Liver Disease and Hepatitis Overview
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Questions and Answers

What is the primary function of the liver?

  • Regulation of blood pressure
  • Production of hormones
  • Synthesis of proteins and detoxification (correct)
  • Absorption of nutrients

Which virus is primarily transmitted via the fecal-oral route?

  • Hepatitis B Virus (HBV)
  • Hepatitis A Virus (HAV) (correct)
  • Hepatitis D Virus (HDV)
  • Hepatitis C Virus (HCV)

What is the result of chronic hepatitis infection?

  • Fibrosis and cirrhosis (correct)
  • Increased bile production
  • Instant liver recovery
  • Complete organ failure

Which of the following is NOT a cause of hepatitis?

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

What is the functional unit of the liver?

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

What is one of the primary prevention methods against Hepatitis A?

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

Which organ is responsible for detoxifying substances in the blood?

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

What is a common characteristic of acute liver infection?

<p>Hepatocyte regeneration can occur (B)</p> Signup and view all the answers

What condition develops due to blood backing up in the portal vein?

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

Which complication is caused by splenomegaly?

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

What is the primary risk associated with esophageal varices?

<p>Life-threatening bleeding (B)</p> Signup and view all the answers

Which symptom is indicative of hepatic encephalopathy?

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

Which medication is commonly used to manage portal hypertension?

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

What is a primary cause of ascites formation in patients with liver disease?

<p>Portal vein obstruction (C)</p> Signup and view all the answers

Which of the following is a common treatment option for ascites?

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

What neurotoxic substance accumulates in hepatic encephalopathy due to liver dysfunction?

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

What is a characteristic feature of cirrhosis?

<p>Formation of scar tissue (A)</p> Signup and view all the answers

Which of the following is a common cause of cirrhosis?

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

What is an early clinical manifestation of cirrhosis?

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

Which symptom is typically associated with late-stage cirrhosis?

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

Which laboratory test is commonly used to evaluate liver function in cirrhosis?

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

What does 'Caput Medusae' refer to in the context of cirrhosis?

<p>Dilated veins in the abdomen (A)</p> Signup and view all the answers

Which of the following is NOT a potential complication of advanced cirrhosis?

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

What is portal hypertension?

<p>Increased pressure in the portal vein (C)</p> Signup and view all the answers

What does an IgM antibody indicate in the context of hepatitis?

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

Which nutritional vitamins are recommended for someone with hepatitis?

<p>Vitamin A, D, E, &amp; K (B)</p> Signup and view all the answers

What does the HCV RNA quantitative test measure?

<p>Amount of Hepatitis C virus (B)</p> Signup and view all the answers

Which of the following is a potential side effect of interferon therapy?

<p>Flu-like symptoms (D)</p> Signup and view all the answers

What type of drug therapy involves reducing viral load and decreasing liver damage?

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

What is the primary focus of nursing care for patients with acute or chronic hepatitis?

<p>Well-balanced diet and rest (D)</p> Signup and view all the answers

Which of the following should be avoided in nursing care for hepatitis patients?

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

What is the purpose of the HBV DNA quantitative test?

<p>To confirm viral infection (C)</p> Signup and view all the answers

What is a significant risk factor for developing chronic disease from a hepatitis B virus infection?

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

Which of the following is a common mode of transmission for hepatitis C virus?

<p>IV drug use (B)</p> Signup and view all the answers

What percentage of people with acute hepatitis C develop chronic disease?

<p>About 85% (B)</p> Signup and view all the answers

What does the Acute Hepatitis Panel primarily detect?

<p>Presence of antibodies and viruses (C)</p> Signup and view all the answers

Which liver function test enzyme has normal values ranging from 7-55 IU/L?

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

Which symptom is NOT typically associated with hepatitis infection?

<p>High-grade fever (D)</p> Signup and view all the answers

What is the diagnostic procedure used to assess fibrosis or cirrhosis in the liver?

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

Which lab test measures the time for blood clotting and is a protein made in the liver?

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

What is the recommended diet for a patient with cirrhosis?

<p>High carbohydrate, low fat, and low sodium (B)</p> Signup and view all the answers

Which medication is commonly prescribed to manage symptoms of hepatic encephalopathy?

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

What is a complication that may arise during the treatment of cirrhosis?

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

Which of the following should be avoided by a patient with cirrhosis?

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

What characterizes hepatocellular carcinoma?

<p>It originates from hepatocytes (B)</p> Signup and view all the answers

What is advised for the management of fluid balance in cirrhosis?

<p>Monitor and manage fluid intake carefully (B)</p> Signup and view all the answers

Which treatment is appropriate for ascites in cirrhosis patients?

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

What is a common sign of hepatic encephalopathy?

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

Flashcards

What is the liver?

The largest internal organ in the body, located in the upper right abdomen.

What is a lobule?

The functional unit of the liver, responsible for carrying out various liver functions.

What is hepatitis?

Inflammation of the liver, often caused by viruses, drugs, chemicals, or autoimmune disorders.

What is cirrhosis?

A chronic liver disease characterized by scarring and fibrosis, often caused by long-term hepatitis infections.

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What is hepatocellular carcinoma?

A serious liver cancer that can develop in patients with chronic liver damage.

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What is hepatitis A?

A type of hepatitis caused by the hepatitis A virus, usually transmitted through contaminated food or water.

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What is hepatitis B?

A type of hepatitis caused by the hepatitis B virus, primarily spread through contact with infected blood or bodily fluids.

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What is hepatitis C?

A type of hepatitis caused by the hepatitis C virus, also primarily spread through contact with infected blood.

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Hepatitis

Inflammation of the liver caused by a viral infection.

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Hepatitis B Virus (HBV)

A virus that causes inflammation of the liver, leading to acute or chronic infection with a long-term risk of developing liver cancer (HCC).

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Hepatitis C Virus (HCV)

A virus that causes liver inflammation leading to acute or chronic infection, and often progressing to chronic disease. A major cause of liver cancer.

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Liver Function Tests (LFTs)

A blood test that measures the levels of enzymes and proteins in your blood reflecting the health and function of your liver.

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Alanine Aminotransferase (ALT)

An enzyme mainly found in the liver, reflecting liver damage.

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Aspartate Aminotransferase (AST)

An enzyme found in the liver, heart, muscles, kidneys, and brain. Elevated levels can indicate liver damage but also heart problems.

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Acute Hepatitis Panel (A, B, C)

A test that detects antibodies, virus, or viral load associated with different hepatitis viruses.

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Genotype Testing for Chronic HBV and HCV

A test that classifies the hepatitis B or C virus into specific subtypes, providing insights into possible treatment options and disease progression.

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What are the drug therapies used for Chronic Hepatitis B?

Anti-viral drugs that are specifically used to treat chronic Hepatitis B. These drugs can either be injected or taken orally.

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What are hepatitis antibodies?

A blood test used to diagnose acute hepatitis infections. IgM antibodies indicate ongoing infection, while IgG antibodies signal past exposure or recovery.

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What is the HCV RNA quantitative test?

A quantitative blood test that measures the amount of Hepatitis C virus present in the blood, confirming infection.

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What is jaundice?

A condition characterized by yellowing of the skin and eyes, often caused by liver dysfunction. It can be a sign of hepatitis.

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What is compensated cirrhosis?

An early stage of cirrhosis where symptoms are mild or absent.

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What is decompensated cirrhosis?

A later stage of cirrhosis where symptoms become severe and life-threatening.

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What is ascites?

A complication of cirrhosis where fluid builds up in the abdomen.

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What is portal hypertension?

A complication of cirrhosis where high pressure in the portal vein (serving the liver) causes blood to back up and form enlarged veins.

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What are spider angiomas?

A sign of cirrhosis where small, spider-like blood vessels appear on the skin.

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What is elevated liver enzymes?

The hallmark sign that the liver is no longer functioning properly.

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What is a liver biopsy?

A procedure that involves removing a small sample of liver tissue for examination.

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Hepatic encephalopathy

A type of liver failure caused by chronic liver disease.

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Asterixis

A neurological symptom of hepatic encephalopathy. It is characterized by involuntary flapping movements of the hands.

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Fetor hepaticus

A sweet, musty odor on the breath that is characteristic of hepatic encephalopathy.

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Lactulose

A medication used to treat hepatic encephalopathy by decreasing ammonia levels in the blood.

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Rifaximin

A medication used to treat hepatic encephalopathy by killing bacteria in the gut.

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Paracentesis

A procedure to remove fluid from the abdomen, commonly used to manage ascites.

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Ligation

A procedure to tie off blood vessels in the liver to prevent blood flow from the portal vein to the systemic circulation.

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Transjugular intrahepatic portosystemic shunt (TIPS)

A procedure that creates a connection between the portal vein and the hepatic vein, improving blood flow in the liver.

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What is portal hypertension and its consequences?

The portal vein carries blood from the digestive system to the liver. When the liver is damaged, blood backs up in the vein, leading to increased pressure (portal hypertension). This backup causes fluid to leak into the peritoneal cavity (ascites) and can also result in the development of collateral circulation paths, such as enlarged veins in the esophagus (esophageal varices) or spleen (splenomegaly).

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What is splenomegaly and how does it affect platelets?

Splenomegaly is an enlargement of the spleen, a common complication of portal hypertension. The enlarged spleen can trap platelets, leading to a decrease in their number in circulation (thrombocytopenia).

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What are esophageal varices?

Esophageal varices are enlarged veins in the esophagus that develop as a result of portal hypertension. These varices are fragile and prone to bleeding, which can be life-threatening.

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What are some common treatments for complications of portal hypertension?

Paracentesis is a procedure to drain fluid from the peritoneal cavity, a treatment for ascites. Propanolol is a beta-blocker that can help reduce portal pressure and prevent bleeding from varices. Nitrates are medications that can help dilate blood vessels and improve blood flow, also aiding in managing varices.

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What is TIPS?

TIPS (Transjugular Intrahepatic Portosystemic Shunt) is a procedure that involves creating a shunt between the portal vein and the hepatic vein, diverting blood flow away from the liver and reducing portal pressure. This can help prevent varices and ascites.

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What is hepatic encephalopathy?

Hepatic encephalopathy is a brain disorder that develops when the liver is unable to convert ammonia into urea. Ammonia builds up in the bloodstream and becomes neurotoxic.

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What are the symptoms of hepatic encephalopathy?

Hepatic encephalopathy can cause changes in consciousness, inappropriate behavior, sleep disturbances, and other neurological symptoms. It is a serious complication of liver disease and requires prompt medical attention.

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Study Notes

Liver Disease Overview

  • Liver is the largest internal organ, located in the upper right quadrant of the abdomen.
  • It has four lobes and its functional unit is the lobule.
  • Blood circulates to the liver from the stomach, intestines, spleen, and pancreas.
  • The liver is responsible for metabolism, storage, detoxification, bile production, and synthesizes proteins.

Hepatitis

  • Hepatitis is inflammation of the liver.
  • Causes include viral (A, B, C, D, E), drugs, chemicals, and autoimmune diseases.
  • Hepatitis can be acute (short-term) or chronic (long-term).
    • Acute inflammation may lead to liver failure, but liver tissue can usually regenerate after resolution.
    • Chronic hepatitis can lead to fibrosis and cirrhosis which are irreversible.

Hepatitis A Virus (HAV)

  • HAV is transmitted through the fecal-oral route.
  • HAV can be contracted through contaminated food or water, poor hygiene, and improper food handling.
  • Oral sex can also transmit the virus if fecal material is present.

Hepatitis B Virus (HBV)

  • HBV is transmitted through blood and bodily fluids.
  • HBV infections in children often lead to chronic disease.
  • It is often spread percutaneously (through IV use, needle-sticks).
  • Exposure to infectious blood, blood products, and bodily fluids (semen, vaginal fluids, saliva) can also spread the virus.

Hepatitis C Virus (HCV)

  • HCV can lead to chronic disease in 85% of affected individuals.
  • It's a leading cause of hepatocellular carcinoma.
  • HCV is spread through blood and bodily fluids.
  • Injection drug use, high-risk sexual behavior, and occupational exposure (tattoos/medical procedures) are common transmission routes.

Diagnostic Studies (Liver)

  • Liver function tests (LFTs): Measure liver enzymes (ALT, AST, GGT) and proteins (albumin, bilirubin).
  • Hepatitis panel: Screens for specific viral hepatitis antibodies and antigens.
  • Genotype testing: Is used to determine the type of HBV and HCV viruses present.
  • Liver biopsy: Examines liver tissue for inflammation or fibrosis (scarring).
  • Ultrasound, CT, or MRI: Visualize the liver's structure and detect abnormalities.

Clinical Manifestations: Hepatitis

  • Common symptoms include fatigue, nausea, vomiting, anorexia, abdominal pain, jaundice, dark urine, and light-colored stools.

Nursing Care for Patients with Hepatitis

  • Encourage a balanced diet, including vitamins A, D, E, and K.
  • Rest periods are necessary.
  • Avoid or limit alcohol consumption and medications that cause liver damage.
  • Monitor skin condition and notify the healthcare provider if necessary.
  • Notify healthcare providers of any potential risk of contact or transmission to others.

Drug Therapy for Chronic Hepatitis

  • Interferon injections (PEG-interferon): Can lead to flu-like symptoms.
  • Oral antiviral drugs (e.g., nucleoside and nucleotide analogs): Reduce viral load and prevent liver damage.

Portal Hypertension

  • Increased pressure in the portal vein causes blood to back up, leading to collateral circulation and leaks into the peritoneum.
  • Complications include splenomegaly, ascites, and esophageal varices.
  • Diagnosis relies on symptoms as well as diagnostics.

Complications of Hepatitis

  • Can lead to acute liver failure (fulminant hepatitis).
  • Can lead to hepatic encephalopathy (brain dysfunction from ammonia).
  • Chronic hepatitis can lead to cirrhosis and liver cancer.

Cirrhosis

  • Is a progressive liver disease that involves scar tissue replacing healthy liver tissue, which leads to irregular shaped and sized lobules.
  • Common causes include chronic hepatitis C, alcohol abuse, and nonalcoholic fatty liver disease (NAFLD/NASH).

Clinical Manifestations of Cirrhosis

  • Early (compensated) cirrhosis is often asymptomatic.
  • Late (decompensated) cirrhosis is characterized by symptoms such as ascites, varices, hepatic encephalopathy, and coagulopathy.
  • Other symptoms include jaundice, esophageal varices, hepatomegaly, splenomegaly, hemorrhoids, changes in neurological status (e.g., confusion), spider angiomas, anemia, thrombocytopenia, and coagulation disorders.

Diagnostic Studies for Cirrhosis

  • Liver function tests (LFTs)
  • Complete blood count (CBC)
  • Prothrombin time/international normalized ratio (PT/INR)
  • Ammonia level, Ultrasound, and Liver Biopsy

Hepatocellular Carcinoma (HCC)

  • HCC is a type of liver cancer that often develops in the context of chronic liver disease.
  • Similar symptoms to cirrhosis including abdominal pain, abdominal mass, nausea, vomiting, weight loss, anorexia, and jaundice etc.

Diagnostic Studies for HCC

  • Alpha-fetoprotein (AFP) is a tumor marker.
  • Ultrasound, CT, or MRI
  • Liver biopsy

Nursing care for cirrhosis:

  • Supportive care, Pain management, medication administration , and education.
  • Referral to community or home health nurse is often recommended.

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F21 Liver Disease Student PDF

Description

This quiz explores key concepts related to liver disease, including its anatomy, functions, and the various forms of hepatitis. Understand the differences between acute and chronic hepatitis, and learn about the causes and transmission routes of Hepatitis A. Test your knowledge on liver health and disease prevention.

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