Nur 222 Actual Exam Questions and Correct
Solutions
What is the function of the liver?
1. Produces Bile
2. Protein metabolism (Specifically Albumin-> If you have Hypoalbuminemia, the liver is
metabolizing Albumin fast= decrease in coag. factors-> bleeding risk, Increased ammonia levels,
Filters blood & removes infections-> Increased risk for infections, & ammonia levels will rise;
leads to ascites and will see abd. edema)
3. Metabolizes drugs and hormones (ex. Increase in Aldosterone (hormone)= Cushing's
syndrome)
4. Converts ammonia to Urea (Urea is excreted in the urine)-> will see an increase in ammonia
levels
5. Fat metabolism
6. Breaks down nutrients & converts them to substances essential for the body
7. Vitamin & Iron storage (A, B, D, Iron and copper)
8. Bilirubin excretion (partially excreted in the feces and partially absorbed through the intestinal
,mucosa into the portal blood)
Extra:
- Liver disorders may arise from Virus, obesity, insulin resistance, or exposure to toxic
substances, such as alcohol, or tumors
- The liver synthesizes Glucose, Plasma, Proteins, and Blood Clotting factors
- Blood from the GI, Spleen, & Pancreas travel to the liver through the Portal Vein b/f returning
it to the heart
- Liver has 4 lobules; Located inside the Ribcage; Can't be palpated on a Healthy Person;
Palpated on Lower right
Billirubin:
- Pigment release in bile by the liver when there's a destruction of Heme in the RBC's
- It gives bile its Yellow color (aka. Jaundice)
- Normal level of Serum Billirubin is Less than 1.5 (class lecture)
- Serum bilirubin direct & Serum Bilirubin total= 1.7-3.7 measures ability of liver to conjugate &
excrete Bilirubin
(Med-surg Lippincott pg. 1370)
Jaundice:
- Yellow skin, tissues, and sclera of the eye
- Indicative of High Billirubin in the blood
,- Noticeable when above 2.0
- Jaundice can be Pre-hepatic, Intra-Hepatic, & Post-Hepatic
Pre-Hepatic causes of Jaundice:
1. Hemolysis (increased destruction of RBC's)
- Neonatal Bilirubinemia (premies-> just look yellow)
- Hemolytic blood transfusions
- Sickle cell
- Thalassemia
- Autoimmune hemolytic anemia
Intra-hepatic causes of Jaundice:
2. Hepatocellular Jaundice (Inability of damaged cells to clear normal amount of bilirubin
from the blood)
- Hepatitis
- Cirrhosis
- Drugs (Estradiol, Chlorpromazine (antipsychotic), Amoxicillin, Erythromycin, Tylenol
(acetaminophen), Ketoconazole, Valproic acid)
- Cancer of the liver
- Yellow-fever
- Epstein-barr virus
, S/S:
- Bilirubin= Increase
- ALP= Increase
-Urine will be very dark b/c of Bili in it
Post-hepatic causes of Jaundice:
1. Obstructions between Liver & Intestine
- Structure disorders
- Bile-duct obstruction
- Cholelithiasis
- Tumor
- Pressure from enlarged organ
S/S:
Bilirubin= Increase
ALP= Increase
Dark-orange Foamy Urine & Clay-colored stools (because bili is no longer in stool)
------------------------------------------
* If Hereditary Hyperbilirubinemia Bilirubin levels will be increased (Gilbert syndrome);
Liver histology tests will be normal
Not a part of Post, just added here.... Its separate from all
Solutions
What is the function of the liver?
1. Produces Bile
2. Protein metabolism (Specifically Albumin-> If you have Hypoalbuminemia, the liver is
metabolizing Albumin fast= decrease in coag. factors-> bleeding risk, Increased ammonia levels,
Filters blood & removes infections-> Increased risk for infections, & ammonia levels will rise;
leads to ascites and will see abd. edema)
3. Metabolizes drugs and hormones (ex. Increase in Aldosterone (hormone)= Cushing's
syndrome)
4. Converts ammonia to Urea (Urea is excreted in the urine)-> will see an increase in ammonia
levels
5. Fat metabolism
6. Breaks down nutrients & converts them to substances essential for the body
7. Vitamin & Iron storage (A, B, D, Iron and copper)
8. Bilirubin excretion (partially excreted in the feces and partially absorbed through the intestinal
,mucosa into the portal blood)
Extra:
- Liver disorders may arise from Virus, obesity, insulin resistance, or exposure to toxic
substances, such as alcohol, or tumors
- The liver synthesizes Glucose, Plasma, Proteins, and Blood Clotting factors
- Blood from the GI, Spleen, & Pancreas travel to the liver through the Portal Vein b/f returning
it to the heart
- Liver has 4 lobules; Located inside the Ribcage; Can't be palpated on a Healthy Person;
Palpated on Lower right
Billirubin:
- Pigment release in bile by the liver when there's a destruction of Heme in the RBC's
- It gives bile its Yellow color (aka. Jaundice)
- Normal level of Serum Billirubin is Less than 1.5 (class lecture)
- Serum bilirubin direct & Serum Bilirubin total= 1.7-3.7 measures ability of liver to conjugate &
excrete Bilirubin
(Med-surg Lippincott pg. 1370)
Jaundice:
- Yellow skin, tissues, and sclera of the eye
- Indicative of High Billirubin in the blood
,- Noticeable when above 2.0
- Jaundice can be Pre-hepatic, Intra-Hepatic, & Post-Hepatic
Pre-Hepatic causes of Jaundice:
1. Hemolysis (increased destruction of RBC's)
- Neonatal Bilirubinemia (premies-> just look yellow)
- Hemolytic blood transfusions
- Sickle cell
- Thalassemia
- Autoimmune hemolytic anemia
Intra-hepatic causes of Jaundice:
2. Hepatocellular Jaundice (Inability of damaged cells to clear normal amount of bilirubin
from the blood)
- Hepatitis
- Cirrhosis
- Drugs (Estradiol, Chlorpromazine (antipsychotic), Amoxicillin, Erythromycin, Tylenol
(acetaminophen), Ketoconazole, Valproic acid)
- Cancer of the liver
- Yellow-fever
- Epstein-barr virus
, S/S:
- Bilirubin= Increase
- ALP= Increase
-Urine will be very dark b/c of Bili in it
Post-hepatic causes of Jaundice:
1. Obstructions between Liver & Intestine
- Structure disorders
- Bile-duct obstruction
- Cholelithiasis
- Tumor
- Pressure from enlarged organ
S/S:
Bilirubin= Increase
ALP= Increase
Dark-orange Foamy Urine & Clay-colored stools (because bili is no longer in stool)
------------------------------------------
* If Hereditary Hyperbilirubinemia Bilirubin levels will be increased (Gilbert syndrome);
Liver histology tests will be normal
Not a part of Post, just added here.... Its separate from all
