Hepatic Disorders
Name 3 potential causes of hepatic dysnfunction
malnutrition related to alcoholism, infection, anoxia, metabolic disorders, toxins and medications, nutritional deficiencies, hypersensitivity states
Name 3 clinical manifestations of viral hepatitis
•Abdominal pain
•Irritability
•Pruritus
•Malaise
•Fever
•Nausea, vomiting
•Jaundice
What are the main risk factors for developing gallstones?
obesity, type 2 diabetes, dyslipidemia, and insulin resistance. (high-cal diet, family history, elevated estrogen, rapid weight loss, gastric bypass, elderly age)
Describe Cullen's sign and Grey turner's sign
cullen's sign: ecchymosis around the umbilicus
grey turner's sign: ecchymosis in the flank
What is the most reported side effect of chemotherapy?
nausea/vomitting
What is the lab value for the outward clinical manifestation of elevated serum biliruben?
> 2.5 mg/dL
What is the route of transmission for hepatitis A
What is the difference between cholelithiasis and cholecystitis?
cholelithiasis: calculi has formed in the gallbladder
Cholecystitis: acute/chronic inflammation of the gallblader
Where is the pain located with acute pancreatitis, and where can it raidiate to?
in the upper left quadrant or mid-abdomen, can radiate to the back or shoulder blades.
name 3 potential carcinogenic agents or factors
•Viruses such as Epstein Barr virus, HPV, Hep B,
•H. pylori bacteria has been linked to stomach cancer
•Physical agents: sunlight, radiation
•Chemical agents: tobacco, asbestos
•Genetic, familial factors – family history of cancer
•Life-style factors – increased risk with poor diet – increased fat, alcohol, salt-cured or smoked meats, red meat, processed meat & a high calorie diet
•Hormonal agents – estrogen
Fill in the blank: With portal HTN, the failure of the liver to metabolize aldosterone increases _ and _ retention by the kidneys, which increases intravascular fluid volume.
sodium and water
How long is the period of illness for hepatitis B
about 6 months
What are the 2 causes of cholecystitis?
inflammation without obstruction by gall stones (acaculous), blockage of the bile passage by a gall stone (calculous)
When is pain more severe for a patient with acute pancreatitis?
after meals
What is extravasation, and why does it often happen with chemotherapy?
Leakage of chemotherapy from a vein into surrounding tissue. occurs with chemo as the drugs are typically vesicants and are harsh to the surrounding tissue causing death.
What is the name of the assessment used to assess for ascites? (2 physical assessments)
percussion for shifting dullness
fluid wave test
What is the #1 and #2 causes of hepatitis C in the united states
injected drug use, sexual behaviors
What sign will be positive with acute cholecystsitis?
+ Murphy's sign: pain occurs when patient is holding a deep breath
fill in the bank: with severe acute pancreatitis, the lungs aren't able to completely inflate, and the patient experiences pain on _.
inspiration
Give an example of secondary prevention method for cancer
any kind of screening (colonoscopy, mammogram, papsmear)
For a patient with esophageal varices, there is abnormal dilation of the veins surrounding the esophagus. These veins are at risk for rupture, what two things could cause them to rupture?
Valsalva maneuver
erosion of the gastric mucosa
How are the symptoms often described for hepatitis C
often asymptomatic or nonspecific symptoms (fatigue, malaise, anorexia, weight loss)
What kind of diet is recommended for a patient with a gallbladder issue?
low-fat diet
For a patient with chronic pancreatitis, what may exacerbate their condition?
alcohol consumption or over eating
What are the 3 aspects of the T,N,M system for staging tumors/cancer
tumor size, spread to lymph nodes, signs of metastasis