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24 Cards in this Set
- Front
- Back
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clinical signs of liver disease
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-- hepatomegaly with hepatic inflammation (should only be palpated a fingersbreth below the costal margin)
-- elevated liver enzymes (out from the liver) - aspartate aminotransferase (AST) - lactic dehydrogenase (LDH) - alkaline phosphatase - alanin aminotransferase (ALT) - amma glutamyl-transferase (GGT) [all help with liver processes] -- caval obstruciton with pedal edema -- portal hyptertension (congestion into hepatic portal vein) & splenomegaly -- depression of clotting mechaninsm, easy bleeding* (prothrombin time, INR inc.) -- circulation plasma protein dec. (causes edema) |
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PT treatment of liver patient
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need to use extreme precaution
-- do not use aggressive physical treatment as can lead to bruising and possible internal bleeding |
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ascites
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- compression of abdominal lymphatics
- portal passive congestion (blood back up into abd. organs) - hypoalbuminemia (dec. plasma proteins-> edema) - sodium retension (retain H2O) - impaired water excretion |
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more signs of liver disease
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- elevated plasma bilirubin w/ jaundice (icterus) -> bilirubin collect in skin
- pruitis (itching) [bilirubin -> product of hemoglobin breakdown |
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sclera jaundice
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- yellow tinted skin (if lighted skin)
- look at sclera of eyes for jaudice |
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anarsarca
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- hypoproteinemeia
- swelling all over |
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hepatitis A
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-- Type A virus (HAV)
- oral-facal route mode of entry* (eating something contaminated by feces) - 28 day incubation - 4-6 week course (self limiting) - serological marker -> anti HAV antibody - treatment: dose of gammaglobulins |
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Hepatitis A s/s
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- constitutional
- nasea & diarrhea - jaundice w/ pruritis - hepatomegaly, elevated enzymes - aversion to food & cigarette smoke |
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Hepatitis B
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- HBV
- mode of entry: inoculation (through open wound or skin penetration), oral-fecal route, or STD* - 120 day incubation - variable course, longer term, "self limiting" - "carriers" may exist (2%) -> assymtomatic, still carrying disease, can pass onto others - marker: anit HBsAg (outer protein coat); Australian antigen |
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components of HBV
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- HVsAg
- HBeAG - HBcAg - has incomplete ring of circular DNA within a core particle (HBcAg) surrounded by a surface protien coat (HBsAg) |
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Hepatitis B s/s
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- constitutional
- nausea & diarrhea - jaundice with pruritis - hepatomegaly, elevated enzymes - aversion to food & cigarette smoke -> more severe presentation than HAV |
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HBV percentages
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- 90& complete recovery w/ 2% carriers
- 10% chronic, progressive hepatitis |
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non A/non B Hepatitis
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-- Type C - similar to HBV
- blood transfusion related - EV drug use - STD?? - tattoos, body piercing - RNA virus - marker: anti-HCV antibodies |
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HCV percentages
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- 50% develop chronic hepatitis
- 20% cirrhosis or hepatic cancer - 1-6% may be HCV carriers |
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HCV s/s
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- constitutional
- nausea & diarrhea - jaundice w/ pruritis - hapatomegaly, elevated enzymes - aversion to food & cigarette smoke -> may be most benign of hepatitis infections -> long term potential damage to liver bad |
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cirrhosis
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- end stage liver disease
- fatal, irreversible - 50% is alcohol related (Laennec's) |
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cirrhosis progression
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-- develop fatty liver
-- marked ascites -- cirrhosis progression -cobblestone appearance -replacement w/ car tissue -end stage liver disease (ESLD) -hepatocellular failure |
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hepatocellular failure - ESLD
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-- uniformly fatal
-- contributing events -hemorrhage -failure to detoxify ammonia (NH3) -metabolic acidosis (pH <7.4)-> depresses CNS -hepatic encephalopathy |
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acute pancreatitis
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- inflammation of pancreatic tissue and ducts
- overuse of alcohol - mild to severe pain (in pit of stomach or radiate up back to b/t scapulas) - 95% resolution in a few days to a few weeks - prolonged cases result in autodigestion of pancreas |
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chronic pancreatitis
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- chronic, ongoing pancreatic inflammation
- may develop from acute pancreatitis or chronic alcohol abuse - may develop from cystic fibrosis in children - gradual replacement of functional tissue with scar tissue |
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pancreatic neoplasia
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- benign cysts & tumors
- malignant tumors (5 year survival <5%); most die w/in 6 months - occur most often in AA males - risk factors: smoking, diabetes mellitus, aging, male, genetics |
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cholelithiasis (gall stones)
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- 6 F's: fat, fair, fertile, flatulent, forty, female
- disease of older individuals (>65) - females > males |
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gall stone etiology
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- unknown
- precipitation of cholesterol & bile pigments - stasis of bile - bacterial infection |
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gall stones s/s
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- pain-upper right quadrant
- may radiate to the mid upper back - relief-pain food pattern |
