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5 Written questions

5 Matching questions

  1. cholelithiasis s/s
  2. obstructive jaundice: intrahepatic
  3. varices from portal HTN
  4. cirrhosis: fibrosis
  5. obstructive jaundice s/s
  1. a => portal HTN => ascites, edema, splenomegaly, varices

    => liver failure, hepatorenal failure => encaphalopathy => coma => death
  2. b clay-colored stools
    jaundice skin
    sclera
    pruritis
  3. c hepatocyte/canal damage
    if severe: only inc unconjugated (indirect) bilirubin
    if not severe: inc conjugated (direct) bilirubin
  4. d abdominal pain radiating to R scapula
    jaundice if CBD blocked
    heartburn
    flatulence
    fat intolerance
  5. e esophageal, hemorrhoids, umbilical

5 Multiple choice questions

  1. => biliverdin => unconjugated bilirubin (insoluble/indirect) => bound to albumin for transport to liver => CONJUGATED with glucuronic acid (water soluble/direct) => ileum/colon (bacteria) => urobilinogen => bowel (brown feces) => plasma => kidney (yellow urine)
  2. splenomegaly from inc splenic vein pressure
    ascites: from inc pressure mesenteric vessles => inc capillary permeability and dec COP => fluid shifting
    hepatic encaphalopathy
    hepatorenal syndrome
    jaundice
  3. EtOH
    biliary blockage
    hyperlipidemia
    smoking
    stones
  4. dec hair, gynecomastia, altered menses, angiomas, palmar erythema from INC HORMONES

    dec metab ADH, aldosterone => inc ADH/aldosterone
  5. ascites
    hypotension due to liver disease can lead to ATN (acute tubular necrosis) & oliguria
    altered Na concentration
    azotemia (inc BUN and inc creatinine)

5 True/False questions

  1. serology of hepatitis BHBsAg (surface) is 1st marker (incubation, infectious as long as present, >6 mos = carrier or chronic
    HBeAg = highly infectious
    inc anti-HBe @ peak s/s => seroconverted
    inc anti-HBc: may be only marker, window period
    inc anti-HBs => recovery, immunity
    acute: inc IgM anti-HBc

          

  2. toxic hepatitispoisonous mushrooms
    analgesics (tylenol, NSAIDs), anesthetics, statins, some anticonvulsants, anti-fungal, antibiotics
    anabolic steroids, anti-HTN, some herbs, industrial/chemicals/pesticides/herbicides

          

  3. hepatitis Atransmission: FECAL-ORAL
    hep A antigen
    anti-HAV antibody
    NO chronicity
    30 days incubation

          

  4. cholelithiasisabdominal pain radiating to R scapula
    jaundice if CBD blocked
    heartburn
    flatulence
    fat intolerance

          

  5. pancreatitis: autodigestionfever
    inc WBC (inc bands)
    pain

          

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