NUTR chapter 19-20 REV

Most common disorders affecting the liver:

Fatty liver and hepatitis

Accumulation of fat in liver tissue:

Fatty liver

May be caused by defects in metabolism, excessive alcohol ingestion, or exposure to various drugs and toxins:

Fatty liver

In cases unrelated to alcohol, ___ resistance is the primary risk factor for fatty liver:

Insulin

Frequently accompanies type 2 diabetes mellitus, metabolic syndrome, and obestiy:

Fatty liver

Other causes of fatty liver include:

Protein-energy malnutrition and long-term total parenteral nutrition

Fatty liver is estimated to affect as many as:

One-third of adults in Westernized countries, 90% of heavy drinkers

Associated with inflammation (steatohepatitis), liver enlargement (hepatomegaly), and fatigue:

Fatty liver

If inflammation and scarring develop, fatty liver may progress to:

Cirrhosis, liver failure, and liver cancer

Most common cause of abnormal liver enzyme levels in the blood:

Fatty liver

ALT stands for:

Alanine aminotranferase

AST stands for:

asparte aminotranferase

Treatment of fatty liver:

Cutting out the causes, lol, drink less, work out more, reduce added sugars

Condition of liver inflammation, results from damage to liver tissue:

Hepatitis

Long-term hepatitis can lead to:

Cirrhosis and liver cancer

Damage to liver tissue in hepatitis can be caused by:

Infection with specific viruses, excessive alcohol intake, exposure to some drugs and toxic chemicals, fatty liver disease, and autoimmune disease

Herbal remedies that are reported to cause hepatitis:

Chaparral, comfrey, germander, jin bu huan, kava, ma huang, pennyroyal, senna, and skullcap

Acute hepatitis is most often caused by infection with:

Hepatitis viruses A, B, or C

Primarily spread via fecal—oral transmission, which usually involves the ingestion of foods or beverages that have been contaminated with fecal material:

Hepatitis A virus

Transmitted by infected blood or needles, by sexual contact with an infected person, and from mother to infant during childbirth:

Hepatitis B virus

Spread via infected blood or needles but is not readily spread by sexual contact or childbirth:

Hepatitis C virus

No vaccine is available to protect against:

HCV infection

Individuals with mild or chronic cases of hepatitis are often:

Asymptomatic

The onset of acute hepatitis may be accompanied by:

Fatigue, malaise, nausea, occasional vomiting, anorexia, and pain in the liver area

Jaundice is a possible sign of:

Hepatitis

Yellowing of the skin, urine, and sclera:

Jaundice

Serum levels of the liver enzymes ALT and AST are typically:

Elevated

Chronic hepatitis can cause complications that are typical of:

Liver cirrhosis and may lead to liver cancer

Hepatitis is treated with supportive health such as:

Bed rest and appropriate diet

Patients who have hepatitis should avoid substances that irritate the liver, such as:

Alcohol, drugs, and dietary supplements that can cause liver damage

Which infection usually resolves without the use of medications:

Hepatitis A

Block viral replication:

Lamivudine and ribavirin

Nutrition therapy for hepatitis:

Varies according to patient’s symptoms and nutrition status

Late stage of chronic liver disease:

Cirrhosis

As cirrhosis progresses, the scarring becomes more extensive… therefore:

Leaving fewer areas of healthy tissue

Chief causes of cirrhosis in the United States are:

Chronic hepatitis C infection and alcoholic liver disease

Initial symptoms of Cirrhosis:

Fatigue, malaise, anorexia, and weight loss

Advanced Cirrhosis can disrupt the function of:

Kidney, lung, and brain

The blood vessel that conducts nutrient-rich blood from the digestive tract to the liver:

Hepatic portal vein

Supply approximately 1500 milliliters of blood each minute to the extensive network of vessels in the liver:

Portal hypertension

The scarred tissue of a cirrhotic liver impedes the:

Flow of blood

Restricted blood flow within the liver stimulates the release of vasodilators, which means:

Increased blood flow

Blood vessels that enlarge or newly form to allow an alternative pathway for diverted blood:

Collateral vessels

Abnormally dilated blood vessels:

Varices

Abnormal accumulation of fluid in the abdominal cavity:

Ascites

Small, capillary-like passages that carry blood through liver tissue:

Sinusoids

When blood flow through the portal vein is impeded, the blood is forced ___ into the veins that normally supply the portal vein with blood:

backwards

About 50 percent of patients with cirrhosis develop:

Ascites

The development of ascites indicates that liver damage has reached a ___ stage:

Critical

Ascites is primarily a consequence of:

Portal hypertension and sodium retention in the kidneys

As a result of portal hypertension, the distorted blood flow elsewhere in the body alters kidney function, leading to:

Sodium and water retention and an accumulation of body fluid

Protein that helps retain fluid in blood vessels:

Albumin

Cause abdominal discomfort and early satiety, which contribute to malnutrition:

Ascites

Disorder characterized by abnormal neurological and psychiatric functioning:

Hepatic Encephalopathy

Adverse changes in mental abilities, mood, personality, behavior, and motor functions, are all signs of:

Hepatic encephalopathy

Have been found to improve or reverse some of the neurological symptoms of hepatic encephalopathy:

Ammonia-reducing medication

Much of the body’s free ammonia is produced by bacterial action on:

Unabsorbed dietary protein in the colon

In advanced liver disease the liver is unable to process the ___ sufficiently:

Ammonia

Most patients with advanced cirrhosis develop ___ and experience some degree of wasting:

Protein-energy malnutrition

Reduced bile activity can result in:

Fat malabsorption

Patients with portal hypertension and varices may be given beta-blockers such as:

Propranolol (inderal) and nadolol (corgard)

Diuretics that help control portal hypertension and ascites:

Apironolactone (aldactone) and furosemide (lasix)

Energy estimates generally range from ___ to ___ kcalories per kilogram of body weight per day:

30, 40

Protein estimates range from ___ to ___ grams of protein per kilogram of body weight per day:

1.2, 1.5

Protein requirements are higher in patients who are:

Malnourished, have complications that promote muscle wasting

Clinical studies have suggested that oral supplementation with ___ may improve neurological functioning in patients with heptic encephalopathy:

Branched-chain amino acids (BCAA)

Can be used to provide additional energy when it is difficult to to get carbohydrates and fats:

Medium-chain triglycerides (MCT)

Abnormally low sodium levels in the blood:

Hyponatremia

Formula preferred for patients with ascites:

Energy-dense, supplying at least 1.5 kcalories per milliliter

Acute or chronic liver disease can lead to:

Liver failure

Most common illness that precedes liver transplants is:

Alcoholic liver disease

Accounts for 23% of liver transplant cases:

Alcoholic liver disease

Concerns immediately following a transplant are:

Organ rejection and infection

Immunosuppressive drugs that help reduce the immune responses that cause rejection but also raise risk of infection:

Prednisone, cyclosporine, and tacrolimus

Immunosuppressive drugs can:

Affect nutrition status in numerous ways

Stress associated with transplant surgery increases ___ and ___ requirements:

Protein, energy

Group of metabolic disorders characterized by hyperglycemia and disordered insulin metabolism:

Diabetes mellitus

Pancreatic hormone that regulates glucose metabolism:

Insulin

The blood concentration of a substance that exceeds the kidneys’ capacity for reabsorption, causing the substance to be passed into the urine:

Renal threshold

Refers to metabolic disorders characterized by elevated blood glucose concentration and disordered insulin metabolism:

Diabetes mellitus

A marked elevation in blood glucose levels that can ultimately cause damage to blood vessels, nerves, and tissues:

Hyperglycemia

Symptoms of diabetes are usually related to the degree of ___ present:

Hyperglycemia

A distinctive fruity odor on the breath of a person with ketosis:

Acetone breath

The presence of albumin in the urine, a sign of diabetic nephropathy:

Albuminuria

Pain in the legs while walking, usually due to an inadequate suplly of blood to muscles:

Claudication

A coma that occurs in patients with uncontrolled diabetes, may be due to diabetic ketoacidosis, the hyperosmolar hyperglycemic syndrome, or severe hypoglycemia:

Diabetic coma

Kidney damage that results from long-term diabetes:

Diabetic nephropathy

The individual ingests a 75-gram glucose load, and plasma glucose is measured at one or more time intervals following glucose ingestion:

Oral glucose tolerance test

Reflect hemoglobin’s exposure to glucose over the preceding two or three months, and indirect assessment of blood glucose levels:

Glycated hemoglobin (HbA)

Term used when an individual’s blood glucose levels are above normal but not high enough to be classified as diabetes:

Prediabetes

Diabetes that is characterized by absolute insulin deficiency, usually resulting from the autoimmune destruction of pancreatic beta cells:

Type 1 diabetes

Accounts for 5 to 10 percent of diabetes cases:

Type 1 diabetes

Typically develops during childhood or adolescence:

Type 1

Most prevalent form of diabetes, accounting for 90 to 95 percent of cases:

Type 2 diabetes

The defect in type 2 diabetes is:

Insulin resistance

Reduced sensitivity to insulin in muscle, adipose, and liver cells:

Insulin resistance

Severe lack of insulin causes:

Diabetic ketoacidosis

Treatment of diabetic ketaacidosis includes:

Insulin therapy, intravenous fluid, electrolyte replacement, bicarbonate therapy

Condition of severe hyperglycemia and dehydration that usually develops in the absence of significant ketosis:

Hyperosmolar hyperglycemic syndrome

Meaning low blood glucose, most frequent complication of type 1 diabetes and may occur in type 2 diabetes as well:

Hypoglycemia