Q6 116

Front 1

What are the four characteristic sign and symptoms of Hepatic encephalopathy?

Back 1

➢ HAVING CHRONIC LIVER DISEASE, HEPATIC COMA

➢ CONFUSION AND DISORIENTATION

➢ DELIRIUM AND HALLUCINATION

➢ FETOR HEPATICUS A MUSTY BREATH ODOR OF PT.

Front 2

Is a coarse tremor characterized by rapid, nonrhythmic extension and flexion on the wrist and fingers this due to neurological impairment due elevated serum ammonia?1/1

Back 2

ASTERIXIS

Front 3

What is the characteristic of pain in Cholecystitis?

Back 3

➢EPIGASTRIC PAIN THAT RADIATES TO THE SCAPULA, 2 TO 4 HOURS AFTER EATING FATTY FOODS AND MAY PERSIST 4-6 HRS

➢THE PAIN BVECOMES LOCALIZED ON THE RIGHT UPPER QUADRANT REGARDING RIGIDITY

Front 4

This is end- stage hepatic failure and cirrhosis caused by elevated serum ammonia?1/1

Back 4

HEPATIC ENCEPHALOPATHY

Front 5

Is inflammation of the liver caused by virus, exposure to medications, or hepatotoxins?···

Back 5

HEPATITIS

Front 6

What is the drug of choice to relief of pain in Chlolecystitis?1/1

Back 6

DEMEROL

Front 7

What is the position of the patient during liver biopsy?1/1

Back 7

LEFT SIDE POSITION

Front 8

Inflammation of the gallbladder?

Back 8

Acute cholecystitis

Front 9

is the presence of gallstones

Back 9

Cholelithiasis

Front 10

What is the rationale why patient with cirrhosis of the liver , that his skin always feel itchy and scratches himself raw?

Back 10

DUE TO ACCUMULATION OF BILE SALTS IN THE SKIN

Front 11

What are 5 F's predisposing factor in Cholecystitis?5/5

Back 11

FEMALE

FAT

FORTY

FAIR

FERTILE

Front 12

Known as a post- transfusion hepatitis?1/1

Back 12

HEPATITIS C

Front 13

What is the rationale, why you are going to instruct the patient to exhale deeply; hold breath for 5-10 seconds during insertion of needle of liver biopsy?

Back 13

TO PREVENT TRAUMA TO THE DIAPHRAGM SINCE THE LOCATION OF THE LIVER AND DIAPHRAGM IS NEARBY

Front 14

What is the rationale, why the physician order Neomycin sulfate to patient with cirrhosis?

Back 14

to reduce the risk of infection

Front 15

Is a chronic progressive disease of the liver characterized by diffuse damage to cells with fibrosis and nodular regeneration?1/1

Back 15

LIVER CIRRHOSIS

Front 16

2 Most specific laboratory indicator of liver function ? NO ABBREVIATION PLEASE!2/2

Back 16

➢SERUM GLUTAMIC PYRUVIC TRANSAMINASE

➢SERUM GLUTAMIC-OXALOACETIC TRANSAMINASE

Front 17

What is the rationale , why liver cirrhosis patient are prone to bleeding?2/2

Back 17

BECAUSE LIVER IS A BLOOD RESERVOIR, THAT'S WHY THERE'S A NEED FOR INJECTION OF VITAMIN K TO PREVENT BLEEDING

Front 18

Why Morphine sulfate is avoided in Cholescystitis

Back 18

It causes spasm of the spincter of Oddi and may increase pain.

Front 19

What are three stages of viral hepatitis?3/3

Back 19

PREICTERIC PHASE

ICTERIC PHASE

POSTICTERIC PHASE

Front 20

What is the most common cause of liver cirrhosis ?1/1

Back 20

ALCOHOL ABUSE

Front 21

Incubation period of Hepatitis B ?

Back 21

45 TO 160 DAYS, AVERAGE OF 60 TO 120 DAYS

Front 22

Why is it Chronalac ( Lactulose ) is given to a patient with Liver cirrhosis?2/2

Back 22

➢ IT DECREASES THE PH OF THE COLON

➢ DECREASES PRODUCTION OF ALKALINE AMMONIA, AND FACILITATES THE EXCRETION OF AMMONIA

Front 23

What are the four different types of liver cirrhosis?4/4

Back 23

BILIARY CIRRHOSIS

CARDIAC CIRRHOSIS

Laennec’s Cirrhosis

POSTNECROTIC CIRRHOSIS

Front 24

What is the rationale, why liver cirrhosis patient are prone to infection?

Back 24

DUE TO THE DESTRUCTION OF KUPFFER CELLS

Front 25

What is the rationale, why Albumin is prescribed by the doctor in liver cirrhosis?

Back 25

TO INCREASE COLLOIDAL OSMOTIC PRESSURE AND PREVENT SHIFTING OF PLASMA INTO THE PERITONEAL CAVITY

Front 26

What is the initial manifestation to liver function impairment?

Back 26

JAUNDICE or ANOREXIA

Front 27

What is the drug - related side effects of Spironolactone ( Aldactone ) ?

Back 27

liver is unable to excrete adrenal cortex hormones including aldosterone.

Front 28

What is the rationale , why liver cirrhosis patient manifest ascites?···/2

Back 28

DUE TO CONGESTION OF HEPATIC CAPILLARY

Front 29

Major functions of the liver:

Back 29

➢ Metabolism of carbohydrates, protein and fats

➢ Production of bile salts.

➢ Bilirubin metabolism

➢ Blood reservoir

➢ Storage of minerals and vitamins- vitamins A, D, E, K, B12, Iron.

Front 30

c) Fat metabolism

Back 30

FOSK

✓ Formation of lipoproteins

✓ Oxidation of fatty acids for energy

✓ Synthesis of cholesterol and phospholipids

✓ Ketone formation

Front 31

Protein metabolism

Back 31

✓ Protein catabolism

✓ Protein synthesis: albumin, alpha, beta glubulin

Front 32

gallbladder stores

Back 32

50 to 70 ml

Front 33

liver produces

Back 33

600 to 1,200 mls of bile

Front 34

Laboratory and Diagnostic Tests for Liver Function

Back 34

Fat Metabolism

Protein Metabolism

Bilirubin Metabolism

Conjugated/ Direct Bilirubin

Uncoconjugated/ Indirect Bilirubin

Total serum bilirubin

Front 35

is usually alcohol- induced. Cellular necrosis causes widespread scar tissue, with fibrotic infiltration of the liver.

Back 35

Laennec’s Cirrhosis-

Front 36

occurs after massive liver necrosis.Cirrhosis occur as a compliction of acute viral hepatitis or exposure to hepatotoxins.

Back 36

Postnecrotic cirrhosis-

Front 37

- develops from chronic biliary obstruction, biliary obstruction, bile stasis, and inflammation resulting in severe obstructive jaundice.

Back 37

Biliary Cirrhosis

Front 38

is associated with severe, right- sided congestive heart failure and result in an enlargement, edematous, congestive liver.

Back 38

Cardiac Cirrhosis-

Front 39

Fibrosis and scarring of the liver may cause:

Back 39

1. Fatty infiltration of the liver

2. Obstruction of blood flow within the liver.

3. Increased pressure in the portal vein and sinusoidal channels.

Front 40

PORTAL HYPERTENTION IT LEADS TO

Back 40

HEPATOSPLENOMEGALY

ASCITES

PALMAR ERYTHEMA

SPIDER ANGIOMA

Front 41

LIVER CIRRHOSIS

Collaborative Management:

Back 41

1.Promote rest

2. Diet- high protein, high calorie diet

3. Skin Care. To relieve pruritus

4. Prevent trauma or injury

5. Protect client from infection

Front 42

Prevent rupture of esophageal varices.

Advice the client to avoid

Back 42

Screaming, shouting, yelling

Straining at stool

Hot/spicy,rough foods

Coughing, sneezing.

Front 43

types of viral hepatitis are as follows

Back 43

Hepatitis A virus- Infectious hepatitis.

B-Serum hepatitis

C-Non- A, non-B hepatitis or Posttransfusion hepatitis.

D-Delta agent hepatitis.

E-Enterically transmitted or epidemic Non- A, non- B hepatitis.

G- non- A, non-B, non- C hepatitis.

Front 44

the removal of stone from the common bile duct.

Back 44

Choledochotomy

Front 45

Formation of stone

Back 45

Cholidocholithiasis