Hepatic
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Questions and Answers

What percentage of bile is re-absorbed in the intestine and returned to the liver via the portal vein?

  • 20%
  • 5%
  • 10% (correct)
  • 25%

    • During a postprandial state, how does the liver handle glucose?

  • It stores glucose as glycogen (correct)
  • It releases glucose into the bloodstream
  • It breaks down glycogen to glucose
  • It converts glucose to lipid

    • What is the primary cause of hyperglycemia in chronic liver disease?

  • Impaired glycogen storage
  • Impaired gluconeogenesis
  • Increased glucose uptake by the tumor
  • Portosystemic shunting (correct)

    • What is the fate of amino acids in the liver?

    <p>They are used for glucose production</p> Signup and view all the answers

    What is the end product of ammonia metabolism in the liver?

    <p>Urea</p> Signup and view all the answers

    What is the role of the liver in lipid metabolism?

    <p>It synthesizes fatty acids from excess carbohydrate</p> Signup and view all the answers

    What happens to the T1/2 of high HER drugs with reduced hepatic blood flow?

    <p>It is prolonged</p> Signup and view all the answers

    What is the result of hypoalbuminemia on the concentration of free drug?

    <p>It is increased</p> Signup and view all the answers

    What happens to the volume of distribution of some drugs with hypoalbuminemia and ascites?

    <p>It is increased</p> Signup and view all the answers

    What is the effect of portosystemic shunting on orally administered drugs?

    <p>Increased systemic effect and prolonged duration of action</p> Signup and view all the answers

    Which of the following drugs is classified as high extraction?

    <p>Bupivicaine</p> Signup and view all the answers

    What may be required for high HER drugs with reduced hepatic blood flow?

    <p>Significant dosage reduction</p> Signup and view all the answers

    What can result from inadequate systemic perfusion in the liver?

    <p>Ischemic hepatitis</p> Signup and view all the answers

    What is the effect of laparotomy on splanchnic and hepatic blood flow?

    <p>Decreases blood flow</p> Signup and view all the answers

    What percentage of untreated acute HCV progresses to chronic HCV?

    <p>85%</p> Signup and view all the answers

    What is the most common cause of chronic liver disease in the U.S.?

    <p>Fatty liver disease (non-alcoholic)</p> Signup and view all the answers

    What is the effect of hypoxia on the liver?

    <p>The liver is extremely sensitive to hypoxic insult</p> Signup and view all the answers

    What is the effect of cardiac bypass on hepatic perfusion?

    <p>Worsens hepatic perfusion</p> Signup and view all the answers

    What percentage of Americans have non-alcoholic fatty liver disease (NAFLD)?

    <p>Up to 24%</p> Signup and view all the answers

    What is the most common risk factor for NAFLD?

    <p>Obesity</p> Signup and view all the answers

    What is the primary complication of cirrhosis that affects nearly every organ system in the body?

    <p>Organ system dysfunction</p> Signup and view all the answers

    What is the hallmark of end-stage cirrhosis?

    <p>Portal hypertension</p> Signup and view all the answers

    What is the estimated increase in perioperative morbidity in patients with alcohol abuse?

    <p>2-3 fold</p> Signup and view all the answers

    What is a potential concern when choosing an anesthetic technique for a patient with liver disease?

    <p>Coagulopathy and excessive bleeding</p> Signup and view all the answers

    What is the significance of monitoring filling pressures in patients with liver disease?

    <p>In severe disease or more extensive surgery</p> Signup and view all the answers

    What is a common complication of liver disease in the postoperative period?

    <p>Postoperative jaundice</p> Signup and view all the answers

    What is the definition of fulminant hepatic failure?

    <p>Encephalopathy within 2 weeks of development of jaundice or within 8 weeks of initial manifestation of hepatic disease</p> Signup and view all the answers

    What is the incidence of significant hepatic dysfunction in healthy patients in the postoperative period?

    <p>1/2500</p> Signup and view all the answers

    A large dietary protein load can precipitate Hepatic Encephalopathy (HE).

    <p>True</p> Signup and view all the answers

    The treatment of Hepatic Encephalopathy (HE) includes the administration of flumazenil.

    <p>False</p> Signup and view all the answers

    The primary cause of cirrhosis is Wilson's Disease.

    <p>False</p> Signup and view all the answers

    The survival rate without a transplant for patients with cirrhosis is 42% at 1 year and 23% at 3 years.

    <p>True</p> Signup and view all the answers

    Cathartics, such as lactulose, reduce urease-producing bacteria in the gut.

    <p>False</p> Signup and view all the answers

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