NP235 Exam 2 Review Questions With Complete Solutions
Purpose of the liver
- Receives arterial blood that is rich in oxygen
- Metabolizes glucose
- Regulates blood glucose concentration
- Converts glucose to glycogen to maintain glucose levels
- Synthesizes amino acids for the breakdown of protein or
lactate (gluconeogenesis)
- Converts ammonia into urea
- Metabolizes proteins and fats
- Stores vitamins A, B12, D, and some B-complex, and some
iron and copper
- Metabolizes drugs, chemicals, bacteria, and other foreign
elements
- Forms and excretes bile
- Excretes bilirubin
- Synthesizes factors needed for blood coagulation
Gluconeogenesis
Synthesis of glucose from non-carbohydrate sources
Jaundice
,Abnormally high concentration of bilirubin in the blood; if over
2.5, can be seen on the skin, oral mucous membranes, and sclera
Bilirubin levels
0.2 to 1.3
Bilirubin
Produced in the liver, spleen, bone marrow from hemoglobin
metabolism and a byproduct of hemolysis; levels increase from
excessive hemolysis or the liver cannot excrete it normally
Hemolytic jaundice
Caused by excess destruction of RBCs
Hepatocellular jaundice
Caused by liver disease
Obstructive jaundice
Caused by a blockage between the liver and intestinal tract
Cirrhosis
Chronic degenerative liver disorder caused by cellular damage
Alcoholic cirrhosis
Most common form; from chronic alcohol intake and poor
nutrition and can also be from poisoning (hepatotoxic drugs)
Post necrotic cirrhosis
From destruction of liver cells secondary to infection (hepatitis),
metabolic liver disease, or hepatotoxin exposure
, Biliary cirrhosis
Scarring of the bile ducts in the liver from chronic biliary
obstruction and infection (progressive autoimmune disease of
the liver)
Non-alcoholic steatohepatitis/NASH
Build up of fat (diabetes, elevated cholesterol, coronary artery
disease)
Compensated cirrhosis
Less severe and more vague
Intermittent mild fever, vascular spiders, palmar erythema,
unexplained epistaxis, ankle edema, vague morning indigestion,
splenomegaly, firm enlarged liver, abdominal pain
Decompensated
When the disease progresses and signs and symptoms are more
pronounced
Ascites, jaundice, weakness, muscle wasting, weight loss,
continuous mild fever, clubbing, purpura, spontaneous bruising,
hypotension, sparse body hair, white nails
Cirrhosis nutrition
Restrictions used to improve symptoms (fat restriction, sodium
restriction, fluid restriction), high calorie diet for malnutrition,
weight loss, or infection, prevention of muscle
wasting, carbohydrate controlled diet for those with diabetes or
Purpose of the liver
- Receives arterial blood that is rich in oxygen
- Metabolizes glucose
- Regulates blood glucose concentration
- Converts glucose to glycogen to maintain glucose levels
- Synthesizes amino acids for the breakdown of protein or
lactate (gluconeogenesis)
- Converts ammonia into urea
- Metabolizes proteins and fats
- Stores vitamins A, B12, D, and some B-complex, and some
iron and copper
- Metabolizes drugs, chemicals, bacteria, and other foreign
elements
- Forms and excretes bile
- Excretes bilirubin
- Synthesizes factors needed for blood coagulation
Gluconeogenesis
Synthesis of glucose from non-carbohydrate sources
Jaundice
,Abnormally high concentration of bilirubin in the blood; if over
2.5, can be seen on the skin, oral mucous membranes, and sclera
Bilirubin levels
0.2 to 1.3
Bilirubin
Produced in the liver, spleen, bone marrow from hemoglobin
metabolism and a byproduct of hemolysis; levels increase from
excessive hemolysis or the liver cannot excrete it normally
Hemolytic jaundice
Caused by excess destruction of RBCs
Hepatocellular jaundice
Caused by liver disease
Obstructive jaundice
Caused by a blockage between the liver and intestinal tract
Cirrhosis
Chronic degenerative liver disorder caused by cellular damage
Alcoholic cirrhosis
Most common form; from chronic alcohol intake and poor
nutrition and can also be from poisoning (hepatotoxic drugs)
Post necrotic cirrhosis
From destruction of liver cells secondary to infection (hepatitis),
metabolic liver disease, or hepatotoxin exposure
, Biliary cirrhosis
Scarring of the bile ducts in the liver from chronic biliary
obstruction and infection (progressive autoimmune disease of
the liver)
Non-alcoholic steatohepatitis/NASH
Build up of fat (diabetes, elevated cholesterol, coronary artery
disease)
Compensated cirrhosis
Less severe and more vague
Intermittent mild fever, vascular spiders, palmar erythema,
unexplained epistaxis, ankle edema, vague morning indigestion,
splenomegaly, firm enlarged liver, abdominal pain
Decompensated
When the disease progresses and signs and symptoms are more
pronounced
Ascites, jaundice, weakness, muscle wasting, weight loss,
continuous mild fever, clubbing, purpura, spontaneous bruising,
hypotension, sparse body hair, white nails
Cirrhosis nutrition
Restrictions used to improve symptoms (fat restriction, sodium
restriction, fluid restriction), high calorie diet for malnutrition,
weight loss, or infection, prevention of muscle
wasting, carbohydrate controlled diet for those with diabetes or
