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19 Cards in this Set
- Front
- Back
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What is hemolytic jaundice? |
- Caused by blood transfusion reactions, sick cell crisis, hemolytic anemia - RBCs break down, producing large amount of unconjugated bilirubin in the blood - Liver unable to handle increased load |
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What is hepatocellular jaundice? |
- Caused by hepatitis, cirrhosis, hepatocellular carcinoma - Results from liver's altered ability to take up bilirubin from the blood or to conjugate or excrete it - In hepatocellular disease, damaged hepatocytes leak bilirubin |
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What is obstructive jaundice? |
- Causes are hepatitis, cirrhosis, hepatocellular carcinoma, common bile duct obstruction from stones, biliary strictures, sclerosing cholangitis, pancreatic cancer - Results from decreased or obstructed flow of bile through liver or biliary duct system - Obstruction may occur in intrahepatic or extrahepatic bile ducts - Intrahepatic obstructions are due to swelling or fibrosis of the liver's canaliculi and bile ducts |
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What are cautions for acetaminophen? |
- Patients tend to be unaware of its prevalence in pain relievers, fever reducers, cough medicines - Common cause of acute liver failure - Combining acetaminophen with alcohol increases risk of liver damage |
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A patient presents with decreased serum colloidal oncotic pressure. What does this indicate? |
- The vessels are more permeable to leakages due to deficient albumin, leading to ascites |
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What are the effects of hyperaldosteronism? |
- Increased sodium and water retention, but potassium loss |
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What factors cause ammonia to increase, resulting in hepatic encephalopathy? |
- GI hemorrhaging allow ammonia to leak with blood into GI tract - With hypokalemia, there is no longer any potassium present to metabolize ammonia - Ammonia increases with hypovolemia - Infection increases cerebral sensitivity to toxins, allowing ammonia to do more damage after crossing blood brain barrier - CNS depressants cause decreased liver metabolism -> Ammonia runs free - Metabolic alkalosis facilitates ammonia transport across blood brain barrier - Paracentesis causes loss of sodium and potassium - Dehydration potentiates ammonia toxicity |
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How do vasopressin and octreotide treat cirrhosis? |
- Controls bleeding in esophageal and gastric varices - Vasoconstriction of splanchnic arterial bed |
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How do beta blockers like propranolol and nadolol treat Cirrhosis? |
- Reduce portal hypertension
- Reduce esophageal varices and bleeding |
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How do lactulose infusions treat Cirrhosis? |
- Acidify feces in bowel and trap ammonia inside the feces so it can't cause hepatic encephalopathy |
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How do rifaximin, neomycin sulfate, and magnesium sulfate treat Cirrhosis? |
- Decrease bacterial flora to decrease ammonia formation
- Replace magnesium lost in bleeding |
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How does vitamin K treat Cirrhosis? |
- correct clotting abnormalities |
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How do proton pump inhibitors like pantoprazole treat Cirrhosis? |
- Decrease gastric acidity |
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How do diuretics like spironolactone and furosemide treat Cirrhosis? |
- Blocks action of aldosterone in sodium and water retention; causes water excretion to alleviate hyponatremia - Act on distal tubule and loop of henle to decrease reabsorption of sodium and water |
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How does morphine treat pancreatitis? |
- Relieves pain |
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How do antispasmodics treat pancreatitis? - Dicyclomine |
- Decrease vagal stimulation, motility, pancreatic outflow, leading to decreased volume and concentration of bicarbonate and pancreatic enzyme secretion IE trypsin - Contraindicate in paralytic ileus because it further slows GI motility |
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How do carbonic anhydrase inhibitors treat pancreatitis? - Acetazolamide |
- Decrease volume and bicarbonate concentration of pancreatic sections IE trypsin |
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How do antacids treat pancreatitis? |
- Neutralize gastric acid secretion, which stimulates pancreatic enzyme activity - Decreases production and secretion of pancreatic enzymes and bicarbonate |
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How do proton pump inhibitors treat pancreatitis? - Omeprazole |
- Decrease gastric acid secretion, which stimulates pancreatic enzyme activity |
