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19 Cards in this Set

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  • Back

how does bilirubin get transported?

the bilirubin binds to albumin and is transported to the liver

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)

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)

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.

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

what are the complications in the Icterus phase of viral hepatitis?

- enlarged liver and right upper quadrant pain

- hepatic jaundice

- coagulopathy

- encephalopathy

what are some complications of cholelethiasis?

- peritonitis

- increased risk for carcinoma

- acute cholecystitis

- pancreatitis

- obstruction that can cause jaundice

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

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

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

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

is it normal not being able to palpate the liver?


what is a possible false positive for hepatomegaly?

- you may percuss a false positive due to right pleural effusion or consolidation.

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

what can you expect to see when doing an assessment for ascites?

- you may notice a shifting dullness - the dullness level is higher.

what would be the value of INR of a patient with cirrhosis?

- you would see increased INR levels typically greater than 1.2

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

what is cholangitis?

- infection of biliary tract

how would you know that the gall bladder is filled with stones?

- having an enlarged, non-tender gall bladder during palapation.