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5 Written questions

5 Matching questions

  1. phases of hepatitis: icteric
  2. insoluble bilirubin
  3. cirrhosis: dec bilirubin metabolism
  4. chronic pancreatitis
  5. cirrhosis: dec CHO, protein, fat metabolism
  1. a jaundice phase; 2-6 wks
    s/s: jaundice, dark urine, pruritis, clay-colored stools (if obstruction)
    severe => hepatomegaly (tender/painful), s/s of inc estrogen/androgens, CNS changes
  2. b indirect or unconjugated bilirubin
  3. c => jaundice, clay stools/dk UA bleeding
  4. d DM and cancer of pancreas
  5. e => dec BS, ascites

5 Multiple choice questions

  1. highly infectious 2 wks after exposure to onset of jaundice
    s/s is vague: malaise, fatigue, nausea, low-grade fever, sudden distaste for smoking/foods, joint pain
  2. poisonous mushrooms
    analgesics (tylenol, NSAIDs), anesthetics, statins, some anticonvulsants, anti-fungal, antibiotics
    anabolic steroids, anti-HTN, some herbs, industrial/chemicals/pesticides/herbicides
  3. HBsAg (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
  4. ALT/SGPT is most sensitive
    alkaline phosphatase
  5. EtOH
    biliary blockage

5 True/False questions

  1. bilirubin metabolism=> 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. hepatitis Atransmission: parental/body fluids, sexual, vertical
    s/s: absent but LFT positive for HCV
    HC antigen and anti-HCV antibody
    90% chronicity
    20% => cirrhosis


  3. pancreatitis: acute inflammationfever
    inc WBC (inc bands)


  4. cholestatic obstructive syndrome locationsbleeding: varices => mild (melena) or severe (rupture red/coffe-ground = life threatening)
    bleeding: dec Vit K => dec clotting
    anemia: bleeding, dec storage B vit, dec Fe storage


  5. portal HTN: organ complicationssplenomegaly from inc splenic vein pressure
    ascites: from inc pressure mesenteric vessles => inc capillary permeability and dec COP => fluid shifting
    hepatic encaphalopathy
    hepatorenal syndrome