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N370: Hepatobiliary
Disease/Patho pt. 1
| Term | Definition |
|---|---|
| Liver; gallbladder; pancreas | Hepatobiliary system consists of _____, ______, ______. If one is dysfunctional, the other ones will follow. |
| Liver | ______ filters the blood, breaks down, balances and creates nutrients, stores and makes glucose (glycogen). + immunity, storage of vits & blood, detoxification, synthesis of clotting factors & phospholipids, ammonia conversion to urea, & bilirubin conj. |
| Gallbladder | ______ stores and concentrates bile from the liver -> bile is then released to the first section of the small intestine (duodenum); it helps body break down & absorb fat from foods. |
| Pancreas | ______ aids for digestion; they make pancreatic juices called "enzymes" which break down sugars, fats, & starches. |
| Cholelithiasis; supersaturated stagnant bile | _______ is the formation of GALLSTONES in the gallbladder; happens because _________ precipitates into pigmented cholesterol. -> high cholesterol diet inc risk of stone development |
| Bile; breaks down | _______ is a digestive enzyme produced by the liver and _______ fats in fatty acid; the biggest culprit of cholelithiasis |
| True | T or F: Liver MAKES bile from unconjugated bilirubin (byproduct of RBC production - brought to liver by albumin); gallbladder STORES bile and BREAKS it down into fatty acids. |
| Cholesterol stones | ______ is the biggest culprit of cholelithiasis which is why high cholesterol diet increases risk of stone development. |
| True | T or F: Cholelithiasis becomes pathological when stone forms and becomes inflamed within the gallbladder or gets stuck in the CYSTIC duct (gallbladder) or COMMON BILE duct (gallbladder and liver). |
| Gender (women); obesity; rapid weight loss (esp if on diet pills); use of estrogens | Some risk factors for cholelithiasis are: ______, ______, _____, and _______. |
| Endoscopic Retrograde Cholangiopancreatography (ERCP) | _______ is a procedure where a camera goes down the esophagus -> into the duodenum -> up through pancreatic, common, cystic, or hepatic duct; can be diagnostic to map ducts flow or tx by breaking down and removing obstruction. |
| Risk for rupture of blood vessels d/t buildup of pressure from plaques | What is our biggest concern with Cholelithiasis? |
| Cholecystitis; food (postprandial) | ______ is the INFLAMMATION of the gallbladder; can be bacterial, chemical, stone irritation, obstruction dt trauma, surgery, sepsis, SLE; but ______ is really what triggers it esp high fat foods. |
| USN; dye injection | Main diagnostic test for cholecystitis is ______/_____ to map out flow or obstruction. |
| Gallbladder perforation; peritonitis; empyema; suppurative cholecystitis -> sepsis/shock | Concerns with cholecystitis: ______ (inflamed organ -> compart syndrome of organ -> ischemia/necrosis leads to this) -> ruptures -> bile spill -> ______ (inflammation - RIGID), ______ (puss pockets), ______ (pus in peritoneal lining, very vascular) |
| Cholangitis | _______ inflammation of COMMON bile duct; usually d/t bacterial infection (T-tube infections), obstruction (80%) (tumors), or scraping/abrasions (ERCP) |
| T-tubes | ______ are straw-like tubes that sit in the COMMON bile duct to remove drainage of bile; provides external drainage of bile during the healing process/maturation of of choledochotomy |
| Liver | _______ is highly vascular and this is affected in cases of right-sided HF; it has the portal triad. |
| Jaundice | ______ is a result of hyperbilirubinemia d/t hemolysis, impairment conjugation/excretion, or obstruction. |
| Liver | These are fns of the _____: immunity (kupffer cells), storage of ADEK and 1L of blood, detoxification of hormones & drugs, synthesis of proteins, chol and clotting F, metabolic/conversion or ammonia-urea, secretes bile, vascular reservoir |
| Cirrhosis | _______ are diffuse, fibrotic changes to the liver; irreversible b/c they're scars -> can lead to portal HTN d/t stenotic vessels -> can develop varicose veins |
| Laennec's, Postnecrotic, Biliary, Cardiac | Some of the causes of cirrhosis are: ______ (alcohol-induced), _____ (hepa/toxic exposure), ______ (obstruction, bile stasis, inflammation), ______ (right-sided HF) |
| True | T or F: liver problem affects clearing of blood (toxins stay in the body) and blood affects all systems, hence, liver dysfn affects all body systems. |
| Complications of cirrhosis | Portal HTN, ascites (can affect ventilation d/t fluid pressure against alveoli), hepatic encephalopathy (neuro sx), bacterial peritonitis, hepatorenal syndrome, esophageal varices, sexual characteristics, hemorrhoids, spider angiomas are ________. |
| Portal HTN | _______ can alter bile production/secretion, protein/lipid/CHO metabolism, hormone clearance, DETOXIFICATION (might need smaller dose if meds hepatically metabolized), esophageal-gastric-rectal varices d/t back up in flow, hemorrhoids d/t vasodilation |
| Ascites | _______ causes reduced ECV d/t reduced albumin = dec oncotic pressure & inc hydrostatic pressure; can also be d/t malnourishment |
| Hepatic Encephalopathy | ______ occurs when there is toxin build up in the blood and crosses blood-brain barrier -> neurotoxic (ammonia is not converted to urea -> can't be excreted) -> affects the brain |
| Hepatic Encephalopathy | Confusion, altered consciousness, behavior, neuromuscular (LIVER FLAP/ASTERIXIS - pt hold out arms and starts flapping), trembling and coma are s/sx of ______. |
| Chronic, irreversible disease (usually cirrhosis, NOT fatty), primary malignant tumors, primary sclerosing cholangitis, hepatic metabolic diseases, hepatic failure from toxins & hepatitis, no malignancies | What is the specific liver transplant criteria? |
| Advanced sequelae of liver disease, systemic conditions (sepsis, CVS, DM, severe HTN), psychosocial instability -> not ready for transplant rejection management, active alcoholism, advanced catabolic state, portal vein thrombosis | Who is NOT considered for liver transplant? |
Created by:
yortiz
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