BC3 - Liver
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| show | Bile production & excretion; excretion of bilirubin, cholesterol, hormones & drugs; metabolism of fats, proteins, CHO. Enzyme activation
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| show | Storage of glycogen, vitamins, and minerals; Synthesis of plasma proteins - albumin and clotting factor; Blood detoxification and purification
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| show | Stomach, intestines, spleen, pancreas - to the liver through the portal vein
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| show | secrete bile
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| show | Formed in hepatocytes - Through canaliculi - to bile duct - combined to form larger ducts - empty into common bile duct
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| Sinusoids | show 🗑
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| Portal Circulation | show 🗑
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| Kupffer Cells | show 🗑
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| Portal Hypertension | show 🗑
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| Obstruction of the portal circulation | show 🗑
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| show | cirrhosis
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| show | development of collateral circulation (blood makes its own route)
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| Long term problems of portal hypertension | show 🗑
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| show | esophageal, stomach, rectum
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| show | d/t gastric acid & elevated pressure
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| show | vomiting blood, anemia if slow chronic bleed, they will have low Hgb
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| show | endoscopy identifes portal HTN
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| show | Beta Blockers; Nitrates;
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| show | Used cocomitantly with NTG to reduce vasopressive action on other organs especially cardiac
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| show | endoscopically delivered medications (injected at site),
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| TIPPS | show 🗑
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| Splenomegaly | show 🗑
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| show | fluid accumulates n the peritoneal cavity
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| show | enlarged abd.; visible venous mapping showing collateral circulation; dyspnes because organs displaced; bacterial peritonitis can develoop
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| Tx of ascites | show 🗑
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| show | evaluate fluid, relieve discomfort
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| show | CNS disturbance, alterations in consciousness - toxins, ammonia, hormones accumulate in circulation and lead to damage in the brain
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| show | hepatic coma
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| show | ammonia freely circulating in the blood: competes with oxygen on Hgb causing hypoxia; it crosses the blood-brain barrier leading to toxic buildup of ammonia/urea in the brain
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| show | lethargy, personality changes, irritability, sleep disturbances
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| Late stages s/s of hepatic encephalopathy | show 🗑
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| Liver flap | show 🗑
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| Jaundice (other name) | show 🗑
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| show | Hemolytic, Hepatocellular, Obstructive
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| show | excessive breakdown of RBC's; metabolism of the heme component
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| Hepatocellular jaundice | show 🗑
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| show | Extrahepatic - bile duct into duodenum obstructed (gallstones); Intrahepatic - obstruction of bile canaliculi
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| show | r/t water soluble; excreted by kidneys; transformed/metabolized by liver; cirrhosis; biliary obstruction; infectious hep; pancreatic CA; meds
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| Hepatitis | show 🗑
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| Hepatorenal syndrome | show 🗑
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| S/S of hepatorenal syndrome | show 🗑
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| Hepatorenal syndrome is usually associated with | show 🗑
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| show | Viral, most common
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| show | life long carrier
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| Hepatitis A rout of transmission | show 🗑
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| Hep A comes from | show 🗑
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| Hepatitis B routes of transmission | show 🗑
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| show | Same as B, Significant number develop chronic
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| show | Causes infection only in conjunction with B (Very fragile); Superinfection; Same as B - unable to survive independently; infectious during all stages
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| show | Fecal-oral
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| Hepatitis E is found in | show 🗑
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| show | Approximately 2 weeks after exposure; ends with jaundice
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| show | fatigue, N/V, flu like symptoms
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| show | starts when they turn yellow (jaundice); 1-2 weeks after prodromal phase; lasts approx 2-6 wks; enlarged liver (palpable below the ribs and painful); Actual disease phase of hepatitis
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| Recovery phase of hepatitis is called | show 🗑
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| Posticteric phase begins | show 🗑
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| Chronic active hepatitis | show 🗑
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| show | Complication of Hep B/C; Severe impairment or necrosis of liver cells
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| show | Abd Xrays; Liver US; Nuclear scan of liver & spleen, CT, Percutaneous Liver Bx; Hepatic Angiography
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| Cirrhosis | show 🗑
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| show | Alcoholic; Chronic Hep C; Chronic Hep B & D; Autoimmune hepatitis; Inherited disease
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| show | blocked bile ducts; drugs, toxin & infections; Severe reactions to Rx; Prolonged exposure to environmental toxins; Repeat bouts of heart failure with liver congestion
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| show | Corticosteroids; Rest; Nutrition management - controlling Na, Diuretics, Paracentesis (for ascites)
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| Cholelithiasis | show 🗑
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| show | cholesterol stones & pigmented stones
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| Cholecystitis | show 🗑
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| S/S of cholecystitis | show 🗑
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| What labs are elevated with cholecystitis | show 🗑
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| show | Cholangiography & ERCP
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| Endoscopic Retrograde Cholangiopancreatography (ERCP) | show 🗑
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| Tx of cholecystitis | show 🗑
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| show | Morphine, Demerol, Dilaudid
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| Pancreatitis | show 🗑
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| Pancreatitis is associated with | show 🗑
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| Complications of pancreatitis | show 🗑
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| Some pts with pancreatitis develop | show 🗑
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| show | Usually mild disease; leaking enzymes into the pancreatic tissue from obstruction
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| show | Pain med, NGT to low intermittent suction, NPO, IVF, Hyperailmentation
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| Chronic pancreatitis | show 🗑
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| show | Oral enzymes replacement tx; potential loss of islet cells (lead to IDDM); No More Booze; Surgical intervention; at risk for developing pancreatic CA
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| Surgical intervention of chronic pancreatitis | show 🗑
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