liver dysfunction

Question 1

vascular functions of liver

Answer 1

• stores blood

- filters blood

Question 2

metabolic functions of liver

Answer 2

• carbohydrates
• protein
• fat
• detoxification
• steroid metabolism

Question 3

storage functions of liver

Answer 3

• blood
• glucose
• vitamins
• fat
• minerals
• proteins

Question 4

mononuclear phagocyte system - function of liver

Answer 4

• breakdown of RBCs, WBCs, and bacteria

- breakdown of hgb from old RBCs to bilirubin

Question 5

cirrhosis

Answer 5

• chronic progressive disease of the liver
• excessive degeneration
• destruction of the liver cells
• liver can regenerate itself, but once the cell dies, it cannot

Question 6

types of cirrhosis

Answer 6

• alcoholic
• postnecrotic
• biliary
• cardiac

Question 7

alcoholic cirrhosis

Answer 7

• associated with etoh abuse
• accumulation of fat in the liver cells
• fatty changes are potentially reversible

Question 8

postnecrotic cirrhosis

Answer 8

• massive necrosis of the liver following a:
• viral infection
• metabolic disorders
• exposure of industrial chemicals and hepatotoxins

Question 9

biliary cirrhosis

Answer 9

• associated with chronic biliary obstruction and infection

- there is diffused fibrosis of the liver with jaundice as the main feature

Question 10

cardiac cirrhosis

Answer 10

• chronic liver disease
• results from long term severe R sided HF
• associated with cir pulmonate, constrictive pericarditis, and tricuspid insufficiency

Question 11

primary biliary cirrhosis

Answer 11

• chronic inflammatory condition
• genetic and environmental factors
• t-cell mediated attack of the small bile duct epithelial cells

Question 12

nonalcoholic fatty liver disease

Answer 12

• group of disorders characterized by hepatic steatosis
• fatty changes in the hepatocytes
• inflammation and scaring

Question 13

diagnostic testing for cirrhosis

Answer 13

• LFTs
• aPTT, PT, INR
• total protein, alb, MP, y-globulins
• bilirubin
• decreased chol levels
• ammonia
• CT, liver scan and biopsy
• EGD, abd US

Question 14

classifications child’s cirrhosis

Answer 14

-used to determine the prognosis and life span for cirrhosis

Question 15

child’s classification is based upon

Answer 15

• albumin
• ascites
• total bilirubin
• PT
• encephalopathy

Question 16

classification MELD

Answer 16

• assesses the severity of chronic liver disease
• predicts death within 3 months of surgery in patients who had undergone a TIPS procedure
• determining and prioritizing for receipt of a liver transplant

Question 17

early s/s of cirrhosis

Answer 17

• onset usually insidious
• anorexia
• dyspepsia
• flatulence
• n/v
• change in bowel habits **
• abd pain (dull, heavy feeling)
• palpable liver

Question 18

late s/s of cirrhosis

Answer 18

• neuro: hyperactive reflexes, + babinski, asterixis (hands flexed, still shaking), altered LOC, peripheral neuropathy
• jaundice, pruritus
• spider angiomas
• palmar erythema
• hema: thrombocytopenia, leukopenia, anemia, coag disorders, splenomegaly
• endocrine problems

Question 19

meds for cirrhosis

Answer 19

• propanolol
• lactulose
• vitamin K
• PPI
• diuretics
• mag sulfate
• H2 blocker

Question 20

diet for cirrhosis

Answer 20

• high calorie
• high carbs
• protein: 1-1.5g/kg/day
• low fat
• 2g Na restriction
• enteral formulas (ammonia taken out of protein)

Question 21

complications of cirrhosis

Answer 21

• portal HTN
• esophageal varices
• ascites
• hepatic encephalopathy
• hepatorenal syndrome