Functions of the Liver
Cirrhosis
Cirrhosis
Cirrhosis
Cirrhosis
100
Which are functions of the liver?
A. Filter blood coming from the digestive tract
B. Detoxifies chemicals
C. Metabolizes drugs
D. Produces bile and stores it in the gallbladder
E. Makes proteins important for blood clotting.
F. Stores vitamins such as Vitamin K and Vitamin D.
G. Controls blood pressure
F. All EXCEPT G (control blood pressure) are true
100
Which of the following are complications of Portal HTN? SATA
A. Esophageal Varices
B. Splenomegaly
C. Compromised MS system
D. Hepatic Encephalopathy
A. B. D.
In portal hypertension is the portal vein becomes narrow due to scar tissue in the liver. The pressure is increased in the portal vein and affects the organs connected via the vein to the liver. The patient may experience ascites, enlarged spleen "splenomegaly", and esophageal varices etc
100
Identify signs and symptoms of liver cirrhosis.
A. Fatigue
B. Increased appetite
C. Edema
D. Nausea
E. Jaundice
A, C, D, E
100
Patient who is experiencing hepatic encephalopathy is having issues with toxin build up in the body, specifically ammonia. Patient should avoid which of the following food item on the tray?
A. Salad with grilled fish
B. Mashed potatoes with low fat gravy
C. Hamburger with broccoli
D. Rice with vegetables
C. Ammonia is the byproduct of protein breakdown, and normally the liver can take the ammonia from the protein breakdown and turn it into urea. With Cirrhosis this is not possible. Therefore, the patient should consume foods LOW in protein until the encephalopathy subsides
100
This is fat build up in the liver? This is one of the causes of cirrhosis that is not caused by alcohol use
What is Nonalcoholic steatohepatitis (NASH)?
This is much more serious than a simple fatty liver. NASH means you have inflammation in your liver. The inflammation and liver cell damage that happen with NASH can cause serious problems such as fibrosis and cirrhosis,
200
Which are true about the liver? Select all the apply.
A. The liver is the largest organ in the body.
B. The liver is located on the left side of the abdomen.
C. Stores vitamins E, A, Bilirubin and iron
D. Secretes bile to emulsify fats
E. Removes excess glucose and amino acids from the portal blood
A & E
200
Which medicine helps prevent the buildup of ammonia and other natural toxins in the large intestine.
A. Betablockers
B. Ammonia
C. Lactulose
D. Nitrates
C. Lactulose
200
What are some complications with Liver Cirrhosis?
A. High blood pressure in the veins that supply the liver.
B. Malnutrition
C. Increased blood clotting
D. Build up of toxins in the brain
a b d
200
Patient with cirrhosis has severe splenomegaly? Patient will have the following manifestations. Select all that apply:
A. Thrombocytopenia
B. Vision changes
C. Increased PT/INR
D. Leukopenia
A, C, D.
The spleen stores platelets and WBCs. An enlarged spleen can develop due to portal hypertension, which causes the platelets and WBCs to become stuck inside the spleen due to the increased pressure in the hepatic vein (hence lowering the count and the body’s access to these important cells for survival
200
Procedure in which a needle is inserted through the abdominal wall to remove fluid from the abdominal cavity.
What is paracenthesis?
300
Which vitamins does the liver store? Select all that apply.
A. A
B. D
C. E
D. K
E. B12
All of the above.
The liver stores vitamin A, D, E, K and B12. The first four of these are all fat soluble. This means that the bile secreted during digestion is essential for absorbing them so that the body can use them. If bile production is compromised by liver damage, the proper absorption of these vitamins may be affected.
300
What are causes of liver cirrhosis? Select all that apply.
A. Chronic hepatitis C
B. Alcoholism
C. Non-alcoholic fatty liver disease
D. Non-alcoholic steatohepatitis
E. all of the above
E
300
These cells reside in the liver and help remove bacteria, debris, and old red blood cells.
A. Hepatocytes
B. Langerhan cells
C. Enterocytes
D. Kupffer cells
D. Kupffer cells.
These cells play a role in helping the hepatocytes turn parts of the old red blood cells into bilirubin.
300
Which of the following findings shows that lactulose is working effectively? Select all that apply:
A. Decrease albumin levels
B. Decrease in Fetor Hepaticus
C. Increased disorientation
D. Decreased ammonia blood level
E. Presence of asterixis
B and D.
300
Which electrolyte should be limited for a patient with liver cirrhosis?
A. Magnesium
B. Glucose
C. Sodium
D. Calcium
C. Sodium
400
The liver receives it's blood supply from two sources. One of these sources is called the _________________, which is a vessel network that delivers blood _____________ in nutrients but ________ in oxygen.
A. hepatic artery, low, high
B. hepatic portal vein, rich, low
C. hepatic lobule, rich, low
D. hepatic vein, low, high
B. Majority of the blood flow to the liver comes from the hepatic portal vein. This vessel network delivers blood HIGH in nutrients (lipids, proteins, carbs etc.) from organs that aid in the digestion of food, but the blood is POOR in oxygen. The organs connected to the hepatic portal vein are: small/large intestine, pancreas, spleen, stomach. Rich oxygenated blood comes from the hepatic artery to the liver.
400
What are implications for poor liver function? Select all that apply.
A. Increased drug toxicity
B. Decreased bilirubin levels
C. Increased coagulation factors.
D. Impaired blood sugar regulation.
E. Impaired protein metabolism
a, d, e,
400
Which are tested for in a blood sample when suspecting liver cirrhosis?
A. ALT
B. AST
C. Total Bilirubin
D. Albumin
E. All of the above
E.
alt = Enzyme in the liver that is elevated with injury
ast = Elevated with liver injury as it is released into the blood
400
The liver cells fail to remove estrogen properly from the body, which causes the following symptoms?
A. Gynecomastia.
B. Spider Angioma.
C. Decreased libido
D. All of the above
D.
400
This procedure can divert fluid from the abdominal cavity and may be used to treat ascites that does not respond to other forms of treatment.
What is transjugular intrahepatic portosystemic shunt (TIPS)
500
Which of the following cause cirrhosis of the liver?
A. Obesity
B. Alcohol
C. Blockage of the bile duct
D. Hep C
E. None of the above
A. Obesity B. Alcohol
C. Blockage of the bile duct & D. Hep C
All will contribute to cirrhosis of the liver
500
A patient with late-stage cirrhosis develops portal hypertension. Which of the following options below are complications that can develop from this condition? Select all that apply.
A. Increased albumin levels
B. Ascites
C. Splenomegaly
D. Fluid volume deficient
E. Esophageal varices
B, C, E
The answer are B, C, and E. Portal Hypertension is where the portal vein becomes narrow due to scar tissue in the liver, which is restricting the flow of blood to the liver. Therefore, pressure becomes increased in the portal vein and affects the organs connected via the vein to the liver. The patient may experience ascites, enlarged spleen “splenomegaly”, and esophageal varices etc.
500
Which is NOT a test used to diagnose liver cirrhosis?
A. Liver Biopsy
B. Blood test
C. Ultrasound
D. Urine Culture
E. MRI
D
500
All of these are contraindicated in patient with esophageal varices? Select all that apply.
A. Eating soft diet
B. Alcohol consumption
C. Excessive coughing
D. Straining during a bowel movement
D. Hep D
E. Autoimmune hepatitis
B, C, D
Esophageal varices are swollen veins in the esophagus.
The patient should avoid activities that could rupture these vessels, such as excessive cough, drinking alcohol, and constipation
500
These techniques may be used to treat and prevent variceal bleeding in the esophagus.
What is Endoscopic variceal banding or sclerotherapy.