NUR 425 - Week 2 Digestive System Review
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Questions and Answers

What is the most common manifestation of chronic hepatitis?

  • Pruritis
  • RUQ tenderness
  • Weight loss
  • Palmar erythema (correct)

    • What is the primary process that converts unconjugated bilirubin to conjugated bilirubin?

  • Liver processing (correct)
  • Gallbladder synthesis
  • Kidney filtration
  • Spleen metabolism

    • Which condition results from a buildup of bilirubin in the liver?

  • Cholecystitis
  • Jaundice (correct)
  • Hepatitis A
  • Anemia

    • What is the main reason for the development of clay-colored stools?

    <p>Lack of bilirubin in stool (A)</p> Signup and view all the answers

    What role do bile salts play in the skin when bilirubin levels are elevated?

    <p>They lead to pruritis (A)</p> Signup and view all the answers

    If the liver fails to synthesize enough albumin, what can occur?

    <p>Buildup of bilirubin (B)</p> Signup and view all the answers

    Where does bilirubin metabolism primarily occur?

    <p>Liver (B)</p> Signup and view all the answers

    What condition can lead to splenomegaly due to blood backup in the spleen?

    <p>Cirrhosis (C)</p> Signup and view all the answers

    Which of the following is a common complication of advanced cirrhosis affecting blood clotting?

    <p>Thrombocytopenia (C)</p> Signup and view all the answers

    What is the primary purpose of performing paracentesis in patients with ascites?

    <p>To relieve symptoms temporarily (D)</p> Signup and view all the answers

    Which clinical sign is associated with hepatic encephalopathy and involves irregular muscle jerking?

    <p>Asterixis (C)</p> Signup and view all the answers

    In the management of hepatic encephalopathy, which medication is primarily used to decrease ammonia absorption?

    <p>Lactulose (D)</p> Signup and view all the answers

    What is the most likely cause of renal failure in patients with cirrhosis?

    <p>Decreased blood volume to kidneys (C)</p> Signup and view all the answers

    Which diagnostic test is considered the gold standard for identifying liver cell changes in cirrhosis?

    <p>Liver biopsy (D)</p> Signup and view all the answers

    What is the primary mode of transmission for Hepatitis B?

    <p>Exposure to blood or blood products (C)</p> Signup and view all the answers

    What is the significance of HBsAg in Hepatitis B diagnosis?

    <p>Confirms chronic infection if present after 6 months (C)</p> Signup and view all the answers

    Which of the following symptoms can indicate increased bleeding due to liver dysfunction?

    <p>Gingival bleeding (C)</p> Signup and view all the answers

    What type of breath odor is associated with hepatic encephalopathy?

    <p>Fetor hepaticus (D)</p> Signup and view all the answers

    Which of the following antiviral agents is contraindicated in pregnancy for Hepatitis B treatment?

    <p>Entecavir (A)</p> Signup and view all the answers

    Elevated levels of which laboratory test indicate liver dysfunction in cirrhosis?

    <p>Bilirubin (B)</p> Signup and view all the answers

    What is the major distinguishing feature of Hepatitis D virus infection?

    <p>It requires Hepatitis B to be present for infection (B)</p> Signup and view all the answers

    What characterizes the treatment for Hepatitis C using DAAs?

    <p>They directly target RNA replication in HCV (D)</p> Signup and view all the answers

    What is the common side effect of ribavirin when used in treatment?

    <p>Hemolytic anemia (D)</p> Signup and view all the answers

    What is the primary goal when treating patients with chronic Hepatitis C?

    <p>Cure the infection (B)</p> Signup and view all the answers

    In which condition is the presence of Anti-HCV antibodies significant?

    <p>It indicates previous exposure or current infection with Hepatitis C (A)</p> Signup and view all the answers

    Which Hepatitis virus is primarily associated with oral-fecal transmission?

    <p>Hepatitis A (B)</p> Signup and view all the answers

    Which laboratory test is crucial for monitoring the effectiveness of Hepatitis C treatment?

    <p>HCV RNA at 12 weeks after therapy (A)</p> Signup and view all the answers

    What is a characteristic symptom of cirrhosis?

    <p>Development of scar tissue in the liver (B)</p> Signup and view all the answers

    What is the recommended vaccination schedule for Hepatitis B?

    <p>3 doses at 0, 1, and 6 months (A)</p> Signup and view all the answers

    Which type of hepatitis typically leads to chronic disease in immunocompromised individuals?

    <p>Hepatitis E (C)</p> Signup and view all the answers

    Which protein is primarily synthesized by the liver?

    <p>Albumin (B)</p> Signup and view all the answers

    What provides the majority of the liver’s blood supply?

    <p>The hepatic portal vein provides most of the blood supply (A)</p> Signup and view all the answers

    Which substance is primarily detoxified by the liver?

    <p>Ammonia (D)</p> Signup and view all the answers

    What clinical manifestation is most characteristic of chronic hepatitis?

    <p>Palmar erythema (D)</p> Signup and view all the answers

    Which class of medications is commonly used in the treatment of chronic hepatitis B?

    <p>Nucleoside analogs (C)</p> Signup and view all the answers

    Which hepatitis viruses are preventable through vaccination in Canada?

    <p>Hep A, B and D (B)</p> Signup and view all the answers

    Hepatic fat accumulation is most commonly seen in which form of cirrhosis?

    <p>Alcoholic cirrhosis (B)</p> Signup and view all the answers

    The most common clinical manifestation of portal hypertension is ________ bleeding.

    <p>Esophageal (B)</p> Signup and view all the answers

    What condition can arise from the accumulation of estrogen due to impaired liver function?

    <p>Gynecomastia (A)</p> Signup and view all the answers

    Which clinical manifestation is a common result of portal hypertension?

    <p>Ascites (D)</p> Signup and view all the answers

    What is the primary factor that leads to the development of ascites?

    <p>Hypoalbuminemia (A)</p> Signup and view all the answers

    Which hormone accumulates due to the damaged hepatocytes in cirrhosis that can lead to fluid retention?

    <p>Aldosterone (D)</p> Signup and view all the answers

    What treatment is commonly used to reduce bleeding from esophageal varices?

    <p>Beta-blockers (B)</p> Signup and view all the answers

    What is hepatic encephalopathy characterized by?

    <p>Neuropsychiatric abnormalities (D)</p> Signup and view all the answers

    Which complication is NOT associated with portal hypertension?

    <p>Gynecomastia (A)</p> Signup and view all the answers

    How can sodium restriction help manage ascites?

    <p>It prevents fluid retention (D)</p> Signup and view all the answers

    What is the goal of using sclerotherapy in the management of varices?

    <p>To induce clotting (A)</p> Signup and view all the answers

    Which sign may indicate the presence of ascites?

    <p>Everted umbilicus (A)</p> Signup and view all the answers

    What assessment is crucial in monitoring a patient with ascites?

    <p>Daily abdominal girth measurement (A)</p> Signup and view all the answers

    What condition may occur as a late-stage complication involving acute kidney injury in liver patients?

    <p>Hepatorenal syndrome (C)</p> Signup and view all the answers

    What is the primary cause of abdominal distension in patients with ascites?

    <p>Fluid accumulation (C)</p> Signup and view all the answers

    What is a key function of the liver that, when impaired, can affect estrogen levels?

    <p>Metabolizing hormones (B)</p> Signup and view all the answers

    Which symptom is associated with the accumulation of bile salts beneath the skin due to elevated bilirubin levels?

    <p>Pruritis (D)</p> Signup and view all the answers

    What occurs if the liver fails to synthesize enough albumin in relation to bilirubin?

    <p>Decreased bilirubin excretion (A), Buildup of bilirubin in the liver (D)</p> Signup and view all the answers

    What color might urine appear if there is a significant level of bilirubin being excreted by the kidneys?

    <p>Dark amber (A)</p> Signup and view all the answers

    Which condition is characterized by clay-colored stools due to a lack of bilirubin?

    <p>Obstructive jaundice (B)</p> Signup and view all the answers

    Which of the following best describes the metabolic pathway of bilirubin in the liver?

    <p>Conjugated to form water-soluble bilirubin (D)</p> Signup and view all the answers

    What can prolonged elevation of unconjugated bilirubin levels in the blood lead to?

    <p>Jaundice (B)</p> Signup and view all the answers

    Which clinical manifestation is most commonly seen in chronic hepatitis related to bilirubin metabolism?

    <p>Palmar erythema (A)</p> Signup and view all the answers

    Which of the following indicates a failure of the liver to properly process bilirubin?

    <p>High fat content in stool (B), Elevated bilirubin levels in urine (D)</p> Signup and view all the answers

    What percentage of the liver's blood supply is received from the hepatic artery?

    <p>30% (C)</p> Signup and view all the answers

    Which of the following is NOT a function of the liver?

    <p>Respiration (D)</p> Signup and view all the answers

    Which type of hepatitis virus is responsible for acute infections and is RNA-based?

    <p>Hepatitis A (C)</p> Signup and view all the answers

    What is indicated by the presence of icteric jaundice?

    <p>Presence of jaundice (A)</p> Signup and view all the answers

    Which of the following manifestations is typically associated with chronic hepatitis?

    <p>Easy bruising (B)</p> Signup and view all the answers

    What leads to the activation of the complement system during a hepatitis infection?

    <p>Antigen-antibody complex formation (C)</p> Signup and view all the answers

    Which of the following symptoms is characteristic of acute hepatitis?

    <p>Hepatomegaly (B)</p> Signup and view all the answers

    During the acute phase of hepatitis, which symptom might a patient experience?

    <p>Anorexia (D)</p> Signup and view all the answers

    Which factor is primarily impaired in liver function during hepatitis?

    <p>Synthesis of coagulation factors (D)</p> Signup and view all the answers

    Which type of blood does the hepatic portal vein primarily carry?

    <p>Partly oxygenated blood with nutrients (D)</p> Signup and view all the answers

    What dietary adjustment is recommended for patients with cirrhosis and associated ascites?

    <p>High in calories and moderate to low levels of fat (A)</p> Signup and view all the answers

    Which procedure is commonly performed to relieve symptoms of ascites in cirrhosis patients?

    <p>Paracentesis (B)</p> Signup and view all the answers

    What is a crucial aspect of the regular monitoring process for patients with cirrhosis?

    <p>Scheduled blood tests and imaging studies (D)</p> Signup and view all the answers

    What is the primary purpose of using diuretics in the management of cirrhosis?

    <p>To manage ascites (C)</p> Signup and view all the answers

    Which of the following vitamins and nutritional supplements may be necessary for patients with cirrhosis?

    <p>Vitamin D and folic acid (D)</p> Signup and view all the answers

    Which statement accurately represents the management of chronic hepatitis B?

    <p>Nucleotide analogs and nucleoside analogs may be used (B)</p> Signup and view all the answers

    Which term describes the process of creating a portosystemic shunt to alleviate portal hypertension?

    <p>Transjugular intrahepatic portosystemic shunt (TIPS) (A)</p> Signup and view all the answers

    Which of the following conditions is considered a complication of portal hypertension?

    <p>Hepatic encephalopathy (B)</p> Signup and view all the answers

    Which clinical manifestation is primarily associated with an accumulation of estrogen due to liver dysfunction?

    <p>Gynecomastia (D)</p> Signup and view all the answers

    Which process describes the formation of new blood vessels to bypass high-pressure areas in the portal venous system?

    <p>Collateral circulation (A)</p> Signup and view all the answers

    What is the primary complication of portal hypertension related to esophageal and gastric varices?

    <p>Rupture and bleeding (A)</p> Signup and view all the answers

    What is the main action of octreotide in the management of bleeding varices?

    <p>Reduces portal venous pressure (B)</p> Signup and view all the answers

    Which clinical feature is a consequence of both hypoalbuminemia and portal hypertension in cirrhosis?

    <p>Edema (A)</p> Signup and view all the answers

    What is the main reason for fluid retention in patients with cirrhosis related to hyperaldosteronism?

    <p>Increased sodium reabsorption (C)</p> Signup and view all the answers

    Which therapeutic strategy may serve as a last resort for managing severe portal hypertension?

    <p>Transjugular intrahepatic portosystemic shunt (TIPS) (B)</p> Signup and view all the answers

    What is a typical characteristic of palmar erythema associated with liver dysfunction?

    <p>Warm, red palms (B)</p> Signup and view all the answers

    Which condition results from an impaired lymphatic drainage combined with portal hypertension?

    <p>Ascites (D)</p> Signup and view all the answers

    What is the most appropriate initial management for a patient with bleeding varices?

    <p>Hemodynamic stabilization (D)</p> Signup and view all the answers

    Which sign may suggest the presence of ascites during a physical examination?

    <p>Shifting dullness (D)</p> Signup and view all the answers

    Which treatment is commonly used for the management of ascites related to cirrhosis?

    <p>Sodium restriction (B)</p> Signup and view all the answers

    What complication may arise due to the use of diuretics in patients with cirrhosis?

    <p>Hyponatremia (D)</p> Signup and view all the answers

    Which physiological change contributes to the manifestation of hepatic encephalopathy?

    <p>Buildup of ammonia in the bloodstream (B)</p> Signup and view all the answers

    What is the main role of nucleoside analogues in the treatment of Hepatitis B?

    <p>To inhibit viral DNA replication (C)</p> Signup and view all the answers

    Which hepatitis virus can only cause infection in the presence of Hepatitis B?

    <p>Hepatitis D (D)</p> Signup and view all the answers

    Which of the following statements about Hepatitis C is true?

    <p>Most people with acute HCV will clear the infection spontaneously. (C)</p> Signup and view all the answers

    What constitutes the primary treatment approach for acute Hepatitis D?

    <p>Supportive care (C)</p> Signup and view all the answers

    What common adverse effect is associated with the use of protease inhibitors in Hepatitis C treatment?

    <p>Photosensitivity (D)</p> Signup and view all the answers

    Which hepatitis virus is primarily associated with oral-fecal transmission?

    <p>Hepatitis A (A)</p> Signup and view all the answers

    What is the importance of checking HCV RNA levels 12 weeks after treatment?

    <p>To assess treatment effectiveness (B)</p> Signup and view all the answers

    Which laboratory test is specifically indicative of immunity to Hepatitis B?

    <p>Anti-HBs (C)</p> Signup and view all the answers

    What is the recommended vaccination schedule for Hepatitis B?

    <p>3 doses at 0, 1, and 6 months (B)</p> Signup and view all the answers

    What is a significant complication of long-term Hepatitis B infection?

    <p>Cirrhosis (A)</p> Signup and view all the answers

    What kind of treatment is typically not recommended during pregnancy for Hepatitis C?

    <p>All of the above (D)</p> Signup and view all the answers

    Which test is crucial for determining chronic Hepatitis C infection?

    <p>Anti-HCV (A)</p> Signup and view all the answers

    What type of therapy was rarely used since the advent of oral antiviral therapies for Hepatitis B?

    <p>Pegylated-interferon alfa (C)</p> Signup and view all the answers

    Which condition is characterized by fibrosis and progressive inflammation of the liver?

    <p>Cirrhosis (D)</p> Signup and view all the answers

    Study Notes

    Hepatitis B

    • Caused by the Hepatitis B Virus (HBV), transmitted through blood, sexual contact, and perinatal exposure.
    • Infectious before symptoms, may be asymptomatic.
    • Infants born to HBV-infected individuals should receive vaccination and immunoglobulins within 12 hours to prevent acute and chronic infection.
    • Management includes symptom relief and education; antiviral therapy may be necessary.
    • Key serologic tests include HBsAg (indicates infection), Anti-HBs (immunity), and HBV DNA (viral load).
    • Pharmacotherapy aims to reduce viral load and prevent complications like cirrhosis.
    • Two main classes of antiviral agents: nucleoside analogues (entecavir, tenofovir) and pegylated-interferon alfa.

    Hepatitis C

    • Caused by the Hepatitis C Virus (HCV), with similar transmission routes as Hepatitis B.
    • Infectious 1-2 weeks before symptoms appear; most infections are asymptomatic initially.
    • Anti-HCV test indicates past or present infection; HCV RNA confirms active disease.
    • There are six genotypes, significant for treatment planning.
    • Direct-acting antivirals (DAAs) target steps in HCV replication and have a typical 12-week treatment course.
    • DAAs can cause fatigue and headaches; non-recommended in pregnancy.

    Hepatitis D and E

    • Hepatitis D requires co-infection with Hepatitis B.
    • Treatment for Hepatitis D is primarily supportive; chronic cases may use pegylated interferon alfa.
    • Hepatitis E, transmitted via the oral-fecal route, is generally mild and self-limiting, with chronic cases primarily in immunocompromised individuals.

    Cirrhosis

    • Chronic progressive disease resulting in fibrosis, impacting liver structure and function.
    • Diagnosis often involves biopsy, but can also be assessed through ultrasound.
    • Symptoms include fatigue, weight loss, pruritis, splenomegaly, and various endocrine disturbances.
    • Portal hypertension leads to complications such as esophageal varices, ascites, and hepatic encephalopathy.

    Bilirubin Metabolism

    • Bilirubin results from the breakdown of old RBCs and is processed in the liver, converted from unconjugated to conjugated form for excretion.
    • Increased bilirubin levels can cause jaundice, pruritus, dark urine, and clay-colored stools.

    Portal Hypertension

    • Caused by fibrosis and changes in liver blood vessels, leading to increased pressure in the portal venous system.
    • Complications include varices, ascites, and hepatic encephalopathy.
    • Management strategies focus on relieving pressure and managing symptoms.

    Varices

    • Enlarged veins that may rupture and cause hematemesis or melena; require careful management to prevent bleeding.
    • Treatment options include beta-blockers, sclerotherapy, band ligation, and in severe cases, shunting procedures.

    Ascites

    • Accumulation of fluid in the peritoneal cavity caused primarily by portal hypertension and hypoalbuminemia.
    • Symptoms include abdominal distension and discomfort; management involves sodium restriction and diuretics.
    • Paracentesis may be performed for symptomatic relief.

    Hepatic Encephalopathy

    • Results from the accumulation of ammonia due to impaired liver function.
    • Early signs include mood changes, memory loss, and drowsiness; late signs can involve confusion, tremors, and distinct breath odor.
    • Lactulose and rifaximin are key treatments to reduce ammonia levels.

    Hepatorenal Syndrome

    • Characterized by renal failure related to portal hypertension and fluid shifts.
    • Often seen after diuretic therapy or gastrointestinal bleeding; difficult to treat effectively.
    • Liver transplantation may reverse kidney failure.

    Diagnostic Tests for Cirrhosis

    • Liver function tests reveal increased AST, ALT, and bilirubin levels.
    • Prolonged PT and INR indicate impaired liver function.
    • A CBC may show thrombocytopenia and anemia.### Cirrhosis: Management Overview
    • No specific medication for cirrhosis; treatment targets underlying causes (e.g., antivirals for hepatitis).
    • Manage symptoms with medications such as antacids for gastric discomfort and diuretics for ascites.
    • Lifestyle changes: avoid alcohol, adopt a healthy diet, and engage in regular exercise.
    • Vitamins and nutritional supplements may be necessary for nutritional support.
    • Recommended diet: high in calories and carbohydrates, moderate to low fat content.
    • Sodium restriction is advised in cases of ascites and peripheral edema.
    • Procedures such as paracentesis and Transjugular Intrahepatic Portosystemic Shunt (TIPS) may be performed.
    • Regular monitoring through blood tests, imaging studies, and endoscopies is crucial.
    • Liver transplantation may be necessary for advanced cirrhosis.

    Key Review Questions

    • The liver primarily synthesizes Albumin.
    • Most of the liver's blood supply is provided by the hepatic portal vein.
    • The liver detoxifies Ammonia, converting it to urea.
    • The most characteristic clinical manifestation of chronic hepatitis is Jaundice.
    • Common medications for chronic hepatitis B include Nucleoside analogs and Nucleotide analogs.
    • Hepatitis A and B viruses are preventable through vaccination in Canada.
    • Hepatic fat accumulation is associated with Alcoholic cirrhosis.
    • The most common clinical manifestation of portal hypertension is Esophageal bleeding.
    • A key strategy in managing cirrhosis involves implementing lifestyle modifications and monitoring health conditions.

    Hepatitis Overview

    • Hepatitis B Virus (HBV) is transmitted through blood, sexual contact, and perinatal exposure.
    • Infants born to HBV-infected mothers require vaccination and immunoglobulins within 12 hours post-birth to prevent chronic infection.
    • Symptoms may be absent initially; management aims for symptom relief and education.
    • Hepatitis B serologic tests include HBsAg (indicates infection), Anti-HBs (indicates immunity), and HBV DNA (monitors viral load).

    Pharmacotherapy of Hepatitis B

    • Antiviral therapy manages virus load and disease progression, particularly in severe or symptomatic cases.
    • Older pegylated-interferon alfa is less common, with nucleoside analogues like entecavir and tenofovir being preferred.
    • Potential side effects include severe hepatomegaly, nephrotoxicity with tenofovir, and pregnancy contraindication with entecavir.

    Hepatitis B Vaccination

    • Available as Hep B only (Energix-B, Recombivax) or combination (Twinrix).
    • Vaccines administered in three doses: 0, 1, and 6 months.

    Hepatitis C Overview

    • Hepatitis C Virus (HCV) is similarly transmitted as hepatitis B and can be asymptomatic in early stages.
    • Anti-HCV indicates infection; HCV RNA confirms active disease.
    • Six genotypes of HCV affect treatment strategies and outcomes.

    Pharmacotherapy of Hepatitis C

    • Acute hepatitis C often resolves spontaneously; however, early treatment is recommended to prevent complications.
    • Direct-acting antiviral agents (DAAs) target HCV RNA replication and came into use in 2011.
    • DAAs include protease inhibitors, NS5A inhibitors, and NS5B inhibitors with common side effects of headache and fatigue.
    • Treatment typically lasts 12 weeks, and response monitored by HCV RNA levels post-therapy.

    Hepatitis D Overview

    • Hepatitis D Virus (HDV) requires the presence of Hepatitis B for infection.
    • Treatment for acute HDV focuses on supportive care; chronic cases may involve pegylated interferon alpha.

    Hepatitis E Overview

    • Hepatitis E Virus (HEV) is transmitted orally, often via contaminated water supply.
    • Mild, self-limiting disease; chronic cases typically in immunocompromised individuals may require ribavirin.

    Cirrhosis

    • Cirrhosis features chronic liver fibrosis and inflammation with disorganized regeneration.
    • Diagnosed through liver biopsy or ultrasound.
    • Major causes include alcohol abuse, viral hepatitis, and non-alcoholic fatty liver disease.

    Liver Blood Supply

    • Hepatic artery supplies 30% of blood, while the hepatic portal vein provides 70% with nutrients and toxins from the digestive system.

    Main Functions of the Liver

    • Key roles include blood filtration, metabolism, bile production, storage of vitamins, and immune function.

    Clinical Manifestations of Hepatitis

    • Acute symptoms include altered taste, jaundice, fatigue, and potential hepatomegaly.
    • Chronic presentation may involve splenomegaly, easy bruising, and palmar erythema.

    Bilirubin Metabolism

    • Bilirubin is a byproduct of RBC breakdown, processed in the liver into water-soluble conjugated form for excretion.
    • Increased bilirubin levels result in jaundice, pruritis, dark urine, and clay-colored stools.

    Clinical Manifestations of Cirrhosis

    • Symptoms from endocrine disturbances include gynecomastia, palmar erythema, and spider angiomas due to hormonal imbalance.

    Portal Hypertension and Complications

    • High pressure in the portal venous system from liver fibrosis leads to complications like varices, ascites, and hepatic encephalopathy.

    Management of Varices

    • Avoid NSAIDs to reduce irritation, use non-selective beta-blockers for prevention, and treat bleeding with medications and endoscopy.

    Peripheral Edema and Ascites

    • Peripheral edema arises from fluid accumulation due to decreased oncotic pressure from low albumin levels.
    • Ascites manifests as abdominal distension and is caused by portal hypertension, hypoalbuminemia, and hyperaldosteronism.

    Management of Ascites

    • Regular assessment and monitoring of vitals, fluid balance, and abdominal girth.
    • Sodium restriction and diuretic therapy to manage fluid retention.### Cirrhosis Management
    • No specific medication for cirrhosis; treatment focuses on the underlying cause or managing symptoms.
    • Antivirals may be used for hepatitis; antacids can alleviate gastric discomfort.
    • Diuretics are prescribed for complications like ascites.
    • Lifestyle changes are crucial: abstain from alcohol, maintain a nutritious diet, and increase physical activity.
    • Nutritional needs may include vitamins and supplements.
    • Recommended diet: high in calories and carbohydrates, moderate to low fat intake.
    • Sodium intake should be limited in cases of ascites and peripheral edema.
    • Invasive procedures like paracentesis and Transjugular Intrahepatic Portosystemic Shunt (TIPS) are used when necessary.
    • Regular monitoring through blood tests, imaging studies, and endoscopies is essential for managing cirrhosis.
    • Liver transplant may be considered in advanced cases.

    Review Questions Overview

    • The liver primarily synthesizes albumin, a key plasma protein.
    • Most blood supply to the liver comes from the hepatic portal vein, not the hepatic artery.
    • The liver is crucial for detoxifying ammonia, converting it into urea.
    • Jaundice is a hallmark symptom of chronic hepatitis.
    • Common medications for chronic hepatitis B include nucleotide analogs.
    • Hepatitis A and B are preventable via vaccines in Canada.
    • Alcoholic cirrhosis is primarily associated with hepatic fat accumulation.
    • The most frequent manifestation of portal hypertension is esophageal bleeding.
    • Key management strategies for cirrhosis include lifestyle modification and regular monitoring.

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