OST 575 Exam 3 Questions And Correct
Answers
Bare area of liver - answer-Lies b/t two layers of the coronary ligament
-Devoid of peritoneum
-Important bc portacaval anastamosis potentially spreading infection from abdominal to thoracic
cavity
Blood supply of liver - answer-Proper hepatic arte...
Bare area of liver - answer✔-Lies b/t two layers of the coronary ligament
-Devoid of peritoneum
-Important bc portacaval anastamosis potentially spreading infection from abdominal to thoracic
cavity
Common sites of fistula in intestines for fistula w/ gallbladder - answer✔-Superior part of
duodenum
-Transverse colon
Cystic duct obstruction - answer✔Causes pain but NO jaundice
Common bile duct obstruction - answer✔Causes pain + jaundice + vomiting
Pain sensation of the foregut - answer✔Greater splanchnic nn.
Aminotransferases - answer✔-AST and ALT
-Transfer NH2 from a donor alpha-amino acid to an acceptor alpha-keto acid
-ALT is more specific for liver disease
-AST is more sensitive (higher quantity in liver)
Albumin - answer✔-Liver protein that functions as a transporter in blood for FFA's, Bile acids,
and Bile pigments
-*Decreased albumin leads to ascites:* Decreases osmotic pressure and leads to edema
Bilirubin - answer✔-Formed by separation of heme from globin polypeptides
Jaundice - answer✔Deposition of bilirubin and yellowish coloration of skin, nail beds, and
sclerae due to hyperbilirubinemia
Players in Liver Function Tests - answer✔1) Aminotransferases
2) Serum proteins (Albumin)
3) Bilirubins
4) Blood clotting factors
Prothrombin time - answer✔-How long it takes a plasma sample to clot after being mixed w/
thromboplastin (Factor III) and calcium ions
-Reported as International Normalized Ratio (INR)
Activated partial thromboplastin time (aPTT) - answer✔Time it takes plasma to clot from the
activation of Factor XII
Nonalcoholic Fatty Liver Disease (NAFLD) - answer✔-Steatosis w/o ethanolism
-Most common cause of chronic liver injury
-Risk factors are obesity, T2DM, insulin resistance, metabolic syndrome
-Steatosis --> Steatohepatitis --> Steatofibrosis (*chicken wire fence/sinusoidal pattern*)
Steatofibrosis - answer✔-Early on before cirrhosis develops, new collagen delicately encircles
hepatocytes in a *chicken wire fence/sinusoidal pattern*
-Seen in NAFLD
Nonalcoholic Steatohepatitis (NASH) - answer✔-Subset of NAFLD w/ *inflammation and
cellular injury*
-Pt's w/ *persistently elevated aminotransferases*
-Usually asymptomatic
Primary causes of NASH - answer✔-Obesity
-Glucose intolerance
-T2DM
One drink - answer✔-12 oz beer / 5 oz wine / 1.5 oz spirits
-Delivers about 12 to 14 g of alcohol
NASH dx - answer✔-Persistently elevated aminotransferase
-Fatty infiltrate on imaging
-Mallory bodies
-Dx best done w/ *liver biopsy*, however, don't do this in pt's w/ normal AST, ALT
NASH management - answer✔-Directed at risk factors
-*Gradual* weight loss
What causes "Asian flush?" - answer✔Asians have a deficiency of aldehyde dehydrogenase,
leading to decreased alcohol metabolism
Drugs that are affected by alcohol consumption - answer✔-Metronidazole
-Cimetidine
-Tricyclics
-Nitro, propanolol
-Morphine
-Acetaminophen
Fatty liver - answer✔-Benign, usually seen in moderate drinkers and alcoholics
-Frequently asymptomatic, however, *hepatomegaly* is common
-AST > ALT; GGT elevation
-Tx: Abstinence. *Return to normal in 2-4 weeks*
Alcoholic hepatitis - answer✔-Frequently precipitated by period of binge drinking
-Prodrome sx: anorexia, nausea, fatigue, weight loss
-May progress to cirrhosis over months to years
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