusoids. YOU HAVE SO MANY OF THESE IN YOUR LIVER

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20
Q

Portal Triad is made up of?

A

Hepatic artery, portal vein, bile duct

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21
Q

Largest gland in your body?

A

Liver bitch

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22
Q

What does the liver do?

A

Storage, protection, metabolism

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23
Q

This is used to make RBCs and HgB in bone marrow?

A

Iron

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24
Q

The is used to make blood clot

A

Vitamin K

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25
Q

This is needed for calcium absorption

A

Vit D

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26
Q

What are Kupffler cells?

A

Destroy intestinal bacteria

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27
Q

How does the liver protect us?

A

It detoxifies blood! Foreign bodies are attacked!

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28
Q

Two ways for us to get cholesterol

A

Diet and liver production

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29
Q

Liver is supposed to convert Bilirubin into

A

Bile

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30
Q

Build of bilirubin leads to?

A

Jaundice

31
Q

1 reason for liver failure?

A

ALCOHOL

32
Q

2 reason for liver failure

A

HEP C

33
Q

3 reason for liver failure?

A

NASH

34
Q

What is NASH?

A

Non-alcoholic steatohepatisis

35
Q

Who is more at risk for NASH?

A

Pt with DM or chronically obese

36
Q

What’s another name for NASH?

A

“fatty liver”

37
Q

Early signs and symptoms

A

fatigue, may or may not have weight loss (caused by malnutrition), anorexia, vomiting/nausea, RUQ tenderness

38
Q

Late signs and symptoms

A

GI B, Jaundice, Ascites (third spacing), spontaneous brushing

39
Q

Complications with liver failure:

A 
portal hypertension
splenomegaly
esophageal varices
coagulation defects
ascites
GIB
spontaneous bacterial peritonitis
Hepatorenal syndrome
Hepatic enchephalopathy
40
Q

Is cirrhosis reversible?

A

fucking no it’s not.

41
Q

Is acute liver failure reversible?

A

yes boy it is

42
Q

How many stages of liver failure are there?

A

4 stages

43
Q

What is liver cirrhosis?

A

SCARRING

when the liver is unable to carry out excretory function, metabolic function are inadequate to meet demands

44
Q

What labs are we looking at for Liver Cirrhosis?

A

AST, ALT, LDH, ALK PHOS, Bilirubin, direct and total, urine urobilinogen, albumin, ammonia, PT/INR, platelets, HCT, Hgb

45
Q

Serum Enzymes: AST, ALT, LDH, ALK Phos

A

elevated

46
Q

Bilirubin: direct, total, urine urobilinogen

A

elevated

47
Q

Serum Proteins: Albumin

A

decreased

48
Q

PT/INR:

A

Prolonged (more time, increase)

49
Q

Ammonia:

A

Elevated

50
Q

CBC:

A

decreased

51
Q

What is Ascites?

A

Collection of fluid in the peritoneal cavity (3rd spacing) due to portal vein hypertension

52
Q

Ascites signs and symptoms

A

rigid, guarding behavior, abd. pain, warm, edema, yellow (amber) colored urine, hyperkalemia

53
Q

Treatment of Ascites

A 
Lasix 
Aldactone
IV albumin
low sodium diet
stricts I&Os
54
Q

What diuretic is potassium sparing?

A

Aldactone

55
Q

What is Jaundice?

A

A build up of bilirubin, the livers inability to convert bilirubin to bile

56
Q

What are some different reasons that Jaundice can happen?

A

Hemolytic, hepatocellular, obstructive

57
Q

Signs and symptoms of Jaundice

A

yellow eyes, ITCHY, amber urine, pale stools, fatigue, abdominal pain, vomiting

58
Q

Portal Hypertension

A

Splenomegaly > caput medusae > hemorrhoids > espophageal varices > gastropathy

59
Q

A pt says, “what the hell are these snake like things on my belly” what is it?

A

Caput Medusae

60
Q

Signs and symptoms or portal hypertension

A 
veins that pop out
prone to bleeding
coffee ground emesis
maroon stool
iron smelling stool
61
Q

Coagulation defects

A

Liver makes clotting factors, if liver is impaired the clotting factors are impaired.
injury > vessel contracts > platelet plug > fibrin clot

62
Q

Hepatic Encephalopathy is?

A

Increase ammonia

Shunting of portal venous blood back to central circulation, the substances from the intestines are not detoxified

63
Q

Treatment for Hepatic encephalopathy

A

lactalose

antibiotic

64
Q

Signs and symptoms of Hepatic Encephalopathy

A

shortened attention
lethargy and disorientation
somnolence with gross orientation
coma

65
Q

Those who have hepatic encephalopathy at at risk for

A

FALLS

66
Q

Hepatorenal syndrome

A

decreased renal perfusion

67
Q

Signs and symptoms of hepatorenal syndrome

A 
decreased UO, 
chronic ascites
reoccurring GIB
coffee ground emesis
hypovolemic shock
68
Q

At risk: Hemorrhage (congestion)

A

INTERVENTIONS: Screen for esophageal varices, IV fluids, Drug therapy, endoscopic therapy, Labs
TX: Fresh frozen plasma

69
Q

At risk: Fluids (fluid volume excess r/t third spacing/ ascites and peripheral edema

A

INTERVENTIONS: nutrition therapy, drug therapy, paracentesis, respiratory, position

70
Q

At risk: Hepatic Encephalopathy

A

INTERVENTIONS: Assessment (confusion, hand tremors), Nutrition therapy, Drug Therapy

71
Q

Transplant

A

refer if bilirubin increased, clotting increased, creatinine increase

72
Q

Hepatoxic Drugs

A

Acetaminophen, anti-platelet meds: aspirin, codeine, cyclosporine, valium, oral contraceptives, anti-seizure meds, anti psychotic meds
amiodarone

73
Q

IV albumin

A

Thicker, short/vented tubing

Liver Function (2 decks)

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