Cirrhosis and Acute Pancreatitis Management Quiz

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Questions and Answers

What is the main characteristic of cirrhosis?

Conversion of normal liver architecture to abnormal nodules

Which is a common cause of chronic liver failure leading to cirrhosis?

Excessive alcohol intake

What are the early clinical manifestations of liver cirrhosis?

Anorexia, Dyspepsia, Flatulence

What are late manifestations of liver cirrhosis related to?

Portal hypertension & liver failure Signup and view all the answers

What is the most common cause of biliary cirrhosis?

Chronic alcohol abuse Signup and view all the answers

What is the primary etiology of acute (fulminant) liver failure?

Viral, toxic, or idiopathic hepatitis Signup and view all the answers

What is the main effect of chronic alcohol abuse on the liver?

Direct hepatotoxic effect leading to cell necrosis Signup and view all the answers

What are the environmental factors associated with liver cirrhosis?

Excessive alcohol intake, Malnutrition, Genetic predisposition Signup and view all the answers

What is a common symptom of acute pancreatitis aggravated by eating?

Abdominal tenderness and guarding Signup and view all the answers

Which sign is associated with hemorrhagic discoloration near the umbilicus in acute pancreatitis?

Cullen's sign Signup and view all the answers

What is a possible consequence of a pseudocyst in acute pancreatitis?

Peritonitis Signup and view all the answers

What may result from extensive necrosis in the pancreas during acute pancreatitis?

Abscess Signup and view all the answers

Which electrolyte imbalance is associated with acute pancreatitis?

Hypocalcemia Signup and view all the answers

What may be a consequence of a large fluid-containing cavity within the pancreas in acute pancreatitis?

Pleural effusion Signup and view all the answers

What may be a manifestation of an abscess in acute pancreatitis?

High fever Signup and view all the answers

What is a possible presentation of shock in acute pancreatitis?

Hypovolemic or septic shock Signup and view all the answers

What are the etiological factors of hepatic encephalopathy?

Ammonia entering systemic circulation without liver detoxification Signup and view all the answers

Which clinical manifestations are associated with hepatic encephalopathy?

Sleep disturbances, personality changes, and asterixis Signup and view all the answers

What are the factors that can precipitate hepatic encephalopathy?

GI hemorrhage, constipation, hypokalemia, and metabolic alkalosis Signup and view all the answers

What is hepatorenal syndrome?

Functional renal failure with azotemia and intractable ascites Signup and view all the answers

What are the diagnostic studies for hepatic encephalopathy and hepatorenal syndrome?

History, physical examination, liver function tests, and liver biopsy Signup and view all the answers

What is the goal of collaborative management for hepatic encephalopathy and hepatorenal syndrome?

Slowing cirrhosis progression and minimizing symptoms Signup and view all the answers

Which drug is used in the therapy for hepatic encephalopathy and hepatorenal syndrome?

Lactulose Signup and view all the answers

What is the focus of management for ascites?

Sodium restriction, diuretics, fluid removal, and albumin to increase intravascular volume Signup and view all the answers

What is the purpose of paracentesis in managing ascites?

Removing ascitic fluid Signup and view all the answers

How is salt-poor albumin used in managing ascites?

To increase plasma colloid osmotic pressure and manage ascites Signup and view all the answers

What is crucial in managing cirrhosis?

Monitoring of vital signs and fluid balance Signup and view all the answers

How should esophageal variceal bleeding be prevented?

Avoiding alcohol and treating URTIs promptly Signup and view all the answers

What is involved in the management of variceal bleeding?

Stabilizing the patient, IV therapy, and endoscopic and drug therapies Signup and view all the answers

What are the supportive measures for variceal bleeding?

TIPS, sclerotherapy, endoscopic ligation, and balloon tamponade Signup and view all the answers

What is essential in the long-term management of variceal bleeding?

Repeated sclerotherapy, endoscopic ligation, and portosystemic shunts Signup and view all the answers

What are the nursing responsibilities during endoscopy?

Assessing respiratory status, monitoring for shock, maintaining IV access, and administering antihypertensive medications if needed Signup and view all the answers

How is hepatic encephalopathy managed?

Reducing ammonia formation, monitoring LOC, and using lactulose and antibiotics Signup and view all the answers

Why is rest essential for cirrhosis patients?

For conserving energy and reducing ascites Signup and view all the answers

What is included in the nutrition for cirrhosis patients?

High-calorie and high-carbohydrate diets, low sodium for ascites, and monitoring weight Signup and view all the answers

What is involved in skin care for cirrhosis patients?

Repositioning, assessing the Braden scale, and administering antipruritic medication Signup and view all the answers

What is crucial in managing cirrhosis and its complications?

Regular monitoring of laboratory values, signs of F&E imbalance, and response to treatment Signup and view all the answers

What are the primary causative factors of acute pancreatitis?

Biliary tract disease and hypertriglyceridemia Signup and view all the answers

How can cirrhosis be prevented and early treated?

By focusing on eliminating the primary cause and treating alcoholism Signup and view all the answers

What is the primary function of pancreatic exocrine function?

Production of digestive enzymes Signup and view all the answers

What lifestyle changes are required for patients with cirrhosis?

Avoiding alcohol and major dietary changes Signup and view all the answers

What are the symptoms of acute pancreatitis?

Abdominal pain in the left upper quadrant or mid-epigastrium Signup and view all the answers

What leads to autodigestion of the pancreas in acute pancreatitis?

Injury to pancreatic cells and activation of pancreatic enzymes Signup and view all the answers

What should patients with cirrhosis avoid?

Alcohol, NSAIDs, ACE-I Signup and view all the answers

What is the mortality rate of necrotizing acute pancreatitis?

25% Signup and view all the answers

What is essential to prevent muscle loss in cirrhosis?

Adequate nutrition Signup and view all the answers

What is the focus of treatment for acute pancreatitis?

Relieving abdominal pain and providing health promotion and home care instructions Signup and view all the answers

What are the causative factors of cirrhosis?

Alcohol, viral hepatitis, biliary obstruction, and right-sided heart failure Signup and view all the answers

What is the primary function of pancreatic endocrine function?

Production of insulin and glucagon Signup and view all the answers

Which is a late sign of hyperbilirubinemia?

Jaundice Signup and view all the answers

What is the primary cause of peripheral edema in cirrhosis?

Decreased colloidal oncotic pressure Signup and view all the answers

What is the most life-threatening complication of cirrhosis?

Bleeding esophageal varices Signup and view all the answers

What is the primary mechanism of portal hypertension in cirrhosis?

Increased resistance to blood flow through the liver Signup and view all the answers

What is the characteristic skin lesion associated with liver cirrhosis?

Spider angiomas Signup and view all the answers

What is the primary cause of ascites in cirrhosis?

Increased portal pressure Signup and view all the answers

What is the primary cause of pruritus in biliary tract obstruction?

Accumulation of bile salts under the skin Signup and view all the answers

What is the primary cause of splenomegaly in cirrhosis?

Backup of blood from the portal vein into the spleen Signup and view all the answers

What is the primary cause of peripheral neuropathy in cirrhosis?

Dietary deficiencies of thiamine, folic acid, and cobalamin Signup and view all the answers

What is the main characteristic of esophageal varices?

Tortuous veins at the lower end of the esophagus Signup and view all the answers

What is the primary cause of hyperaldosteronism in cirrhosis?

Impaired liver metabolism of aldosterone Signup and view all the answers

What is the primary cause of bleeding tendencies in cirrhosis?

Decreased production of hepatic clotting factors Signup and view all the answers

What diagnostic study is considered the best for identifying pancreatic problems?

Contrast medium–enhanced CT Signup and view all the answers

What is the primary cause of pleural effusion, atelectasis, and pneumonia in the context of this text?

Passage of enzymes from the peritoneal cavity to the diaphragm Signup and view all the answers

What is a characteristic symptom associated with hypocalcemia in the context of this text?

Positive trousseau’s sign Signup and view all the answers

What electrolyte imbalance is associated with assessing dysrhythmias and muscle weakness?

Hypokalemia Signup and view all the answers

Which drug is used for pain control in acute pancreatitis?

IV Morphine Signup and view all the answers

What is the primary goal of conservative therapy in acute pancreatitis?

Aggressive hydration to prevent shock Signup and view all the answers

Which factor may necessitate the need for surgical therapy in acute pancreatitis?

Conservative therapy not working Signup and view all the answers

What is the initial nutritional status for a patient with acute pancreatitis?

NPO status Signup and view all the answers

Which intervention may be needed if the patient has lost muscle strength in acute pancreatitis?

Physiotherapy Signup and view all the answers

What is a crucial aspect of home care for a patient with acute pancreatitis?

Counselling on alcohol abstinence and smoking cessation Signup and view all the answers

Which drug is used to suppress gastric acid secretion in acute pancreatitis?

Histamine (H2) receptor blockers (ranitidine) Signup and view all the answers

What is the primary goal of drug therapy in acute pancreatitis?

Relieve pain, prevent or alleviate shock, and decrease pancreatic secretions Signup and view all the answers

What is the initial dietary recommendation for a patient with acute pancreatitis?

NPO status initially Signup and view all the answers

What may be a consequence of a large fluid-containing cavity within the pancreas in acute pancreatitis?

Increased risk of infection Signup and view all the answers

What is a key aspect of nutritional therapy for a patient with acute pancreatitis?

Small, frequent feedings once food is allowed Signup and view all the answers

What is a primary risk factor for developing acute pancreatitis?

Excessive alcohol consumption Signup and view all the answers

What is the characteristic odor on a patient's breath due to the accumulation of digestive by-products that the liver is unable to degrade?

Fetor hepaticus Signup and view all the answers

What is the term for the musty, sweet odor on a patient’s breath due to liver's inability to degrade digestive by-products?

Fetor hepaticus Signup and view all the answers

Which drug is used to induce vasoconstriction and decrease portal blood flow to reduce bleeding?

Octreotide Signup and view all the answers

Which drug is used to block hyperaldosteronism, reduce ascites, and elevate serum potassium?

Spironolactone Signup and view all the answers

Which drug is used to destroy bowel bacteria and reduce ammonia production?

Neomycin sulphate Signup and view all the answers

Which drug is used to correct clotting abnormalities?

Vitamin K Signup and view all the answers

Which drug is used in combination with a potassium-sparing diuretic to mobilize ascitic fluid?

Spironolactone Signup and view all the answers

Which drug is used to induce vasoconstriction and reduce portal blood flow in the context of bleeding?

Octreotide Signup and view all the answers

Which drug is used to block hyperaldosteronism and reduce ascites in cirrhosis?

Spironolactone Signup and view all the answers

Which drug is used to destroy bowel bacteria and reduce ammonia production?

Rifaximin Signup and view all the answers

Which drug is used in combination with a potassium-sparing diuretic to mobilize ascitic fluid?

Furosemide Signup and view all the answers

Which drug is used to decrease portal venous pressure and prevent variceal bleeding?

Propranolol Signup and view all the answers

Study Notes

Management of Cirrhosis and Acute Pancreatitis

Cirrhosis is caused by alcohol, viral hepatitis, biliary obstruction, and right-sided heart failure
Prevention and early treatment focus on eliminating the primary cause, with alcoholism being treated and patients urged to avoid alcohol
Adequate nutrition is essential to prevent muscle loss, and chronic viral hepatitis and biliary disease must be identified and treated early
Patients should avoid drugs such as aspirin, NSAIDs, ACE-I, and alcohol, and seek prompt medical attention for infections
Cirrhosis requires major lifestyle changes, and patients should be provided with information on community support programs
Acute pancreatitis is an inflammatory process of the pancreas, more common in middle-aged men and women
Pancreatic exocrine function involves the production of enzymes for digestion, while endocrine function involves insulin and glucagon release
Biliary tract disease, alcoholism, and hypertriglyceridemia are primary causative factors of acute pancreatitis
Injury to pancreatic cells and activation of pancreatic enzymes lead to autodigestion of the pancreas
Acute pancreatitis has two types: edematous (mild and self-limiting) and necrotizing (severe, with a 25% mortality rate)
Symptoms of acute pancreatitis include abdominal pain in the left upper quadrant or mid-epigastrium
Treatment involves relieving itching, managing peripheral neuropathy, preventing infection due to leukopenia, and providing health promotion and home care instructions

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