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internal med unit 3 > the hepatic, pancreatic, and biliary systems > Flashcards

the hepatic, pancreatic, and biliary systems Flashcards

1
Q

what are four functions of the liver?

A

conversion and excretion of bilirubin

produce of clotting factors and storage of vitamins

metabolize drugs, chemicals, and toxins

filters all of the blood from the GI system

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2
Q

what protein is the liver the sole source of?

A

albumin

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3
Q

TRUE OR FALSE: the liver produces 600 ml of bile each day

A

true

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4
Q

what is the primary function of the exocrine gland of the pancreas?

A

secretion of digestive enzymes and pancreatic juices

neutralize the acidic substances passed from the stomach to the dueodenum

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5
Q

what is the function of the endocrine gland of the pancreas?

A

secretion of glucagon and insulin for the regulation of carbohydrate metabolism

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6
Q

what structures secrete glucagon and insulin in the endocrine gland of the pancreas?

A

islet of Langerhans cells

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7
Q

what organ is a reservoir for bile?

A

gallbladder

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8
Q

what helps in alkalinizing the intestinal contents and plays a role in the emulsification, absorption, and digestion of fat?

A

bile

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9
Q

where does the gallbladder expel the bile into in response to the arrive of food?

A

duodenum

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10
Q

what are primary signs and symptoms of liver diseases?

A

GI symptoms
edema/ascites
dark urine
light colored or clay feces
right upper abdominal pain

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11
Q

what causes hepatic failure?

A

cirrhosis, liver cancer, or infection/inflammation

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12
Q

the following clinical syndromes are signs of what organ failure?

hepatic encephalopathy
renal failure
endocrine changes
jaundice

A

hepatic failure

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13
Q

what do light colored stools and urine the color of tea or cola indicate?

A

liver necrosis

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14
Q

what are some skin changes associated with the hepatic system?

A

jaundice
pallor
orange or green skin

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15
Q

what condition may be vascular manifestations of increased estrogen levels?

A

spider angioma

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16
Q

what condition is the warm redness of the skin over the palms, also called liver palms?

A

palmar erythema

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17
Q

what is hepatic encephalopathy?

A

a condition where the liver fails to filter out toxins from the blood which causes toxins to build up and affect the brain.

As a result, people experience symptoms like confusion, modo changes, etc.

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18
Q

is hepatic encephalopathy reversible?

A

yes

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19
Q

what is asterixis? and what population is it often seen in?

A

people with hepatic encephalopathy

the inability to maintain wrist extension with forward flexion of the upper extremities

20
Q

where is liver referred pain occur on the body?

A

thoracic pain between scapulae, right shoulder, right upper trap, right interscapular, or right subscapular areas

21
Q

what is hepatic osteodystrophy? and what type of liver disease is it common in?

A

a condition where liver disease leads to problems with bone health.

It can happen in people with any type of liver disease that blocks or slows down bile flow

22
Q

where do people with long term liver disease experience bone weakness?

A

wrist and ankles

23
Q

what should you do if a client presenting undiagnosed or untreated jaundice comes into the clinic?

A

refer them to a physician

24
Q

what should be avoided when the liver is compromised? (what physical activity?)

A

active, intense exercise

25
Q

what are some PT implications that we should be aware of with people with liver disease?

A

risk for pressure ulcers

risk of coagulopathy (easy bruising and bleeding under the skin or into the joint)

26
Q

what happens with aging and the hepatic system?

A

liver decreases in size, weight, and blood flow

27
Q

with aging, it requires ____ time to process substances, medication, and alcohol

A

more

28
Q

true or false: you become more tolerant to damage and more able to repair and regenerate the liver

A

FALSE: you become less tolerant and less able to repair and regenerate

29
Q

what happens to albumin production with aging?

A

decreases

30
Q

TRUE OR FALSE: Because there is a decrease in albumin, drugs that typically bind to albumin become more active in the blood

A

true

31
Q

what type of medications have an increased area of distribution in older people in proportion to an increase in fat mass and decrease of lean mass with aging?

A

lipophilic

32
Q

what are the four common causes of jaundice?

A

disease associated with overproduction of bilirubin

decreased uptake or conjugation in bilirubin metabolism

hepatocyte dysfunction

impaired bile flow

33
Q

what is jaundice?

A

yellow discoloration of the skin, sclerae, and mucous membranes

34
Q

what disease does the patient have if their skin is yellow, urine turns darker, and stool is light in color?

A

jaundice

35
Q

what is the final common pathway of chronic, progressive inflammation of the liver?

A

cirrhosis

36
Q

is cirrhosis reverisble?

A

no

37
Q

what is cirrhosis?

A

occurs when inflammation causes liver tissue damage or necrosis

38
Q

what is portal hypertension?

A

an elevated portal pressure gradient occurs when the pressure of the blood entering the liver is higher than the pressure of the blood in the inferior vena cava

39
Q

what increases resistance and forms mechanical barriers in portal hypertension?

A

fibrosis
nodularity
abnormal liver architecture

40
Q

TRUE OR FALSE: blood backs up in the stomach, esophagus, umbilicus, and rectum causing dilation and expansion

A

true

41
Q

what is a complex neuropsychiatric syndrome with symptoms ranging from subtle neuropsychiatric and motor disturbances to coma and death?

A

hepatic encephalopathy (HE)

42
Q

what are common causes of hepatic encephalopathy?

A

GI bleeding, infection, hypovolemia, or electrolyte abnormalities

43
Q

what is ascites?

A

abnormal accumulation of fluid within the peritoneal cavity

44
Q

what other condition accompanies ascites that makes it hard to breath?

A

dyspnea (increased respiratory rate occurs when the fluid displaces the diaphragm)

45
Q

what is spontaneous bacterial peritonitis? and what other condition does it accompany?

A

infection of ascitic fluid in the setting of portal hypertension

ascites

internal med unit 3 (11 decks)

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