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MedSurg #3
Honeynut718
| Question | Answer |
|---|---|
| LIVER | |
| Cirrhosis (slow onset) | -is extensive, irriversible scarring/ the tissue becomes nodular and the nodes can block the bile ducts and the normal blood flow throughout the liver/ in early disease the liver is usually large,firm and hard/ as disease progresses the liver shrinks |
| Laennec's Cirrhosis | - is caused by alcoholism |
| Postnecrotic Cirrhosis | - is caused by viral hepititis and certain drugs or chemicals |
| Biliary Cirrhosis (Cholestatic) | - is caused by chronic biliary obstruction from gallbladder disease. |
| Cardiac Cirrhosis | - is caused by heart failure (rare) |
| Complications of Cirrhosis | - depend on the amount of damage. |
| Compesated Cirrhosis | - the liver is scarred but still can function without causing major symptoms |
| Decompensated Cirrhosis | - liver function is impaired with other manifestations of liver failure |
| Common Complications of Hepatic Cell Damage (8) | - portal hypertension/ ascites/ bleeding esophageal varices/ coagulation deficits/ jaundice/ portal system encephalapothy with hepatic coma/ hepatic-renal syndrome/ spontaneous-bacterial peritonitis |
| Portal Hypertension | - increase in pressure within the portal vein develops as a result of obstruction to flow/ bloodflow backup can cause splenomegaly/ veins in the esophagus, stomach, intestines, abdomen and rectum become dilated |
| Ascites | - free fluid containig almost pure plasma accumlates within the peritoneal cavity |
| Bleeding Esophageal Varices | - fragile thin walled distended esophageal veins becomes irritated and ruptured/ most common in lower esophagus |
| Coagulation Defects | - decrease synthesis of bile fat in the liver and prevents the absorption of fat solible vitamins, A D E & K, specially vitamin K because of clotting factors/ suspectible to bleeding and easy bruising |
| Jaundice | - caused by one of two mechanism, hapatocellular jaundice( liver is unable to excrete bilirubin), intraheptic obstruction( edema, fibosis or scarring of the heptic bile duct channel interferes with bile and bilirubin excretion)/ jaundice is yellowing |
| Portal System Encephalopathy (PSE)or (Hepathic Coma) | - end stage hepatic failure and cirrhosis is manifested by neurologic symptoms and characterized by altered LOC, impaired thinking and neruomuscular disturbance/ caused by elevated ammonia levels, treat with lactulose and nonabsorbable antibiotics |
| Hepato-Renal Syndrome | - progressive oliguric renal failure associated with heptic failure, results in functional impairment of the kidnys with normal anatomic and morphologic features/ sudden ^in urine flow, ^serum urea nitrogen and creatinine levels and ^urine osmalarity, |
| Spontaneous Bacterial Peritonitis | - manfestions include fever, chills, abdominal pain and tenderness |
| Splenomegaly | - enlarged spleen results from backup of blood in spleen |
| Causes of Liver Disease | - alcohol, viral hepititis, autoimmune hepatitis, steotohepititis, drugs and toxins, biliary disease, cardio disease, metabolic/gentic causes |
| Clinical Manifestations of Liver Disease | - (early signs): fatigue, weight change, GI symptoms, abdominal pain, liver tenderness, pruitus (late):jauntice, icterus (orange eyes), dry skin, rashes, petechiae, warm bright red palms, spider angiomas, perpheral edema of the extremities and sacrum |
| Abdominal Assessment of Liver Disease | - massive ascites, umbilicus protrusion, caput medusae( dilated abdominal veins), hepatomegaly (liver enlargement) |
| Hepatogemaly | - can be assessed by palpating the RUQ, below the coastal border(ribcage) |
| Laboratory Assessment | - asparte aminotransferase (AST) elevated, alanine aminotransferase (ALT) is more specific elevated and lactate dehydronase 140-280(LDH) elevated |
Created by:
Honeynut718
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