Advanced Pathophysiology Exam 1 Questions With Solutions

Advanced Pathophysiology Exam 1 Questions With Solutions What is the primary functional unit of the liver? - ANS Liver lobule True or False? Cirrhosis causes hypoglycemia? - ANS True What is the first stage of Alcoholic Liver Disease? - ANS Fatty liver "Steatosis" (reversible) What is the second stage of Alcoholic Liver Disease? - ANS Alcoholic hepatitis (reversible) What is the third stage of Alcoholic Liver Disease? - ANS Cirrhosis (Irreversible) What are three nutritional deficiencies in Alcoholic Liver Disease? - ANS Thiamine, Folic Acid, and Electrolytes What is end-stage chronic liver disease called? - ANS Cirrhosis What are the 3 top causes of Cirrhosis? - ANS Alcoholism Viral Hepatitis Fatty liver disease (obesity) What is the pathophysicology of Cirrhosis? - ANS Diffuse fibrosis throughout the liver (stellate cells are activated by Kupffer cells), formation of nodules, the fibrous scarring begins to form bands called septae in between nodules, and increased fibrous tissue causes an obstruction of blood flow leading to increased pressure in the portal vein. True or False? Portal hypertension causes collateral vessels? - ANS True What complication of Portal hypertension causes anemia (decreased hemoglobin and hemocrit), thrombocytopenia (decreased platelets), and leukopenia (decreased WBCs)? - ANS Splenomegaly What complication of Portal hypertension causes collateral vessels, dark or bright red stools? - ANS Esophageal Varices True or false? Coagulapathy is due to portal hypertension. - ANS False. What is the pathophysiology of Hepatic encephalopathy? - ANS Build up of ammonia in the brain, since ammonia is not being converted to urea in the liver. What is the collection of excess fluid in the peritoneal cavity called? - ANS Ascites/Edema What is the pathophysiology of Ascites? - ANS Activation of the Renin-Angiotensin Aldosterone system causing sodium and water retention. What occurs in the Renin-Angiotensin Aldosterone system? - ANS -Kidneys produce renin -The liver produces angiotensinogen -Renin converts angiotensiongen into AngI -AngI is converted to AngII by ACE -AngII stimulates the adrenal gland to produce Aldosterone -Aldosterone causes sodium and water retention, leading to increased blood volume What is the pathogenesis of Ascities/Edema? - ANS Hypoalbuminemia causes decrease plasma oncontic pressure. This causes excess fluid to leak into the muscles and tissues. What is Spontaneous Bacterial Peritonitis? - ANS Infection of the peritoneal fluid What does a Serum Albumin Ascites Gradiet (SAAG) reading of 1.1 g/dL indicate? - ANS Portal hypertension/cirrhosis What does a PMNs reading of 250 cells/mm3 indicate? - ANS Antibiotics needed (in the case of spontaneous bacterial peritonitis) What disease is characterized by high WBC count, fever, and Ascites? - ANS Spontaneous Bacterial Peritonitis