Week 6.1 Clinical Presentation of Hepatic Diseases Flashcards
what are the major functions of the liver
- produce albumin and other plasma proteins
- bile production
- conversion and excretion of bilirubin
- produce clotting factor
- store vitamins
- immune for the gut
what is the liver and gallbladder primary pain pattern
mid-epigastrium and the right upper quadrant of the abdomen
secondary referral pattern of the liver
T7-T10, right shoulder
secondary referral pattern of the gallbladder
right shoulder, right inter scapular (T4/5-T8), right subscapular
what are some gastrointestinal symptoms that point to hepatic disease
nausea, vomiting, diarrhea, constipation, heartburn
what does stool and urine look like with hepatic disease
dark urine and light pale stool
what part of the abdomen will you get pain with hepatic disease
the right upper quadrant
what skin changes are associated with hepatic disease
jaundice,
bruising,
spider angioma,
palmar erythema
what are the neurologic things involved with hepatic disease
confusion sleep disturbances muscle tremors hyperactive reflexes asterixis (clonus at the wrist)
TF: you can get MSK pain, edema and ascites with hepatic disease
true
what is portal hypertension
increased venous blood pressure in the portal vein, over 6mmHg
when is portal HTN the most common
cirrhosis
describe the process portal HTN has
increased pressure combines with inter hepatic vasoconstriction, secondary to decreased nitric oxide release with alterations in the architecture of the liver, and increased the pressure in the veins, so venous flow backs up to the spleen, stomach, esophagus, umbilicus
what is cirrhosis
progressive loss of normal tissue replaced with fibrous and nodular regeneration, permanent disruption of hepatic tissue
what are the signs and symptoms of cirrhosis
fatigue, weight loss, jaundice, coagulopathies, loss of ability to metabolize drugs and hypoalbuminemia
