Biliary – Flashcard

What causes massive inflammation and necrosis in acute pancreatitis? Question 1 options: formation of multiple thrombi and ischemia infection by intestinal microbes immune complex reaction activation and spread of proteolytic enzymes

Which of the following is/are (a) manifestation(s) of hemolytic jaundice? increased unconjugated bilirubin in the blood increased bleeding tendencies pale stool and dark urine elevated liver enzymes in the blood

What can be concluded if the hepatitis B antigen level remains high in the serum? Question 3 options: Acute infection is present. Chronic infection has developed. Liver failure is in progress. The usual prolonged recovery from any viral infection is occurring.

In patients with cirrhosis, serum ammonia may increase when: ingesting excessive lipids bleeding occurs in the digestive tract an increase in unconjugated bilirubin occurs in the serum less bile is produced

What is the likely effect of long-term exposure to a hepatotoxin? full recovery to normal tissue after the toxic material is removed acute onset of vomiting, steatorrhea, and jaundice continued mild inflammation of the liver without permanent damage gradual irreversible damage to the liver and cirrhosis

Which of the following is a major cause of primary hepatocellular cancer? metastatic tumors acute hepatitis long-term exposure to certain chemicals chronic cholelithiasis

Why does mild hyperbilirubinemia occur in newborns? blood incompatibility between mother and child there is damage to many erythrocytes during the birth process poor circulation and albumin transport for bilirubin the immature liver cannot process bilirubin quickly enough

What indicates the presence of third-stage alcohol hepatitis? below normal blood levels of AST and ALT ULQ tenderness and dull pain a small, firm, nodular liver and portal hypertension accumulation of fat in the hepatocytes and hepatomegaly

What is the most common type of hepatitis transmitted by blood transfusion? HAV HBV HCV HEV

What is the major effect when a gallstone obstructs the cystic duct? intrahepatic jaundice acute pancreatitis severe colicky pain in upper right quadrant inflammation and infection in the gall bladder

Which of the following occurs with hepatitis B? The liver is inflamed and enlarged. Blood clotting delays are apparent at onset. Hepatocytes can not regenerate when virus is present. Infection is self-limiting.

In the liver, amino acids are used to produce complex molecules by means of: glycogenesis anabolic processes catabolic processes autodigestion

Which type(s) of hepatitis increase(s) the risk of hepatocellular carcinoma? HBV HCV HBV and HCV neither HBV nor HCV

Which of the following describes the supply of bile following a cholecystectomy? Bile is no longer available for digestion. Bile is stored in the liver sinusoids until a fatty meal is consumed. Bile is not diluted and is less effective as an emulsifier. Small amounts of bile are continuously secreted and flow into the duodenum.

Predisposing factors to cholelithiasis include excessive: bilirubin or cholesterol concentration in the bile water content in the bile

Which of the following is/are (a) manifestation(s) of hemolytic jaundice? increased unconjugated bilirubin in the blood increased bleeding tendencies pale stool and dark urine elevated liver enzymes in the blood

Which factors contribute to ascites in patients with cirrhosis? increased aldosterone and deficit of albumin severe anemia and increased serum bilirubin hypokalemia and increased serum ammonia hyperproteinemia and persistent hypotension

What indicates the presence of third-stage alcohol hepatitis? below normal blood levels of AST and ALT ULQ tenderness and dull pain a small, firm, nodular liver and portal hypertension accumulation of fat in the hepatocytes and hepatomegaly

Predisposing factors to cholelithiasis include excessive: bilirubin or cholesterol concentration in the bile water content in the bile bile salts in the bile bicarbonate ions in the bile

How does chemical peritonitis and shock frequently result from acute pancreatitis? Inflammation and increased vascular permeability of the peritoneum affect fluid balance. Erosions in the intestinal wall causes release of bacteria. Fat necrosis and hypocalcemia develop. Secretions from the pancreas and intestine become more acidic.

Which of the following is contained in pancreatic exocrine secretions? bicarbonate ion hydrochloric acid activated digestive enzymes insulin

Tetany may develop in patients with acute pancreatitis because: digestion and absorption of calcium is impaired hemorrhage and fluid shift displace calcium from the blood calcium ions are used up in blood coagulation process calcium ions bind with fatty acids in necrotic tissue

What is the primary cause of increased bleeding tendencies associated with cirrhosis? anemia and leucopenia jaundice and pruritus recurrent infections deficit of vitamin K and prothrombin

What is the likely effect of long-term exposure to a hepatotoxin? full recovery to normal tissue after the toxic material is removed acute onset of vomiting, steatorrhea, and jaundice continued mild inflammation of the liver without permanent damage gradual irreversible damage to the liver and cirrhosis

Identify a major reason making it difficult to prevent the spread of hepatitis B. A vaccine is not available. The incubation period is too short to track contacts. Infection is often asymptomatic. Antibodies are not produced

Which of the following are related to post-hepatic jaundice? pruritic skin and light-colored stools dark-colored stools and urine increased serum levels of unconjugated bilirubin loss of all metabolic functions

Open common bile duct (CBD) exploration may be indicated in some cases where: the patient has undergone prior biliary surgery. a positive cholangiogram shows a CBD obstruction during an open cholecystectomy. laparoscopy technology is not available. All of the options are correct.

An example of a potential risk associated with pneumoperitoneum would be: tachycardia caused by peritoneal irritation from the CO2. CO2 absorption into the peritoneal capillaries, causing decreased oxygen saturation. bradycardia from CO2 pressure lower than 15 mm Hg. gas embolus into an exposed blood vessel during the procedure.

The biliary system (also called the biliary tree) drains bile from the gallbladder to the ampulla of Vater. The primary function of the gallbladder is to: manufacture bile. convert bile salts into bile enzymes. store and concentrate bile. contract to secrete bile into the hepatic duct

The liver is essential in the metabolism of carbohydrates, proteins, and fats, generating nutrient stores of which substance that supplies energy sources to the brain and body? Carbohydrate glucose substrate Glycogen Serum glucosamine bile salts

An example of an indication for liver transplantation would be: Primary hepatic cancer

Matthew Ryan, a nine year old boy, is admitted to the emergency department for a sledding accident, when he lost control of his sled and crashed into a tree, He is pale and in pain; his abdomen is tender and firm to palpation. The CT scan suggests rupture of the spleen with internal bleeding. Matthew's scheduled surgery will most probably be in an? Open total splenectomy

What technological characteristic of robotic surgery provides a superior indication for robotic-assisted laparoscopic cholecystectomy? The magnified three-dimensional picture may be reduce bile duct injuries during dissection

A primary factor causing encephalopathy with cirrhosis is the elevated? Serum ammonia

The functional units of the liver are the lobules. The functional cells of the liver are the ___ and they manufacture ___.

The donor liver OR is prepared for an open lap procedure with basic lap and vascular instruments and accessories. A second sterile instrument table is set up to receive and prepare the procured liver. Select additional instruments and accessories needed on the donor organ preparation table? Vascular instruments, silk sutures, ties, sterile ice, flushing solution, and slush machine

Deficiencies of vitamins A, D, and K occur in patients with cirrhosis primarily because of decreased? Production of bile for absorption

The head of the pancreas is fixed to the? Duodenum

The whipple procedure is the removal of the head of the pancreas, the entire duodenum, a portion of the jejunum, the distal third of the stomach, and the _____ as a surgical treatment for ____. lower half of the common bile duct; pancreatic cancer

How does serum biliruben change with cirrhosis? increased conjugated and unconjugated biliruben

A primary factor causing encephalowith cirrhosis is the elevated? Serum ammonia

What causes elevated serum levels of AST and ALT during the preicteric stage of hepatitis? Necrosis of liver cells

Which of the following applies to hepatitis A infection? it is a transmitted by the fecal-oral route

Which of the following processes is likely to occur in the body immediately after a meal? Gluconogenesis

Pancreatic cancer may be diagnosed early if obstruction of bile of pancreatic secretions develops when the tumor is located? At the head of the pancreas

Which of the following statements applies to bile salts? They give feces the characteristic brown color. They are enzymes used to break down fats into free fatty acids. They emulsify lipids and lipid-soluble vitamins. They are excreted in the feces.

Joanne Grizwald, a 24-year-old woman with type 1 diabetes who is in end-stage kidney failure, is scheduled for a combined kidney-pancreas transplant. She is relatively healthy and at normal weight for her height in spite of her disease process. Her bleeding time and coagulation parameters are within normal limits. The circulating nurse has set up the autotransfusion system, verified Joanne's blood type, and crossmatched blood availability. The scrub person, while organizing the sterile back table, identified several instruments that she will not need. She organizes those instruments on the most distant part of the back table. What instruments is the scrub person unlikely to need during this procedure? Based on Joanne's coagulation status, excess bleeding is not expected to be an issue. Hemostasis will be achieved by the use of microfibrillar collagen agents that do not leave electrosurgical eschar (burned tissue) on the bleeding surfaces, thereby reducing the chance of infection. Any excess bleeding will be removed and returned to the patient through the autotransfusion system. The transplant procedure is an open approach and laparoscopic instruments (the insulated electrosurgical-adapted scissors, graspers, and the endoscopic suction tips) are not needed.

While the pancreas' function is carbohydrate metabolism with the production of insulin and digestive enzymes, the spleen's function is primarily ___________ with the production of _______________. immunologic; leukocytes metabolic; granulocytes anabolic; plasma cells as a blood reservoir; phagocytes

The recipient liver OR is arranged for a major laparotomy and vascular procedure with customized instruments, supplies, and sutures according to the transplant surgeon's preference. In addition to the general patient care accessories, equipment, and supplies needed for any large surgery, also included are intraoperative laboratory testing and an autotransfusion system. Describe the boundaries of the surgical skin prep for the patient about to receive a liver transplant. From neck to midthigh; midaxillary line to midaxillary line From nipple line to pubis; bedline to bedline From the neck to midthigh; bedline to bedline From nipple line to midthigh; midaxillary line on the patient's left side, and bedline on the right