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60 Cards in this Set
- Front
- Back
What is the most common cause of portal hypertension?
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Cirrhosis
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Abnormally high blood pressure in the portal vein, the large vein that brings blood from the intestine to the liver.
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Portal hypertension
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How is portal hypertension often classified?
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By the site of portal venous obstruction
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Caused by portal and splenic vein obstruction, most often by thrombosis
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Prehepatic Portal Hypertension
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Caused by intrahepatic vascular obstruction, most often by cirrhosis or metastatic tumor, and more rarely by _____.
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Intrahepatic Portal hypertension
Schistosomiasis (parasitic infection) |
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Caused by venous congestion in the distal hepatic venous circulation, most often as a result of constrictive pericarditis tricuspid inefficiency, congestive heart failure, or hepatic vein occlusion (Budd Chiari Syndrome)
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Posthepatic Portal Hypertentsion
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What two factors can increase blood pressure in the portal veins?
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1. Volume of blood going through vessels
2. Increased resistance to blood flow through the liver |
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What is the most common cause of portal hypertension?
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Increased resistance to blood flow in the liver caused by cirrhosis (alcoholics)
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What are the classic complications of portal hypertension?
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Esophageal varices
Splenomegaly Ascites |
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What is considered by some to be the single most important sign of portal hypertension?
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Splenomegaly
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What is often the first sign of portal hypertension?
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Bleeding from esophageal varices (dilated tortuous veins in the submucosa of the lower esophagus)
Coughing up of blood (Hemoptysis) |
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What is one of the most common causes of death in patients with cirrhosis associated with portal hypertension?
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Upper GI hemorrhage from bleeding esophageal varices
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A columnar metaplasia of the esophageal epithelium that occurs with chronic reflux
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Barrett's Esophagus
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What can be associated with esophageal webs and is also called plummer-vision syndrome and is rare?
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Iron deficiency anemia
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Clinically the first evidence of _____ is an increase in abdominal girth accompanied by weight gain.
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Ascites
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A detectable collection of free fluid in the periosteal cavity. Almost pure plasma and contains large amounts of protein.
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Ascites
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What are the two important factors relating to the formation of ascites?
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1. Increase in total body sodium and water
2. Increased sinusoidal portal pressure |
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What disease is the most common cause of ascites
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Liver disease
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What are the disorders that can be associated with ascites?
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Cirrhosis
Hepatitis Portal V. Thrombosis Constructive Pericarditis Congestive heart failure Liver Cancer Nephrotic Syndrome Pancreatitis |
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End stage renal disease in which the normal hepatic architecture is destroyed and replaced by bands of fibrous scar tissue. 75% of cases are caused by alcoholism.
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Cirrhosis of the liver
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What are the signs and symptoms of cirrhosis of the liver?
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Ascites
Splenomegaly Sudden upper GI bleeding vomiting blood Jaundice |
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What kind of angiomas are common in alcoholics?
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Spider angiomas
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Jaundice is not an illness, but a medical condition in which too much _____ is circulating in the blood.
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Bilirubin
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Where does bilirubin dissolve in jaundice?
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Subcutaneous fat
Causes yellow skin and eyes |
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All cases of jaundice indicate overload or damage to the liver, or inability to move bilirubin from the liver through the biliary tract to the gut except what?
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Newborn jaundice
1st week of life normal |
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What are the common causes of jaundice?
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1. Increased destruction of RBC's with rapid bilirubin release into blood
2. Obstruction of the bile ducts or damaged liver cells keeping bilirubin from excreting into GI tract |
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What is bilirubin the chief component of?
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Bile
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Formed by the conjugation of bilirubin with glucuronic acid.
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Conjugated bilirubin
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What is the important characteristic of Free bilirubin?
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Unbound and toxic
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High levels of bilirubin causing damage to the brain of newborn infants.
Can result in a characteristic form of crippling called _____ _____ _____. |
Kernicterus
Athetoid Cerebral Palsy |
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About 80% of people with hepatocellular carcinomas have what?
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Cirrhosis
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A cancer that arises from hepatocytes, the major cell of the liver.
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Hepatocellular carcinoma
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What increases the risk of developing hepatocellular carcinoma?
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Hep B and Hep C
Also Aflatoxins |
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Produced by a mold that is a contaminant of nuts (peanuts), grains, and beans
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Aflatoxins
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What is a viral hepatitis that was not caused by the type A or type B virus called?
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non-A, non-B Hepatitis
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What other viruses can cause non-A and non-B virus infections?
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Hep C
Hep D Hep E |
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What is the most common reason for liver transplant in the US?
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Hep C
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Serum hepatitis that is caused by a virus antigenically different from Hep A and Hep B. Most cases of post-transfusion hepatitides are of this type. Usu. much milder than A and B but is otherwise clinically indistinguishable from them.
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Hep C
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Which form of hepatitis has a higher incidence of chronic disease, cirrhosis, and hepatocellular carcinoma?
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Hep C
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Requires coinfection with Hep B. Drug addicts are at relatively high risk.
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Hep D
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Transmitted enterically, much like Hep A. A common sporadic cause of viral Hepatitis in _____. Close to 20% mortality in pregnant women.
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Hep E
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Which of the hepatitis forms does not develop into chronic hepatitis or cirrhosis?
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Hep A
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Highly contagious infectious disease of the liver. Usually transmitted by fecal-oral route. May also be transmitted parenterally as can _____ _____. Usually a result from ingestion to contaminated food, milk, or water. Many outbreaks are from ingestion of seafood and polluted water.
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Hep A
Hep B and Hep D |
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In what individuals does Hep A most often occur in?
What are the initial symptoms? |
Young Adults
Fever, malaise, abdominal pain, anorexia, jaundice |
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When do the symptoms of Hep A usually occur?
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Incubation period of 3-6 weeks
Complete resolution in most cases |
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There is _____ _____ of HAV with either cirrhosis or hepatocellular carcinoma, as there is for _____ and _____.
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No Association
Hep B Hep C |
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How is Hep B transmitted?
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Parenteral and sexual contact
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What are the risk factors for Hep B?
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Mult. Sex partners
IV drug abuse Receipt of blood |
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What are the signs and symptoms of Hep B?
What is the incubation period? |
Similar to Hep A
Longer incubation period 6-8 weeks Symptoms slower/ Duration longer |
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Most patients recover fully from Hep B, but what can they develop if they don't?
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Chronic liver disease
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What is an indication of hepatocellular damage?
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Increased serum transamines
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What does the presence of the surface A or B antigen in a patient's serum indicate ?
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Patient is potentially infectious for Hep (carrier state)
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Hepatitis virus is very _____ _____.
More so than _____ _____. |
Hepatitis Virus
AIDS Virus |
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Cirrhosis is twice as common in _____.
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Men
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Characterized anatomically by widespread nodules in the liver combined with fibrosis, the formation of which causes distortion of the normal liver architecture which interferes with blood flow through the liver.
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Cirrhosis
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At what ages is cirrhosis the third most common cause of death behind heart disease and cancer?
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45-65
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What are the causes of cirrhosis?
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Alcohol abuse 9Most common)
Chronic viral Hep B,C, and D Inherited metabolic diseases Chronic Bile Duct Diseases Chronic Congestive Heart Failure Parasitic Infections Nonalcoholic Steatohepatitis Long term exposure to toxins and drugs |
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What can men often develop when they have liver cirrhosis?
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Gynecomastia from increased production of estrogen
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Flapping Tremor
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Tremor common from liver disease
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Small lesions on the skin containing a centrally dilated, enlarged, blood vessel from which several smaller vessels radiate.
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Spider Angiomas (Spider telanglectasias
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