MS 2 - Midterm
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126 Terms
What are included in history taking for the assessment of hepatic disorders?
Alcohol use, Medications, Infections
What is included in physical examination of hepatic disorders?
Skin, Abdomen, Neurological Status
What are the common symptoms of hepatic disorders?
Fatigue, Jaundice, Pruritus, Abdominal Distention
What are the liver function tests used for diagnosis?
ALT, AST, ALP, Bilirubin, Albumin
What imaging studies are used for hepatic disorders?
Ultrasound, CT scan, MRI
What diagnostic procedure is used for histopathology of liver?
Liver biopsy
What diagnostic test is used for varices detection?
Endoscopy
What are the causes of jaundice?
Hemolysis, Hepatocellular dysfunction, Obstruction
What are signs of jaundice?
Yellowing of skin and sclera, dark urine, pale stools
What is the management of jaundice?
Treat the underlying cause, supportive care
What causes portal hypertension?
Cirrhosis, thrombosis
What are complications of portal hypertension?
Varices, ascites, splenomegaly
How is portal hypertension managed?
Beta-blockers, TIPS procedure
What is ascites?
Accumulation of fluid in the peritoneal cavity
What causes ascites?
Cirrhosis, malignancy, heart failure
How is ascites diagnosed?
Fluid wave test, paracentesis
What is the management for ascites?
Sodium restriction, diuretics, paracentesis
What are esophageal varices?
Dilated veins due to portal hypertension
What is the risk of esophageal varices?
Risk of rupture leading to hemorrhage
How are esophageal varices managed?
Endoscopic band ligation, sclerotherapy, beta-blockers, emergency stabilization
What is hepatic encephalopathy and coma?
Neuropsychiatric dysfunction due to liver failure
What are symptoms of hepatic encephalopathy?
Confusion, asterixis, coma
How is hepatic encephalopathy managed?
Lactulose, rifaximin, protein restriction, supportive care
What is TIPS (Transjugular Intrahepatic Portosystemic Shunt)?
A minimally invasive procedure used to treat complications of portal hypertension, such as variceal bleeding and refractory ascites
Who needs TIPS?
Patients with recurrent variceal bleeding, refractory ascites, or hepatorenal syndrome
What are the risks of TIPS?
Hepatic encephalopathy, shunt dysfunction, heart overload
What is hepatitis A virus (HAV) transmission route?
Fecal-oral route
What are HAV symptoms?
Fever, jaundice, nausea, dark urine
What is the prevention for HAV?
Vaccination, hygiene, safe water
How is HBV transmitted?
Blood, sexual contact, perinatal
What are HBV symptoms?
Fatigue, jaundice, abdominal pain
How to prevent HBV?
Vaccination, safe sex, avoiding needle sharing
How is HCV transmitted?
Blood (IV drug use, transfusions)
What is the status of HCV vaccine?
No vaccine, but curable with antiviral therapy
What is required for HDV infection?
HBV co-infection
Why is HEV severe in pregnancy?
Risk of fulminant hepatitis
How are HGV and GBV-C transmitted?
Blood transfusion, needle sharing, mother-to-child transmission
What causes toxic hepatitis?
Exposure to toxins (alcohol, chemicals, herbal supplements)
What drugs commonly cause drug-induced hepatitis?
Acetaminophen, antibiotics, NSAIDs
What is the most common primary liver tumor?
Hepatocellular carcinoma (HCC)
What are symptoms of HCC?
Weight loss, jaundice, pain
What are treatments for HCC?
Surgery, liver transplant, targeted therapy
What are common sources of liver metastases?
Colon, pancreas, lung, breast cancer
What is liver abscess?
Pus-filled cavities due to bacterial, fungal, or parasitic infection
What are symptoms of liver abscess?
Fever, RUQ pain, jaundice
What are the goals of nursing management in hepatic disorders?
Supportive management, symptom relief, prevention of complications, patient education
What are key elements in assessment and monitoring of hepatic disorders?
Vital signs, neurological status, LFTs, jaundice, ascites, bleeding tendencies, nutritional status
What is the dietary recommendation for most hepatic patients?
High-calorie, high-carbohydrate, moderate-protein, low-fat diet
What drug reduces ammonia in hepatic encephalopathy?
Lactulose
What is used to reduce portal hypertension?
Beta-blockers
What procedure removes fluid in severe ascites?
Paracentesis
What is a sign of liver transplant rejection?
Fever, jaundice, elevated liver enzymes
What is the goal of patient education in hepatic disorders?
Alcohol cessation, medication compliance, follow-ups, recognize complications
What does the biliary system consist of?
Organs and ducts responsible for the production, storage, and transportation of bile
What are the components of the biliary system?
Liver, gallbladder, bile ducts (intrahepatic and extrahepatic)
What is the function of bile?
Emulsification of fats, absorption of fat-soluble vitamins, and excretion of bilirubin and cholesterol
What is cholelithiasis?
Formation of gallstones within the gallbladder or bile ducts
What are the types of gallstones?
Cholesterol stones, Pigment stones
What causes cholelithiasis?
Imbalance of bile components leading to stone formation
What are signs and symptoms of cholelithiasis?
RUQ pain, nausea, vomiting, jaundice (if obstructed)
How is cholelithiasis diagnosed?
Ultrasound, ERCP, CT scan
What is the treatment for cholelithiasis?
Cholecystectomy, medications to dissolve stones, lithotripsy
What is cholecystitis?
Inflammation of the gallbladder, usually caused by gallstones obstructing the cystic duct
What are the types of cholecystitis?
Acute, Chronic
What are signs and symptoms of cholecystitis?
RUQ pain, fever, nausea, vomiting, Murphy’s sign
How is cholecystitis diagnosed?
Ultrasound, HIDA scan, blood tests (WBC, liver enzymes)
What is the treatment for cholecystitis?
Antibiotics, pain management, surgical removal
What is choledocholithiasis?
Presence of gallstones in the common bile duct
What are symptoms of choledocholithiasis?
Jaundice, RUQ pain, dark urine, pale stools
How is choledocholithiasis treated?
ERCP for stone removal, surgical options
What is ERCP?
A procedure combining endoscopy and X-ray imaging to examine bile and pancreatic ducts
What is MRCP?
A specialized MRI scan that creates detailed images of the liver, gallbladder, bile ducts, pancreas, and pancreatic duct
What is cholangitis?
Bacterial infection of the bile ducts
What is Charcot’s Triad?
Fever, jaundice, RUQ pain
What is Reynolds’ Pentad?
Charcot’s Triad plus shock and confusion
What is biliary dyskinesia?
Functional motility disorder of the gallbladder or sphincter of Oddi
How is biliary dyskinesia diagnosed?
HIDA scan with CCK stimulation
What is a CCK-HIDA scan?
A nuclear medicine test that evaluates gallbladder function and bile flow using a radioactive tracer and cholecystokinin (CCK)
What is biliary atresia?
A congenital condition where bile ducts are abnormally narrow, blocked, or absent
What are signs of biliary atresia?
Jaundice, dark urine, pale stools, hepatomegaly
What are treatments for biliary atresia?
Kasai procedure, liver transplantation