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