Pathophysiology Chapter 12: Liver, Gallbladder, and Pancreatic Diseases and Disorders – Flashcards
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largest solid organ
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Liver (second place to skin that is largest organ)
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How much blood flows through the liver every minute?
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1,450mL
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What does the liver play a role in?
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digestion, absorption, metabolism, blood clotting, manufacture of chemicals, and storage of nutrients
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How does the liver play a role in blood clotting?
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it is responsible for producing clotting factors
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What chemicals does the liver manufacture?
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bile, albumin (plasma protein)
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what is a major nutrient stored in the liver?
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glycogen (storage form of glucose)
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organ that lies under the liver; stores bile until needed; can live without
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Gallbladder
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lies underneath and behind the stomach; produces and excretes most intestinal enzymes; also released 2 hormones
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Pancreas
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What hormones does the pancreas release? What from wha cells are they released? And what do they do?
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insulin (beta cells) --> lowers blood sugar glucagon (alpha cells) --> raises blood sugar
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what is a common sigh of liver disease
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Liver disease
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what causes jaundice?
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excessive bilirubin in the bloodstream
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What is another name for excessive bilirubin in the bloodstream?
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hyperbilirubinemia
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When is bilirubin produced?
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when the liver does not adequately break down the heme group
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condition in newborn that causes brain dysfunction caused by high bilirubin levels
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Kernicterus
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the most common symptom of gallbladder and pancreas disease
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pain
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What diagnostic tests are used?
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liver function test; ultrasound, X-rays, and CT scab; biopsy; and blood tests
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measure bilirubin, albumin, and alkaline phosphatase
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liver function test
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What will the levels of bilirubin, albumin, and alkaline phosphatase be is the liver isn't functioning well?
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high bilirubin and alkaline phosphatase; low albumin
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mainly used for determine disease states; such as in cirrhosis, chronic hepatitis, and cancer
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biopsy
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used to measure pancreatic function
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Blood tests
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What do the blood tests check for?
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amylase and lipase (the levels of them will be high if the pancreas is inflamed or under attack)
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x-ray of gallbladder
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cholecystogram
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x-ray of blood vessels going to gallbladder
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Cholangiogram
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can range from mild inflammation to those that destroy the organ and result in it's failure
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Liver disease
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inflammation of liver
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Hepatitis
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what are some causes of hepatitis?
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chemical actions of drugs or toxic substances, chronic alcoholism, and group of viruses
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what is the most common cause of hepatitis?
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group of viruses
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most prevalent liver disease in the world today; often asymptomatic to vague symptoms
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Viral hepatitis
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five types of viral hepatitis include:
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A,B,C,D,E
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most common type of hepatitis
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Hepatitis A (HAV)
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key word for hepatitis A
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ambivalent--> benign and harmless
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how is hepatitis A spread?
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oral-fecal contact
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total recovery for hepatitis A?
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about 98% of the time
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What are some risk factors of hepatitis A?
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poor sanitation and overcrowding
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What can hepatitis A lead to?
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it never leads to cirrhosis or chronic hepatitis; and there is a vaccine for it
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hepatitis that attacks DNA and is bad
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Hepatitis B (HBV)
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what was hepatitis B formerly called?
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serum hepatitis
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how is hepatitis B spread?
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blood, urine, feces, saliva, and semen (considers a sexually transmitted disease; can also pass transplacentally
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is hepatitis B more infectious than HIV?
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yes, 100 times more infectious than HIV
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How effective is the Hepatitis B vaccination?
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95% effective in preventing transmission and acquisition of the disease
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hepatitis that attacks RNA; progresses very slowly but is usually chronic
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Hepatitis C (HCV)
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key words for hepatitis C
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Chronic, Cirrhosis, and Clotting problems
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how is hepatitis C spread?
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blood or sexual contact
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what disease(s) are people likely to develop after hepatitis C?
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50% of people will end up developing chronic hepatitis or cirrhosis
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delta virus requires the presence of Hepatitis B to replicate
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Hepatitis D (HDV)
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key word for hepatitis D
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Duel
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If both hepatitis B and D are present what is there a greater rick of?
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developing fulminant hepatitis and then chronic hepatitis
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occurs suddenly and with great intensity
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fulminent
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does not cause chronic hepatitis, but can be potentially fatal for pregnant women
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Hepatitis E (HEV)
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key word for hepatitis E
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egg
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how is hepatitis E spread?
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oral-fecal contact; commonly due to water contamination
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symptoms of hepatitis include:
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jaundice and liver enlargement; malaise; anorexia; fever; myalgia; dark-colored urine; clay or light-colored stools
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liver enlargement
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hepatomegaly
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muscle pain
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myalgia
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how is hepatitis diagnosed?
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based on presence of antibodies produced
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treatment for hepatitis includes:
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rest, good nutrition, and antiviral medications
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what is the most serious complication of hepatitis?
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developing chronic hepatitis or fulminant hepatitis (90% fatal)
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prevention of hepatitis can be done by
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good hygiene and special care when handling needles and body fluids
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chronic, irreversiblem and degenerative disease; the replacement of normal liver cells with nonfunctioning scar tissue
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Cirrhosis
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another name for cirrhosis
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end stage liver disease
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Change in structure and function of liver cells leads to
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blockage in blood flow (resulting in altered function)
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What is the liver then called and why?
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Hobnail liver, called this due to appearance (looks like raised areas on liver)
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most common cause of cirrhosis
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chronic alcoholism
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symptoms of cirrhosis include:
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loss of appetite, nausea, indigestion, weakness, and weight loss
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complications of severe cirrhosis include:
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(1) Portal hypertension (2) Esophageal varices (3)Splenomegaly (4) Gastrointestinal hemorrhage (5)Ascites (6) edema (7) jaundice (8) Altered sex hormone metabolism (9) Hepatic encephalopathy (10) Delirium tremens
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refers to pressure building up in the hepatic portal vein; volume is increased here as a result of blockage
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Portal hypertension
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varicosities across the front of the abdomen are often quite tortuous and unsightly
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caput medusae (head of medusa)
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a condition when the spleen is enlarging and destroying platelets faster than normal, leads to thrombocytopenia
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Splenomegaly
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due low platelets and clotting factors; hematemesis is often the first symptom of severe cirrhosis and is a result of this
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Gastrointestinal hemorrhage
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fluid accumulation in abdominal cavity that develops as a result of liver failure and portal hypertension
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Ascites
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done when ascites are present, and helps alleviate pressure
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abdominocetesis
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which blood protein is responsible for the osmotic pressure of blood
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albumin
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Characteristics developed by the man due to excessive estrogen:
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(1) Gynecomastia (2) Palmar erythema (3) Spider angiomas (4) Female hair distribution (5) testicular atrophy
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an enlargement in breast tissue
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gynecomastia
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palms of the hands become reddened in color
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palmar erythema
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small dilated blood vessels on the face and chest
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spider angiomas
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absent or reduced chest and pubic hair
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female hair distribution
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decrease in testicle size
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testicular atrophy
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alteration in normal brain function due to nitrogenous waste (ammonia) in body --> the liver cannot process the wastes correctly, which causes mental confusion, stupor, and a characteristic shaking or tremor
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Hepatic encephalopathy
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shaking and tremors combined with hallucinations; happens when a person has gone binge drinking and then stops suddenly
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Delirium tremens
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usually metastatic and malignant, primary and benign tumors are rare usually discovered late or end stage
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Liver cancer
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What tissues to tumors normally metastasize from?
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breast, lungs, or digestive tract
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treatment of liver cancer includes:
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radiation, surgery, and chemotherapy
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what is the prognosis for liver cancer?
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very poor, only about 10% individuals live 5 years after diagnosis
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inflammation of the gallbladder usually caused by obstruction of blue due to gallstone
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Cholecystitis
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Symptoms of cholecystitis include:
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pain in upper right quadrant (URQ) (under the liver) of the abdomen when-after eating a fatty meal
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how is cholecystitis diagnosed?
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ultrasound or cholecystogram
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a complication of cholecystitis
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rupture of the gallbladder leading to peritonitis
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treatment for cholecystitis
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surgical removal (usually lapatascopically) called cholecystectomy
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presence of stones in gallbladder or bile ducts
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Cholelithiasis
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important risk factors called the 5 F's of cholelithiasis
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(1) Female; 1 in 5 females 1 in 10 men (2) Fair complexion (3) Fat or obese (4) Fertile or has children (5) Forty years of age
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symptoms of cholelithiasis include:
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nausea, vomiting, and RUQ pain following means with fat
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inflammation of pancreas, commonly caused by alcoholism
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Pancreatitis
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often follows a binge drinking episode and will often be fatal
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hemorrhagic pancreatitis
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symptoms of pancreatitis include:
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nausea, vomiting, severe abdominal pain radiating to back, diaphoresis, and tachycardia
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sweating
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diaphoresis
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digestion of own tissue
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autodigestion
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what is specifically released by the pancreas that causes autodigestion?
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excess enzyme release; protease (digest protein); amylase; lipase (lipids) proteins and lipids make up cell membranes
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What are symptoms of chronic pancreatitis?
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they are similar to those of acute pancreatitis
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how is pancreatitis diagnosed?
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by high blood amylase and lipase levels
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treatment for pancreatitis if caused by gallstones
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cholecystectomy and ESWL
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procedure using shock waves to break up stones
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extracorporeal shock wave lithotripsy (ESWL)
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treatment for pancreatitis if idiopathic (unknown cause)
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palliative, symptomatic treatment
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treatment for pancreatitis if caused by alcoholism
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palliative, symptomatic treatment; BUT can quit drinking (although that will not cure pancreatitis)
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usually adenocarcinoma occurring in head of pancreas; cause is unknown but carcinogens include cigarette smoking, high coffee consumption, chemical exposure, and consumption of high-fat diet
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Pancreatic cancer
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symptoms of pancreatic cancer
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abdominal and back pain, nausea and vomiting, loss of appetite, weakness and fatigue, and jaundice
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treatment for pancreatic cancer includes:
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surgical resection, radiation, and chemotherapy (although it is not very effective, also worried about causing autosuggestion or autolysis)
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prevention for pancreas cancer
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no proven prevention
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prognosis for pancreatic cancer
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very poor, symptoms are not usually present until metastasis has already occurred
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chronic liver disease that gradually destroys bile ducts in liver
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Primary biliary cirrhosis
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congenital liver disorder, more common in males
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Gilbert's syndrome
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body absorbs ans stores excessive amounts of iron; MOST common inherited disease--> affects about 1 million people in the US
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Hemochromatosis
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treatment for hemochromatosis
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take 1-2 units of blood weekly until level is normal, then about every 4 months for the rest of life; not curable, simply treatable
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Effects of aging on the gallbladder, pancreas, and liver:
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increases seriousness of infections, increased mortality rate for hepatitis with age; lifestyle risk factors contribute to health outcome; increases bile stones; decreases pancreatic enzymes
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What organ dysfunction can lead to gastrointestinal hemorrhage?
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liver dysfunction
