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43 Cards in this Set

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What happens when liver can't break down bilirubin?
jaundice
what is caput madusae?
dilated veins around the umbilicus. caused by gradual obstruction of venous blood flow in the liver
what is an esophageal varice?
very dilated thin-walled varicosities in the submucosa of the esophagus.. SUBJECT TO RUPTURE--MASSIVE AND FATAL HEMMORHAGE--consequence of portal hypertension due to cirrhosis.
What is the composition of a gallstone?
80% of all gallstones composed primarily of cholesterol.
the other 20% of gallstones are black/brown pigmented stones composed of bilirubin/calcium salts
What are the three factors that contribute to the formation of gallstones?
1. abnormalities in the composition of bilirubin
2. stasis of bile
3. inflammation of the gallbladder
What is hepatic encephalopathy?
CNS manifestations (i.e. confusion, coma, asterixis) due to liver failure
what is asterixis?
liver flaps (hand flapping) due to hepatic encephalopathy
What are the 4 most common causes of jaundice?
1. excessive destruction of RBC
2. impaired uptake of bilirubin by the liver
3. decreased conjugation of bilirubin
4. obstruction of bile flow
AST lab value normal range
5-40
ALT lab value normal range
7-56
What are manifestations of cirrhosis?

(Aka)Describe the person with cirrhosis?
jaundice, fetor hepaticus (sweet breath), hepatic encephalopathy (confusion, liver flaps), muscle wasting, ascities, hemorrhoids, caput meduasae, palmar erythema, purpura, edema
What is portal hypertension?
increased resistance to flow inthe portal venous system.
What are 3 area of causes of portal hypertension?
prehepatic (e.g. portal vein thrombosis before blood enters liver)
intrahepatic (e.g.
posthepatic(e.g. thrombosis of hepatic veins --after liver)
polycythemia vera?
hypercoag state associated with malignant tumors, pregnancy, trauma, liver dz
prodomal/ preicterus period sysmptoms of acute hep?
Onset abrupt or insidious: general malaise, myalgia,
arthralgia, fatigue, severe anorexia, N/V/D, or
constipation, pain, chills, fever,
icterus period symptoms of acute hep?
Follows by 5-10 days; jaundice, pruritis and liver
tenderness, dark urine
What happens during the convalescent periods of acute hep?
!2-3 week period with improvement and increased
sense of well-being
!Harbors disease and sheds virus
!Recovery may last up to 9-16 weeks per type of
hepatitis
How to treat pancreatitis?
Treatment—rest pancreas 3-7 days
and Pain relief —use opioids carefully
to prevent
sphincter of Oddi dysfunction. Meperdinemore
effective for some
!Relief of nausea/vomiting
!NPO/NG suction
!Complications
!Acute Respiratory Distress Syndrome and acute
tubular necrosis
!Acute necrotizing pancreatitis !Multi organ
dysfunction
!Nutritional deficits
!Pseudocyst-collection of pancreatic fluid-may
resolve or require surgical intervention
What are risk factors for pancreatic cancer?
AGE!
SMOKING!
diabetes and pancreatitis
What sort of diet puts you at risk for pancreatic cancer?
fat, meat, refined sugars, alcohol, fried foods, dehydrated foods, soybeans and nitroamines (carcinogenic)
Which diet will reduce your risk for pancreatic cancer?
diet high in vegetables, fiber, vitamin C
What is celiac disease?
gluten sensitive enteropathy. immune mediated disorder triggered by ingestion of gluten-containing grains (wheat, barley, and rye).
What is the most common cause of chronic hepatitis?
HCV
What are common risk factors for getting HCV?
sharing needles for recreational drugs
risky sexual behavior
healthcare setting needle stick injuries
tattooing, body piercing
Which heps have vaccines?
HAV and HBV
Disease of the liver that causes inflammation?
Viral Hepatitis
What is an intrahepatic biliary disorder?
Cirrhosis
What are the four types of cirrhosis?
1.Primary Biliary Cirrhosis
2. Primary Sclerosing Cholangitis
3. Secondary Biliary Cirrhosis
4. Alcoholic liver disease
-- Alcoholic fatty liver
--Alcoholic hepatitis
What is primary biliary cirrhosis?
type of cirrhosis caused by autoimmune destruction of the liver. bile accumulates. treat the symptoms.
Cholestyramine is a bile acid-binding drug, beneficial for tx of pruritis--a symptom of which dz?
primary biliary cirrhosis
What is the cause of secondary biliary cirrhosis?
prolonged obstruction of extrabiliary tree (cholelithiasis, neoplasms)
What is steatosis?
fatty liver
Clotting factor IV...what is it and when is it required?
Calcium, rquired in all but the first 2 steps of the clotting process
What renal issue is a bad risk for ACEs?
renal stenosis
Beta blocker causes which important AEs
fatigue and depression
don't give clot busters to which patients?
pts with clotting disorders, bleeding, post-op
What are names of cardioselctive beta blockers?
atenolol
What renal issue is a bad risk for ACEs?
renal stenosis
What is paroxysmal nocturnal dyspnea definition?
labored breathing that awakens pt from slumber
Beta blocker causes which important AEs
fatigue and depression
don't give clot busters to which patients?
pts with clotting disorders, bleeding, post-op
What are names of cardioselctive beta blockers?
atenolol
Which anticoag blocks the factors from developing? Which anticoag blocks fibrin from forming?
warfarin; heparin