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N370: Hepatobiliary

Disease/Patho pt. 1

TermDefinition
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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