Liver/Cirrhosis
List 5 liver functions
Stores vitamins/minerals/sugar, metabolizes nutrients from food, produces proteins, removes bacteria from blood, regulates blood clotting, produces bile to digest fat and absorb vitamins, removes toxic byproducts of certain medications
What is hepatitis?
Inflammation of the liver
What is ascites and what are 3 treatment options?
fluid shift into abdominal cavity, causes sodium and water retention by kidneys which causes perpetuating cycle
Low sodium diet, diuretics, paracentesis, fluid restriction, daily weights, bedrest
What are esophageal varices?
Backup of blood into vein lining the GI tract. Bleeding may be an emergency d/t blood loss.
List 5 potential causes of cancer
Viral infection, sun, radiation, chronic inflammation, tobacco, chemical exposure
List 5 manifestations of liver dysfunction
Jaundice, portal hypertension, ascites, esophageal varices, hepatic encephalopathy, edema, bleeding, vitamin deficiency
Transmission of Hep A, B, and C
A: fecal oral
B: blood/body fluids
C: blood/body fluids
Types of jaundice
Hepatocellular (hepatitis or cirrhosis)
Obstructive (bile duct blockage)
Hemolytic (transfusion reaction)
Hereditary
Treatment for esophageal varices?
Vasoactive medications i.e. vasopressin, fluids, PCRBs, EVL.
What is a sarcoma and where may it be?
Cancer among connective/supportive tissue i.e. bone, cartilage, fat, or muscle.
What is cirrhosis
Late stage scarring/fibrosis of liver causing permanent damage
Which types of hepatitis are able to be vaccinated?
Only HAV and HBV
**what about HDV?
HDV only occurs in people with HBV infection, so if you're vaccinated for HBV with will also be protected for HDV
What substance most often causes hepatic encephalopathy
Ammonia
Prevention of bleeding for esophageal varices?
Nitrates, beta blockers, low salt diet
What does TNM stand for?
Primary tumor, regional lymph nodes, distant metastasis
List 5 clinical manifestations of cirrhosis
enlarged/tender liver, abdominal pain, anorexia/weight loss, weakness/fatigue, diarrhea or constipation, dyspepsia, indigestion, intermittent fever, vitamin deficiency, jaundice
Causes and treatment of non-vital hepatitis
Treatment: remove/eliminate cause, supportive treatments, liver transplant
What is portal hypertension?
Blood flows back up the portal vein
Causes splenomegaly, ascites, esophageal varices
Manifestations of esophageal varices bleeding
Vomiting blood, black tarry stools, lightheadedness, decreased LOC in severe cases, shock symptoms
List an example of primary, secondary, and tertiary prevention
Primary: health promotion, risk reduction, i.e. no smoking, diet/weight control
Secondary: screening and early detection i.e. pap-smear, colonoscopy
Tertiary: reduce symptoms, improve quality of life i.e. surgery
AST, ALT, GGT, GGTP, Alk phos, albumin, PT/INR, PTT, Ammonia, total bili
Management for HBV
Alpha interferon, rest, and nutrition management for 3-4 months or longer
What is TIPS
Stent inserted to serve as a stunt between portal circulation and hepatic vein. Purpose is to reduce portal hypertension
What is EVL
Endoscopic variceal ligation
Elastic rubber band placed around the variceal, causing necrosis and sloughing of the varix
What does CEA, PSA, and CD20 tumor markers read?
CEA: Colon and breast
PSA: Prostate
CD20: Non-hodgkin lymphoma