Liver Disease and Anesthesia

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Questions and Answers

Hepatic arterial blood flow is primarily dependent on which of the following?

  • Blood flow through the splenic vein
  • Autoregulation based on metabolic demand (correct)
  • Pressure within the portal vein
  • Blood flow to the gastrointestinal tract

A patient with liver disease has a prolonged prothrombin time (PT) that does not correct with parenteral vitamin K administration. What does this MOST likely indicate?

  • Severe liver disease (correct)
  • Excessive intake of vitamin K antagonists
  • Extrahepatic biliary obstruction
  • Vitamin K deficiency

Why is the relatively short half-life of factor VII important in assessing liver function?

  • It allows for quick detection of changes in the liver's synthetic function. (correct)
  • It prevents overestimation of liver impairment due to other factors.
  • It is essential for breaking down fibrinogen effectively.
  • It accurately reflects long-term protein synthesis capabilities.

Which of the following best explains how liver dysfunction contributes to hepatic encephalopathy?

<p>Accumulation of toxic metabolites like ammonia (A)</p> Signup and view all the answers

What is a key consideration when selecting anesthetic agents for a patient with liver disease?

<p>Using agents primarily metabolized renally (B)</p> Signup and view all the answers

A patient with ascites is undergoing general anesthesia. What is the MOST important consideration regarding ventilation?

<p>Mitigating compromised diaphragmatic excursion (A)</p> Signup and view all the answers

During anesthesia, which intervention is MOST appropriate for maintaining liver perfusion in a patient with chronic liver disease?

<p>Maintaining stable hemodynamics and oxygenation (C)</p> Signup and view all the answers

Which of the following is MOST accurate regarding the use of isoflurane in patients with liver disease?

<p>It may cause increased blood flow. (D)</p> Signup and view all the answers

What is a PRIMARY concern regarding the use of opioids in patients with liver disease?

<p>Risk of prolonged drug effect (C)</p> Signup and view all the answers

What is a critical consideration in the postoperative management of a patient with liver disease to prevent encephalopathy?

<p>Avoiding constipating medications (D)</p> Signup and view all the answers

Flashcards

Liver

The liver is the heaviest and largest organ in the body, weighing approximately 1500 g in adults.

Liver division

Right and left anatomic lobes.

Hepatic Blood Flow

Hepatic arterial flow depends on metabolic demand; portal vein flow depends on flow to the GI tract and spleen.

Metabolic Liver Function

Metabolism of carbs, lipids, amino acids, ammonia formation, interconversion of sugars, and drug metabolism.

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Normal total bilirubin concentration

Less than 1.5 mg/dL

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Serum Aminotransferases

These enzymes are released into the circulation as a result of hepatocellular injury or death.

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Two types of Serum Aminotransferases?

Aspartate aminotransferase (AST) & Alanine aminotransferase (ALT)

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Concentration of Serum Albumin

The normal serum albumin concentration is 3.5 to 5.5 g/dL.

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Elevated Blood Ammonia

Reflect disruption of hepatic urea synthesis.

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Significant Cirrhosis

May be present with few or no laboratory abnormalities evident.

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