NURS 5463 (NURS5463) Test 5 (476 questions) with precise detailed answers

NURS 5463 (NURS5463) Test 5 |! |! |! |!




with precise answers
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Cirrhotic - Correct answer ✔liver has all the nodularities that cause the
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fibrosis



Cirrhosis - Correct answer ✔Abnormal LFT/Transaminitis (elevated LFT)
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Transaminitis - Correct answer ✔Elevated LFT |! |! |! |! |!




Acute or chronic liver disease - Correct answer ✔alanime transaminase
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(ALT) & Aspartate transaminase (AST), Alk Phos, Total Bilirubin, Direct
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Bilirubin, occurs in acute or chronic liver disease
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H&P for transaminitis - Correct answer ✔Helps to determine acute or
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chronic



Cirrhosis risk factors - Correct answer ✔IV drug use: Intranasal cocaine - the
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straws used when using intranasal cocaine causes breakdown in the nasal
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mucosa and that is how the viruses are transmitted, Needle sticks such in
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health care providers,
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HD patients - Correct answer ✔higher risk for contracting Hep B
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,Blood transfusion prior to 1991/1992 - Correct answer ✔pt could have
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contracted hep C before we knew to test for hep C
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Acute liver Failure Work up for Transaminitis - Correct answer ✔Viral
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Serologies (hep ABC), Autoimmune marker |! |! |! |!




Doppler US of liver want to look at the plumbing of the liver - Correct
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answer ✔hepatic veins and arteries
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MRI/MRCP - Correct answer ✔MR that focuses on the biliary tree and bile
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ducts, intrahepatic and extrahepatic ductal dilatation) Liver biopsy
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↑↑Aminotransferases (AST/ALT), +/- ↑ in Bilirubin, AK - Correct answer |! |! |! |! |! |! |! |! |! |!




✔Labs for Severe viral Hepatitis, Acetaminophen overdose, Ischemia,
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Wilson's disease, AIH; related to liver injury
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↑↑ Alkaline Phosphate, GGT, Bilirubin, +/- ↑ AST/ALT - Correct answer
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✔Labs for Biliary Obstruction, Choledocholithiasis, cholangiocarcinoma,
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pancreatic cancer, Intrahepatic cholestatis, Sepsis, PBC, Sex Horm., Biliary
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Epitheleal Damage; related to cholestatic injury
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Synthetic Function/Hepatic Function - Correct answer ✔how well is the liver
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working. INR, albumin (low albumin can represent chronic problems were
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as normal albumin problem is more acute), and total bilirubin
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,Hepatitis A, B, C Full serologic work up - Correct answer ✔Hep A IgM, Hep
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A total, Hep B surface antigen, Hep B surface antibody, Hep B core IgM, Hep
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B core total, and Hep C antibody. ANA, smooth muscle antibody (one or both
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can be elevated), Serum gamma globulins - can also be elevated, ANCA can
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be present, Anti-LKM1
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Hepatotoxic Drugs - Correct answer ✔Dilantin, Tylenol Accutane,
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Allopurinol, HAART, Statin, Methotrexate, INH (TB med), Risperidone,
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Zoloft, Valproic acid, psych meds, Estrogen, Augmentin, Sulfonamides
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Hepatotoxic Herbs - Correct answer ✔Noni juice, Chinese remedies & teas,
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Valerian, Mistletoe, Herbalife. |! |!




Hepatoxic Toxins - Correct answer ✔, , ETOH |! |! |! |! |! |! |!




Acute Liver injury AST/ALT ratio - Correct answer ✔2:1
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Acute Liver Injury abdomen ultrasound shows - Correct answer ✔steatosis,
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cirrhosis, or focal lesions, Result in alcoholic fatty liver disease
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Vascular Liver Disorders - Correct answer ✔Budd-Chiari Syndrome,
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Obstruction of hepatic vein (thrombus) |! |! |! |!




Vascular Liver Disorders Work up - Correct answer ✔US of liver &
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hypercoagulable work up |! |!

, Congestive Hepatopathy - Correct answer ✔Related to right sided HF; Echo
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to look at heart function
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Causes of Congestive Hepatopathy - Correct answer ✔Ischemic (hypotension)
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(e.g. OR prolonged hypotensive) Shocked liver (suspected from prolonged
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Hypotensive Episodes) |!




Alpha 1 antitrypsin - Correct answer ✔inherited disorder (rare) that affect
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lung, liver and skin.
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Alpha antitrypsin Labs - Correct answer ✔antitrypsin phenotype (send out to
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Mayo Clinic) |!




Primary Biliary Cirrhosis - Correct answer ✔Autoimmune disorder that affect
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middle aged women
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Primary Biliary Cirrhosis Labs - Correct answer ✔Alk phos or Total bilirubin,
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anti-mitochondrial antibody and IgM (all
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elevated) - Correct answer ✔ |! |! |! |!




Hemochromatosis - Correct answer ✔Autosomal recessive disease; |! |! |! |! |! |! |!




Caucasians & Western European decent, resulting in very elevated Iron
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saturation or ferritin |! |!