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Hepatic
BC3 - Hepatic
| Question | Answer |
|---|---|
| Identify the three types of Jaundice | Hemolytic, Hepatocellular, Obstructive |
| Hemolytic (prehepatic) jaundice | inc. breakdown of RBC’s which produces an inc. amount of unconjugated bilirubin in the blood |
| Hepatocellular (hepatic) jaundice | The liver’s altered ability to take up bilirubin from the blood or to conjugate or excrete it |
| Obstructive (posthepatic) jaundice | Due to impeded or obstructed flow of bile through the liver or biliary duct system |
| The liver and gallbladder are connected by this structure | The cystic duct (from the gallbladder) joins with the common hepatic duct to form the common bile duct |
| Describe portal hypertension | Increased venous pressure in the portal circulation – collateral circulation develops in an attempt to reduce this high portal pressure and also to reduce the increased plasma volume and lymphatic flow |
| How does portal hypertension develop | Portal hypertension develops because of structural changes in the liver from cirrhotic process – these changes result in obstruction to the normal flow of blood through the portal system |
| Potential complication of portal hypertension | Can lead to or be caused by splenomegaly, large collateral veins, ascites, systemic hypertension and esophageal varices |
| What is the benefit of genotyping in hepatitis? | It does not influence the type of treatment, but may be used to guide the length of treatment |
| What is the clinical significance of ascites? | The accumulation of serous fluid in the peritoneal or abdominal cavity. When BP is c in the liver, proteins move from the blood vessels via the larger pores of the capillaries into the lymph space. When the lymphatic system is unable to carry off the ex |
| Name 3 f/e issues with ascites | Hypoalbuminemia, Hyperaldosteronism, Hypokalemia |
| Hypoalbuminemia from ascites | Caused by the livers inablilty to synthesize albumin |
| Hyperaldosteronism | inc. levels of aldosterone cause inc. sodium reabsorption by the renal tubules causing additional water retention |
| Hypokalemia | Due to an excessive loss of K because of the affects of aldosterone, also from diuretic tx |
| Describe esophageal varices | A complex of tortuous veins at the lower end of the esophagus, enlarged and swollen as a result of portal hypertension – Bleed easily |
| Identify 3 supportive measures used during an acute bleed of esophageal varices | IV administration of vasopressin (and maybe NTG), Endoscopic sclerotherapy – thromboses and obliterates the distended veins, and Endoscopic ligation or banding – elastic O rings or clips are used |
| Describe what is meant by balloon tamponade | Controls the hemorrhage by mechanical compression of the varices; a devise is inserted throuth the nose down through the esophagus and once in place it is inflated |
| Explain the difference between acute and chronic pancreatitis | Acute pancreatitis occurs suddenly and lasts for a short period of time and usually resolves. Chronic pancreatitis does not resolve itself and results in a slow destruction of the pancreas. Either form can cause serious complications |
| What is a Whipple procedure | It is the surgical resection of the proximal pancreas, adjoining duodenum, distal portion of the stomach and distal portion of the common bile duct. An anastomosis of the pancreatic duct, common bile duct and stomach to the jejunum is done |
| Why is a Whipple procedure used | The most effective treatment of pancreatic cancer |
Created by:
okrecota
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