Patho Liver

Front 1

Metabolic Functions of the Liver. Sugars  stored as ______ converted to______ used to make_____

Back 1

glycogen, glucose, fats

Front 2

Metabolic Functions of the Liver. Proteins  synthesized from__________; ammonia made into _____

Back 2

amino acids, urea

Front 3

Metabolic Functions of the Liver. Fats  _______for energy, synthesized, packaged into_______

Back 3

oxidized, lipoproteins

Front 4

Drug and hormone metabolism-liver. Biotransformation into _______-_______ or does what to them?

Back 4

water-soluble forms, Detoxification or inactivation

Front 5

Liver Failure Can Lead To …JVHA

Back 5

Jaundice, varices, hepatic encephalopathy, ascites

Front 6

Jaundice (icterus) a yellow or greenish pigmentation of the skin caused by _________

Back 6

hyperbilirubinemia (serum levels > 2.5-3.5mg/dl)

Front 7

obstructive intrahepatic jaundice- Bilirubin conjugated by hepatocytes cannot flow into the ________, conjugated and unconjugated bilirubin accumulates in the ______ and enters the ______

Back 7

duodenum, liver, bloodstream

Front 8

Varices – distended tortuous collateral veins primarily in lower ______, stomach, or rectum and is the most common cause of ____ bleeding.

Back 8

Esophagus, UGI

Front 9

Hepatic encephalopathy pathophysiology

Back 9

a combination of biochemical alterations that affect neurotrans. Liver dysfunction and vessels which permits toxins to circulate freely to the brain. Most toxic substance is end products of intestinal protein digestion esp. ammonia.

Front 10

Dx of hepatic encephalopathy is

Back 10

hx of liver disease, S&S and EEG and Blood chem

Front 11

S&S of early hepatic encephalopathy include subtle _______ changes, memory loss, irritability, lethargy, sleep disturbances.

Back 11

Personality

Front 12

S&S of late hepatic encephalopathy include

Back 12

confusion, coma, convulsions and asterixis

Front 13

tx for hepatic encephalopathy is 1st to correct what? Then restrict dietary protein intake and elim intestinal bacteria.

Back 13

Fluid and electrolyte imbalances and w/e of depressant Drugs that are metabolized by the liver.

Front 14

Hepatic encephalopathy may develop [rapidly or slowly?] during acute fulminant hep or [rapidly or slowly?] during chronic liver disease and the development of portal hypertension.

Back 14

Rapidly, slowly

Front 15

Asterixis (flapping tremor), confusion, coma, convulsions are S&S of a) Hepatomegaly b) Splenomegaly c)jaundice d) hepatic encephalopathy

Back 15

d) hepatic encephalopathy

Front 16

Ascites is the Accumulation of fluid in the _______ cavity, the Body fluid trapped in the ___________and cannot escape which Reduces the amount of fluid available for normal physiologic functions.

Back 16

Peritoneal, third space”

Front 17

Cirrhosis most common cause of _______and Results from decreased_______ and ________-____________ pressure.

Back 17

Ascites, albumin, capillary oncotic

Front 18

other causes of ascites are malnutrition, nephrotic syndrome and ______-failure.

Back 18

heart

Front 19

Ascites Causes

Back 19

weight gain, abdominal distention, large volumes of fluid (10 to 20 Liters) can displace diaphragm and cause dyspnea

Front 20

pathophysiology of ascites is the impaired excretion of _____ by the kidneys which results in water retention. Portal hypertension and ↓ _______which leads to capillary hydrostatic pressure exceeding capillary _______ pressure. Imbalance pushes water into the peritoneal cavity.

Back 20

Na+, albumin, osmotic

Front 21

Hepatitis A can be found in the feces, bile, and serum of infected individuals,. Usually transmitted by what route?? , Risk factors-Crowded, unsanitary conditions esp. _____ and ______ contamination

Back 21

the fecal-oral route, Food and water

Front 22

Hepatitis B Transmitted through contact with infected ?

Back 22

blood, body fluids, or contaminated needles, The hepatitis B vaccine prevents transmission and development of hepatitis B

Front 23

Hep B Maternal transmission can occur if the mother is infected during the ____trimester,

Back 23

third

Front 24

Hepatitis C is responsible for most cases of post-transfusion hepatitis, Also implicated in infections related to IV drug use, __% to ___% of hepatitis C cases result in chronic hepatitis

Back 24

50-80%

Front 25

An infant whose mother has hepatitis

Back 25

hepB

Front 26

Inflammatory process can damage and obstruct bile canaliculia, leading to cholestasis and _________jaundice

Back 26

obstructive

Front 27

Hepatitis Can range from absence of symptoms to

Back 27

fulminating hepatitis with rapid onset of liver failure and coma (HBV most associated with fulminating type although rare in occurrence)

Front 28

2 weeks after exposure, ends with appearance of jaundice – fatigue, anorexia, N&V, headache, fever a) Prodromal b) icteric c) recovery

Back 28

a-prodromal

Front 29

1 to 2 weeks after prodromal and lasts 2 to 6 weeks, jaundice, dark urine, clay-colored stools, liver enlargement – actual phase of illness a) Prodromal b) icteric c) recovery

Back 29

b-icteric

Front 30

after resolution of jaundice, about 6 to 8 weeks, symptoms diminish but liver remains enlarged and tender a) Prodromal b) icteric c) recovery

Back 30

c-recovery

Front 31

Chronic Viral Hepatitis

Back 31

Caused by HBV, HCV, HDV

Front 32

chronic viral hep. Clinical manifestations and liver inflammation persist after

Back 32

acute phase

Front 33

Principal cause of chronic liver disease, cirrhosis, and hepatocellular cancer in the world is

Back 33

chronic viral hep

Front 34

Chief reason for liver transplantation in adults is?

Back 34

Chronic viral hep

Front 35

Cirrhosis is

Back 35

Irreversible inflammatory disease , Decreased hepatic function caused by nodular and fibrotic tissue synthesis (fibrosis)

Front 36

Biliary channels become ______and cause portal hypertension. Because of the hypertension, blood can be shunted away from the liver, and a hypoxic necrosis develops

Back 36

obstructed

Front 37

alcoholic cirrhosis damages hepatocytes and inhibits export of _____, alters metabolism of vitamins and minerals, and induces ________

Back 37

proteins, malnutrition

Front 38

Cellular damage causes an inflammatory process, that along with necrosis, results in excessive

Back 38

collagen formation, fibrosis and scarring. This alters the structure of the liver and obstructs biliary and vascular channels

Front 39

Cirrhosis- Fatty infiltration occurs as lipogenesis and fatty acid oxydation [increases or decreases??] by damaged hepatocytes

Back 39

decreases

Front 40

cirrhosis Multi-system disease and as it progresses:

Back 40

Hepatomegaly, Splenomegaly, Portal hypertension Leads to esophageal bleeding (varices), Hepatic encephalopathy, Results from impaired ammonia metabolism, Anemia – from blood loss and poor nutrition,

Front 41

Biliary Cirrhosis Primary – autoimmune inflammation and destruction of small intrahepatic bile ducts; affects who

Back 41

women and those older than 30 years