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19 Cards in this Set
- Front
- Back
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how does bilirubin get transported? |
the bilirubin binds to albumin and is transported to the liver |
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how do we diagnose a prehepatic jaundice? |
- pre-hepatic jaundice is characterized by increased amounts of unconjugated bilirubin in the blood. - accompany a decreased amount of hematocrit level and absent bilirubin in the urine. - (< 42% for males and < 37% for females) |
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is it normal for infants to experience jaundice? if not what are the complications? |
it is NOT NORMAL for infants to experience jaundice AT BIRTH OR AFTER 1 WEEK. This could lead to kernicterus, a neurological disorder caused by the unconjugated bilirubin passing the immature blood-brain barrier. (a mature blood brain barrier is not affected) |
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how do we diagnose a patient with hepatic jaundice? |
- total bilirubin will be high (BOTH conjugated and unconjugated) - excess conjugated bilirubin will be excreted in urine causing a dark amber urine - blood work will show elevated levels of liver enzymes as liver cells die. |
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what are the characteristics of a posthepatic jaundice? |
- there will be elevated levels of conjugated bilirubin in the blood - elevated blood cholesterol - dark coloured urine - pale coloured feces - steatorrhea - pruritus |
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what are the complications in the Icterus phase of viral hepatitis? |
- enlarged liver and right upper quadrant pain - hepatic jaundice - coagulopathy - encephalopathy |
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what are some complications of cholelethiasis? |
- peritonitis - increased risk for carcinoma - acute cholecystitis - pancreatitis - obstruction that can cause jaundice |
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what does Anti-HBs positive mean? what does what is HBsAg positive mean? |
- Anti-HBs positive means that the person is immune to hepa B virus - HBsAg positive means that the patient is infected with the hepa B virus and contains the antigen |
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what causes ascites in patients with cirrhosis? |
- portal hypertension - the increased hydrostatic pressure pushed fluid out of the portal circulation into the peritoneal cavity - cirrhosis causes liver impairments which causes decreased production of albumin and thus, decreases the plasma oncotic pressure in the portal circulation - there is also impaired breakdown of aldosterone which causes retention of sodium and water |
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what are some clinical manifestations of cirrhosis? |
- encephalopathy due to inability to produce urea and accumulation of ammonia - hepatic jaundice due to the destruction of hepatocytes - coagulopathy due to the decreased synthesis of clotting factors - can lead to bleeding disorders like anemia and thrombocytopenia. - hormonal imbalances can cause gynecomastia, impotence, testicular atrophy and amenorrhea |
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what are some manifestations of pancreatitis? |
- severe epigastric pain - hemmorhage from the destruction of blood vessels, this can lead to hypovolemic shock - hyperamylasemia and hyperlipasemia occurs due to the destruction of pancreatic cells - hypocalcemia occurs due to increased free fatty acids - hyperglycemia can occur due to the destruction of B cells and cause diabetes - hyperkalemia can occur due to the enzymatic destruction of cells - peritonitis due to irritation of peritoneum |
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is it normal not being able to palpate the liver? |
yes. |
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what is a possible false positive for hepatomegaly? |
- you may percuss a false positive due to right pleural effusion or consolidation. |
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what does it mean when you palpate the liver and find that its enlarged, smooth and non-tender? |
- this may be due to portal obstruction or cirrhosis |
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what can you expect to see when doing an assessment for ascites? |
- you may notice a shifting dullness - the dullness level is higher. |
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what would be the value of INR of a patient with cirrhosis? |
- you would see increased INR levels typically greater than 1.2 |
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what is the endoscopic retrograde cholangiopancreatography?? |
- it is a specialized endoscopic technique used to study the bile ducts, pancreatic duct and gall bladder. This method may cause perforation, infection and even pancreatitis |
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what is cholangitis? |
- infection of biliary tract |
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how would you know that the gall bladder is filled with stones? |
- having an enlarged, non-tender gall bladder during palapation. |
