Chapter 38 Liver diseases

Hepatitis B is usually transmitted by exposure to

blood or semen

Viral hepatitis

ALT is higher than AST

A patient with a history of alcoholism presents with hematemesis and profound anemia. The expected diagnosis is

Gastroesophageal varices

A viral hepatitis screen with positive hepatitis B surface antigen (HBsAg) should be interpreted as

Acute

Liver transaminase elevations in which aspartame aminotransferase (AST) is markedly greater than alanine aminotransferase (ALT) is characteristic of

Alcohol induced injury

Hepatitis with the presence of autoantibodies and positive antinuclear antibodies (ANA) is

Autoimmune hepatitis

An infusion of mannitol would be prescribed to treat

Cerebral edema

Hepatic encephalopathy is a

Complex neuropsychiatric syndrome characterized by symptoms ranging from mild confusion and lethargy to stupor and coma

What lab data would support a diagnosis of hemochromatosis?

Elevated ferritin and serum iron

Steatohepatitis is caused by an accumulation of

Fat in the liver cells

Confusion, subtle behavioral changes, no liver flap

Grade 1

Drowsy, clear behavioral changes, liver flap present

Grade 2

Stuporous, able to follow commands, marked confusion, slurred speech, liver flap present

Grade 3

Coma, no flap

Grade 4

The most common causes of prehepatic jaundice are

Hemolysis and ineffective erythropoiesis

An increased urine bilirubin is associated with

Hepatitis

What form of viral hepatitis is likely to be transmitted sexually

Hepatitis B

Hepatic encephalopathy is associated with

Increased blood ammonia levels

Wilson disease (hepatolenticular degeneration)

Is a rare autosomal recessive disorder in which excessive amts of copper accumulate in the liver and other organs Clinical signs and symptoms- include the presence of Kayser-Fleischer rings on the cornea

Autoimmune hepatitis

Is characterized by the presence of several autoantibodies as well as a polyclonal hypergammaglobulinemia Antinuclear antibody (ANA) is generally positive at a high level

Brain injury secondary to high serum bilirubin is called

Kernicterus

A pt being treated for hepatic encephalopathy could be expected to receive a

Low protein and high fiber diet

A patient admitted with bleeding related to esophageal varices could be expected to receive a continuous intravenous infusion of

Octreotide acetate - a synthetic analog for the naturally occurring hormone somatostatin has been effectively used as a replacement for vasopressin

Jaundice is a common manifestation of

liver disease

Pathophysiologically, esophageal varices can be attributed to

portal hypertension