Liver Physiology & Blood Flow
The liver receives this percentage of cardiac output
What is 25-30%
This complication of advanced cirrhosis involves impaired renal function and extreme renal vasoconstriction
What is hepatorenal syndrome
In chronic liver failure, this neuromuscular blocker may show a prolonged duration of action because of decreased hepatic synthesis of plasma cholinesterase
What is succinylcholine
This physical exam finding, accentuated right upper quadrant pain on inspiratory effort, is a classic sign of acute cholecystitis
What is Murphy sign
This is the most common functioning tumor of the pancreas, causing profound hypoglycemia as part of the Whipple triad
What is insulinoma
This vessel supplies roughly 75% of hepatic blood flow but only 50% of hepatic oxygen supply
What is the portal vein
This liver produced enzyme has a half-life of 14-21 days, making it a slow, unreliable indicator of heptaic synthetic function
What is albumin
This neuromuscular blocker undergoes Hofmann elimination, making it a favorable choice for maintenance in patients with liver disease
What is cisatracurium
This triad of fever and chills, jaundice, and right upper quadrant pain aids the diagnosis of acute common bild duct obstruction
What is Charcot triad
This synthetic opioid is preffered over morphine or meperidine for pain control in severe acute pancreatitis
What is fentanyl
This semireciprocal autoregulatory mechanism causes hepatic arterial flow to change inversely with changes in portal flow, keeping total hepatic flow relatively constant
What is the hepatic artery buffer response
This classification system uses albumin, bilirubin, prothrombin time, ascites, and encephalopathy to score the severity of liver disease
What is the Child-Pugh classification
This opioid has a very short half-life from metabolism by nonspecific esterases in the blood
What is remifentanil
This bacterium is detected in the stomach of almost all patients with duodenal peptic ulcer and is the most common cause of PUD after NSAID use
What is H. Pylori
This condition, a twistin of the bowel on its mesenteric pedicle, most often affects the sigmoid colon and accounts for 5% of large bowel obstructions
What is volvulus
Among the volatile anesthetic agents discussed, this agent causes the greatest reduction in hepatic blood flow
What is halothane
Along with serum bilirubin and INR, this lab value is used to calculate the MELD score
What is serum creatinine
Liver disease increases this drug's volume of distribution and elimination half-life without changing its rate of clearance
What is rocuronium
This condition, in which columnar epithelium replaces normal stratified squamous cells in the distal esophagus, is a risk factor for esophageal adenocarcinoma
What is Barret's esophagus
This long-acting synthetic somatostatin analog is now considered the drug of choice for controlling symptoms in carcinoid syndrome
What is ocreotide
This macrophage cell, located in the hepatic sinusoids, phagocytizes 99% of the bacteria delivered from the GI tract
What are Kuppfer cells
Unlike transaminases, which rise immediately with hepatocyte injury, this liver enzyme does not become elevated for several days after biliary obstruction begins
What is alkaline phosphatase
This opioid is primarily metabolized by CYP3A4, so administoring CYP3A4 inhibitors can increase its concentration and intensify its effects
What is fentanyl
This syndrome, cause by a gastrin-secreting duodenal tumor, results in massive gastric acid hypersecretion and severe, intractable ulcer pain
What is Zollinger-Ellison syndrome
This life-threatening process may be precipitated by physical manipulation of a tumor, including bedside palpation, chemical stimulation, or tumor necrosis
What is a carcinoid crisis