Module 10 Hepatobiliary

What is cholecystitis?

Inflammation of the gallbladder.

What are the two types of cholecystitis?

Acute and chronic.

What is the difference between calculous and acalculous cholecystitis?

Calculous is with stones, while acalculous is without stones.

What are common clinical manifestations of cholecystitis?

Pain, tenderness, and rigidity in the right upper quadrant (RUQ), possibly radiating to the midsternal area or right shoulder.

What is cholelithiasis?

Formation of calculi (gallstones) in the gallbladder.

What is the most common composition of gallstones?

75% of cases are cholesterol-based.

What factors increase the risk of developing gallstones?

Cystic fibrosis, diabetes mellitus, frequent weight changes, estrogen therapy, obesity, and rapid weight loss.

What are the common symptoms of gallstones?

Epigastric distress, abdominal distention, vague pain in RUQ, biliary colic, jaundice, dark urine, gray stool, and fat-soluble vitamin deficiencies.

How can gallstones be diagnosed?

Magnetic Resonance Cholangiopancreatography (MRCP) can detect biliary tract obstruction.

What is the initial management for mild gallbladder disorders?

Supportive care including rest, IV fluids, NG suction, analgesics, and a low-fat diet.

What is the surgical intervention for gallbladder disorders?

Laparoscopic cholecystectomy is performed once symptoms subside.

What is hepatitis?

A systemic viral infection causing necrosis and inflammation of liver cells.

What are the types of viral hepatitis?

Hepatitis A, B, C, D, and E.

How is Hepatitis A transmitted?

Fecal-oral route, often due to poor hand hygiene.

What is the incubation period for Hepatitis A?

2 to 6 weeks.

What are the symptoms of Hepatitis A?

Asymptomatic, GI symptoms, jaundice, dark urine, joint pain, fever, and fatigue.

How is Hepatitis B transmitted?

Through blood, saliva, semen, vaginal secretions; sexually transmitted and from mother to infant at birth.

What are the risk factors for Hepatitis B?

Healthcare workers, birth, tattoos, and IV drug use.

What is the management for chronic Hepatitis B?

Alpha interferon and antiviral agents, along with bed rest and nutritional support.

What is the most common bloodborne infection?

Hepatitis C.

What are the common symptoms of Hepatitis C?

Flu-like symptoms, jaundice, and dark urine.

What is the primary prevention method for Hepatitis?

Vaccination and good hygiene practices.

What are the liver's main functions?

Bile production, nutrient metabolism, detoxification, storage, protein synthesis, immune support, hormone regulation, and cholesterol management.

What are common manifestations of hepatic dysfunction?

Ascites, jaundice, edema, nausea/vomiting, loss of appetite, weight loss, and cognitive changes.

What is jaundice?

Yellowing of skin and eyes due to excess bilirubin.

What are typical symptoms of jaundice?

Dark urine, pale stool, pruritus, and possible hepatomegaly or splenomegaly.

What are the three types of jaundice?

Pre-hepatic, hepatic, and post-hepatic (obstructive).

What causes pre-hepatic jaundice?

Excessive breakdown of RBCs overwhelming the liver's bilirubin processing ability (e.g., hemolytic anemia).

What is hepatic jaundice caused by?

The liver's impaired ability to process bilirubin (e.g., hepatitis, cirrhosis).

What leads to post-hepatic (obstructive) jaundice?

Blocked bile flow from the liver to the intestine (e.g., gallstones, tumors).

What is portal hypertension?

Increased blood pressure within the portal venous system.

What are common causes of portal hypertension?

Cirrhosis, thrombosis, hepatitis, fatty liver disease, splenomegaly.

How is portal hypertension diagnosed?

Imaging (US, CT, MRI), endoscopy, and lab tests to assess liver function.

What is the function of the portal vein?

Carries nutrient-rich, oxygen-poor blood from digestive organs to the liver.

What are varices?

Abnormally dilated collateral vessels prone to rupture and severe bleeding.

What is ascites?

Fluid leakage into the abdominal cavity due to increased pressure.

What are the clinical manifestations of ascites?

Rapid weight gain, increased abdominal girth, shortness of breath.

What is the purpose of a Transjugular Intrahepatic Portosystemic Shunt (TIPS)?

To decrease sodium retention and prevent fluid accumulation recurrence.

What is hepatic encephalopathy?

Accumulation of ammonia and other toxic metabolites in the blood affecting brain function.

What are early signs of hepatic encephalopathy?

Mental changes and motor disturbances.

What is the management for hepatic encephalopathy?

Eliminate precipitating causes, administer lactulose, and restrict protein intake.

What are the types of cirrhosis?

Alcoholic, post-necrotic, biliary, hemochromatosis-related, and NAFLD/NASH-related.

What are compensated cirrhosis clinical manifestations?

Ankle edema, firm enlarged liver, palmar erythema, splenomegaly.

What are decompensated cirrhosis clinical manifestations?

Ascites, clubbing of fingers, jaundice, muscle wasting.

What are common complications of cirrhosis?

Bleeding and hemorrhage, hepatic encephalopathy, fluid volume excess.

What nursing interventions are important for cirrhosis?

Promoting rest, improving nutritional status, and monitoring complications.

What is the role of patient education in liver transplant?

To promote health, adherence to therapeutic regimens, and recognition of symptoms indicating problems.

What are the postoperative nursing interventions for liver transplant?

Monitor for infection, vascular complications, and liver dysfunction.

What is the significance of monitoring ammonia levels in hepatic encephalopathy?

To assess and manage the severity of the condition.

What dietary restriction is recommended for patients with ascites?

A 2g sodium diet to maintain negative sodium balance.

What is the purpose of administering diuretics in ascites management?

To help remove excess fluid from the body.

What is the risk associated with esophageal varices?

They are prone to rupture, leading to massive hemorrhage.

What is the mortality rate of the first hemorrhage from esophageal varices?

10-30% mortality rate.

What is the primary goal of managing portal hypertension?

To treat the underlying liver disease and reduce portal pressure.