GNUR 293 Patho Final Questions And Answers With
Real Study Quiz
The blood supply is delivered to the liver by way of ANS dual arterial sources (25% arterial flow
from the aorta & 75% hepatic artery)
The liver has a dual blood supply, delivering a blood supply (25%) from arterial inflow from the aorta via
the celiac trunk and hepatic artery (75%) and from the portal vein via the capillary bed of the alimentary
canal and pancreas.
Esophageal varices are a complication of liver disease and are a result of ANS elevated portal
pressure/portal HT
Esophageal varices result mainly from impaired blood flow through the liver. Increased pressure in the
portal system leads to portal hypertension and congestion of the esophageal vessels resulting in varices.
Biliary obstruction could result in ANS Jaundice
& more specifically increased level of conjugated bilirubin
What term is used to describe the process of converting bilirubin from its freely lipid-soluble form to the
form that is tightly bound to the plasma protein albumin? ANS Conjugation
Damaged or destroyed red blood cells are lysed and the oxygen-carrying hemoglobin molecule is
recycled. Separation of heme from globin yields biliverdin, which is converted to bilirubin and released
into plasma and transported to the liver. Free unconjugated bilirubin is lipid-soluble and crosses easily
into the brain of the neonate. Conjugation by the liver tightly binds bilirubin to the plasma protein
albumin.
What condition occurs when a form of bilirubin diffuses into the brain and causes a type of
encephalopathy? ANS in babies: kernicterus
,Kernicterus refers to brain injury as a result of hyperbilirubinemia. The immature blood-brain barrier
allows free unconjugated bilirubin to enter the brain, which causes encephalopathy through unknown
mechanisms
The development of hepatocellular carcinoma is ANS Usually associated with chronic viral hepatitis
Hepatocellular carcinoma is often the result of years of injury from chronic alcohol abuse, chronic viral
hepatitis, or injury and is therefore more often seen in older individuals.
Portal hypertension occurs as a result of ANS -Obstruction of blood flow in the liver's venous
sinusoids
-Impaired drainage into the central veins
-A buildup of venous pressure
characterizes the nature and capabilities of the liver ANS -Blood detoxification is a function of the
liver.
-The liver plays a role in the digestion of fats (bile)
-The liver is vulnerable to illness, but has considerable repair abilities
Which manifestation is typical of hepatocellular failure? ANS -hypoalbuminemia
-glucose imbalance
-osteomalacia
Appropriate early treatment for infants with jaundice-related encephalopathy may include which of the
following? ANS -Phenobarbital to increase the levels of UDPGT
-Phenobarbital to increase the levels of UDPGT
-Exchange transfusions
Universal vaccination against hepatitis of child is recommended for which Hep classes? ANS Hep A
&B
What is ascites related to? ANS portal hypertnsion & hypoalbuminemia
,What role does the liver play in nutrient metabolism, bile synthesis, storage of vitamins and minerals,
urea synthesis, clotting factor synthesis, and detoxification? ANS (notice the wide array of roles)
The liver functions as a digestive organ (bile salt secretion for fat digestion; processing and storage of
fats, carbohydrates, and proteins absorbed by the intestines; processing and storage of vitamins and
minerals); as an endocrine organ (metabolism of glucocorticoids, mineralocorticoids, and sex hormones;
regulation of carbohydrate, fat and protein metabolism), a hematologic organ (temporary storage of blood,
removal of bilirubin from bloodstream, hematopoiesis, synthesis of blood clotting factors), and an
excretory organ (excretion of bile pigment and cholesterol via bile, urea synthesis, detoxification of drugs
and other foreign substances).
Manifestations of liver disease due to hepatocelleular failure ANS Jaundice, decreased clotting
factors, hypoalbuminemia, decreased vitamins D and K, and feminization (gynocomastia & female hair
distributionb) are attributed to hepatocellular failure.
Manifestations of liver disease due to portal HT ANS Portal hypertension may result in GI congestion
with the development of esophageal or gastric varices, hemorrhoids, splenomegaly, and ascites.
hat clinical and laboratory findings would lead to a diagnosis of liver cirrhosis? ANS Clinical and
laboratory findings that would lead to a diagnosis of liver cirrhosis include palpation of an enlarged,
nodular liver, jaundice, gastric varices, hemorrhoids, splenomegaly, ascites, decreased clotting factors,
hypoalbuminemia, decreased vitamins D and K, and elevated AST/ALT (more than 40 units)
s/s of alcoholic cirrhosis ANS -weakness
-fatigue
-muscle wasting
-anorexia
-ascites *
-abnormal blood glucose levels
-elevated serum lipids
-feminization
-palmar erythema *
spider telangiectasia *
, ^ all are primarily due to hepato cellular failure
s/s of portal hypertension ANS varices (enlarged veins including hemorrhoids and gastroesophageal)
splenomegaly (enlarged spleen)
Everything enlarged. Why? Pressure pushing out on veins + arteries.
Why is a patient with alcoholic cirrhosis at risk for GI bleeding? ANS The liver is needed in synthesis
of clotting factors; with heptacellular filkure, severe hypoprothrombinemia can develop
Upper GI bleeding may result from varices, portal HT, or gastroduodenal ulcer (all of which are
manifestations of cirrhosis)
What could be the cause of progressive mental deterioration in cirrhosis patients? How is managed? ANS
-probable cause is portal-systemic encephalopathy resulting from the failure of the liver to detoxify
noxious agents due to hepatocellular dysfunction
-*ammonia* is the most readily identified toxin and its rising serum level correlates with the decline in
cerebral fx
-managed by reducing PRO intake (to reduce the production of metabolic wastes), lactulose can be taking
to enhance ammonia excretion in stool, antibiotics to reduce normal flora involved in PRO breakdown
and ammonia production
Hepatitis & Antigen Antibodies ANS IgE: detection of Hep A, acute (allergy reaction)
IgM: Hep A is Active (virus is mean and active)
IgG: Hep A is gone (gone/immune)
HBsAg (Hep B is infectious)
anti-HBV (recovered/immune to Hep B)
Hepatitis A ANS Type: ssRNA
Viral Family: Hepatovirus related to picomavirus
Real Study Quiz
The blood supply is delivered to the liver by way of ANS dual arterial sources (25% arterial flow
from the aorta & 75% hepatic artery)
The liver has a dual blood supply, delivering a blood supply (25%) from arterial inflow from the aorta via
the celiac trunk and hepatic artery (75%) and from the portal vein via the capillary bed of the alimentary
canal and pancreas.
Esophageal varices are a complication of liver disease and are a result of ANS elevated portal
pressure/portal HT
Esophageal varices result mainly from impaired blood flow through the liver. Increased pressure in the
portal system leads to portal hypertension and congestion of the esophageal vessels resulting in varices.
Biliary obstruction could result in ANS Jaundice
& more specifically increased level of conjugated bilirubin
What term is used to describe the process of converting bilirubin from its freely lipid-soluble form to the
form that is tightly bound to the plasma protein albumin? ANS Conjugation
Damaged or destroyed red blood cells are lysed and the oxygen-carrying hemoglobin molecule is
recycled. Separation of heme from globin yields biliverdin, which is converted to bilirubin and released
into plasma and transported to the liver. Free unconjugated bilirubin is lipid-soluble and crosses easily
into the brain of the neonate. Conjugation by the liver tightly binds bilirubin to the plasma protein
albumin.
What condition occurs when a form of bilirubin diffuses into the brain and causes a type of
encephalopathy? ANS in babies: kernicterus
,Kernicterus refers to brain injury as a result of hyperbilirubinemia. The immature blood-brain barrier
allows free unconjugated bilirubin to enter the brain, which causes encephalopathy through unknown
mechanisms
The development of hepatocellular carcinoma is ANS Usually associated with chronic viral hepatitis
Hepatocellular carcinoma is often the result of years of injury from chronic alcohol abuse, chronic viral
hepatitis, or injury and is therefore more often seen in older individuals.
Portal hypertension occurs as a result of ANS -Obstruction of blood flow in the liver's venous
sinusoids
-Impaired drainage into the central veins
-A buildup of venous pressure
characterizes the nature and capabilities of the liver ANS -Blood detoxification is a function of the
liver.
-The liver plays a role in the digestion of fats (bile)
-The liver is vulnerable to illness, but has considerable repair abilities
Which manifestation is typical of hepatocellular failure? ANS -hypoalbuminemia
-glucose imbalance
-osteomalacia
Appropriate early treatment for infants with jaundice-related encephalopathy may include which of the
following? ANS -Phenobarbital to increase the levels of UDPGT
-Phenobarbital to increase the levels of UDPGT
-Exchange transfusions
Universal vaccination against hepatitis of child is recommended for which Hep classes? ANS Hep A
&B
What is ascites related to? ANS portal hypertnsion & hypoalbuminemia
,What role does the liver play in nutrient metabolism, bile synthesis, storage of vitamins and minerals,
urea synthesis, clotting factor synthesis, and detoxification? ANS (notice the wide array of roles)
The liver functions as a digestive organ (bile salt secretion for fat digestion; processing and storage of
fats, carbohydrates, and proteins absorbed by the intestines; processing and storage of vitamins and
minerals); as an endocrine organ (metabolism of glucocorticoids, mineralocorticoids, and sex hormones;
regulation of carbohydrate, fat and protein metabolism), a hematologic organ (temporary storage of blood,
removal of bilirubin from bloodstream, hematopoiesis, synthesis of blood clotting factors), and an
excretory organ (excretion of bile pigment and cholesterol via bile, urea synthesis, detoxification of drugs
and other foreign substances).
Manifestations of liver disease due to hepatocelleular failure ANS Jaundice, decreased clotting
factors, hypoalbuminemia, decreased vitamins D and K, and feminization (gynocomastia & female hair
distributionb) are attributed to hepatocellular failure.
Manifestations of liver disease due to portal HT ANS Portal hypertension may result in GI congestion
with the development of esophageal or gastric varices, hemorrhoids, splenomegaly, and ascites.
hat clinical and laboratory findings would lead to a diagnosis of liver cirrhosis? ANS Clinical and
laboratory findings that would lead to a diagnosis of liver cirrhosis include palpation of an enlarged,
nodular liver, jaundice, gastric varices, hemorrhoids, splenomegaly, ascites, decreased clotting factors,
hypoalbuminemia, decreased vitamins D and K, and elevated AST/ALT (more than 40 units)
s/s of alcoholic cirrhosis ANS -weakness
-fatigue
-muscle wasting
-anorexia
-ascites *
-abnormal blood glucose levels
-elevated serum lipids
-feminization
-palmar erythema *
spider telangiectasia *
, ^ all are primarily due to hepato cellular failure
s/s of portal hypertension ANS varices (enlarged veins including hemorrhoids and gastroesophageal)
splenomegaly (enlarged spleen)
Everything enlarged. Why? Pressure pushing out on veins + arteries.
Why is a patient with alcoholic cirrhosis at risk for GI bleeding? ANS The liver is needed in synthesis
of clotting factors; with heptacellular filkure, severe hypoprothrombinemia can develop
Upper GI bleeding may result from varices, portal HT, or gastroduodenal ulcer (all of which are
manifestations of cirrhosis)
What could be the cause of progressive mental deterioration in cirrhosis patients? How is managed? ANS
-probable cause is portal-systemic encephalopathy resulting from the failure of the liver to detoxify
noxious agents due to hepatocellular dysfunction
-*ammonia* is the most readily identified toxin and its rising serum level correlates with the decline in
cerebral fx
-managed by reducing PRO intake (to reduce the production of metabolic wastes), lactulose can be taking
to enhance ammonia excretion in stool, antibiotics to reduce normal flora involved in PRO breakdown
and ammonia production
Hepatitis & Antigen Antibodies ANS IgE: detection of Hep A, acute (allergy reaction)
IgM: Hep A is Active (virus is mean and active)
IgG: Hep A is gone (gone/immune)
HBsAg (Hep B is infectious)
anti-HBV (recovered/immune to Hep B)
Hepatitis A ANS Type: ssRNA
Viral Family: Hepatovirus related to picomavirus
