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Questions and Answers
What is liver cirrhosis?
Replacement of normal liver tissue with diffuse fibrosis that disrupts the structure and function of the liver.
Which of the following are causes of liver cirrhosis? (Select all that apply)
Match the symptoms of liver cirrhosis with their descriptions:
Fever = Elevated body temperature, often indicating infection or inflammation Anorexia = Loss of appetite Esophageal varices = Swollen veins in the esophagus, risk of bleeding Jaundice = Yellowing of the skin and eyes due to elevated bilirubin Weight loss = Unintentional loss of body weight Palmar erythema = Redness of the palms
What would you monitor during paracentesis?
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Chronic pancreatitis can often be detected in the early stages.
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Which pancreatic enzyme is responsible for fat absorption?
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Study Notes
Liver Cirrhosis
- Replacement of normal liver tissue with diffuse fibrosis disrupts liver structure and function.
- Causes:
- Alcohol abuse
- Biliary obstruction
- Malnutrition
- Infection
- Drugs
- Symptoms:
- Fever
- Anorexia
- Esophageal varices
- Jaundice
- Weight loss
- Ascites
- Palmar erythema
- Diagnostic Tests:
- Decreased total serum cholesterol, protein, and phospholipids
- Prolonged prothrombin time (PT) and partial thromboplastin time (PTT)
- Elevated serum ammonia, total serum bilirubin, unconjugated/indirect bilirubin
- Elevated serum glutamic oxaloacetic transaminase (SGOT), serum glutamic pyruvic transaminase (SGPT), and lactate dehydrogenase (LDH)
- Liver biopsy:
- Patient should be placed in the left lateral position and exhale deeply and hold their breath for 5-10 seconds during needle insertion to prevent trauma to the diaphragm
- Paracentesis:
- Check vital signs, ensure the bladder is empty, and position the patient upright or sitting to localize the fluids
- Monitor for signs of hypovolemic shock, fever, pain, and rigidity in the abdomen.
- Elevated gamma-glutamyl transpeptidase (GGT)
- Ultrasound imaging (UTZ) of the liver.
Collaborative Management
- Hepatic Encephalopathy:
- Administer osmotic laxatives (assess effectiveness by improvement in level of consciousness)
- Give Neomycin or Kanamycin
- Esophageal Varices:
- Insert Sengstaken-Blakemore tube
- Portal Hypertension:
- Limit water intake
- Treat the underlying cause
- Ascites:
- Dietary recommendations include foods high in albumin
- Paracentesis
- Invasive procedure requiring informed consent.
- Nurse should check vital signs and position the patient upright.
- Administer diuretics as prescribed, such as Spironolactone.
- To avoid rupture of the varices, advise the patient to avoid:
- Screaming, shouting
- Straining at stool
- Bending or stooping
- Coughing or sneezing
- Supportive measures for variceal bleeding:
- Vitamin K
- Antibiotics
- Avoid aspirin (ASA)
- Fresh frozen plasma
Pancreatitis
- Inflammation of the pancreas.
- Acute pancreatitis can be a medical emergency with a high risk of life-threatening complications and mortality.
- Chronic pancreatitis is often undetected because typical clinical or diagnostic findings may not be present in the early stages of the disease.
Functions of the Pancreas
- Produces pancreatic enzymes:
- Lipase – fat absorption
- Amylase – carbohydrate absorption
- Trypsin – protein digestion
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Description
This quiz covers the essential aspects of liver cirrhosis, including its causes, symptoms, and diagnostic tests. It aims to enhance your understanding of how liver cirrhosis disrupts normal liver function and the various ways it can be identified. Whether you are studying for a medical exam or seeking to deepen your knowledge, this quiz provides valuable insights.
