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24 Cards in this Set

  • Front
  • Back
clinical signs of liver disease
-- 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)
PT treatment of liver patient
need to use extreme precaution
-- do not use aggressive physical treatment as can lead to bruising and possible internal bleeding
- 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
more signs of liver disease
- elevated plasma bilirubin w/ jaundice (icterus) -> bilirubin collect in skin
- pruitis (itching)

[bilirubin -> product of hemoglobin breakdown
sclera jaundice
- yellow tinted skin (if lighted skin)
- look at sclera of eyes for jaudice
- hypoproteinemeia
- swelling all over
hepatitis A
-- 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
Hepatitis A s/s
- constitutional
- nasea & diarrhea
- jaundice w/ pruritis
- hepatomegaly, elevated enzymes
- aversion to food & cigarette smoke
Hepatitis B
- 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
components of HBV
- HVsAg
- HBcAg
- has incomplete ring of circular DNA within a core particle (HBcAg) surrounded by a surface protien coat (HBsAg)
Hepatitis B s/s
- constitutional
- nausea & diarrhea
- jaundice with pruritis
- hepatomegaly, elevated enzymes
- aversion to food & cigarette smoke
-> more severe presentation than HAV
HBV percentages
- 90& complete recovery w/ 2% carriers
- 10% chronic, progressive hepatitis
non A/non B Hepatitis
-- Type C - similar to HBV
- blood transfusion related
- EV drug use
- STD??
- tattoos, body piercing
- RNA virus
- marker: anti-HCV antibodies
HCV percentages
- 50% develop chronic hepatitis
- 20% cirrhosis or hepatic cancer

- 1-6% may be HCV carriers
HCV s/s
- 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
- end stage liver disease
- fatal, irreversible
- 50% is alcohol related (Laennec's)
cirrhosis progression
-- develop fatty liver
-- marked ascites
-- cirrhosis progression
-cobblestone appearance
-replacement w/ car tissue
-end stage liver disease (ESLD)
-hepatocellular failure
hepatocellular failure - ESLD
-- uniformly fatal
-- contributing events
-failure to detoxify ammonia (NH3)
-metabolic acidosis (pH <7.4)-> depresses CNS
-hepatic encephalopathy
acute pancreatitis
- 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
chronic pancreatitis
- 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
pancreatic neoplasia
- 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
cholelithiasis (gall stones)
- 6 F's: fat, fair, fertile, flatulent, forty, female
- disease of older individuals (>65)
- females > males
gall stone etiology
- unknown
- precipitation of cholesterol & bile pigments
- stasis of bile
- bacterial infection
gall stones s/s
- pain-upper right quadrant
- may radiate to the mid upper back
- relief-pain food pattern