Exam (elaborations)

NURS 5463 Test 5 Questions With Revised Verified Solutions.

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Course
Nurs 5463

Institution
Nurs 5463

Cirrhotic - Answer liver has all the nodularities that cause the fibrosis Cirrhosis - Answer Abnormal LFT/Transaminitis (elevated LFT) Transaminitis - Answer Elevated LFT Acute or chronic liver disease - Answer alanime transaminase (ALT) & Aspartate transaminase (AST), Alk Phos...

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cirrhotic

Institution Nurs 5463
Course Nurs 5463

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NURS 5463 Test 5 Questions With
Revised Verified Solutions.
Cirrhotic - Answer liver has all the nodularities that cause the fibrosis

Cirrhosis - Answer Abnormal LFT/Transaminitis (elevated LFT)

Transaminitis - Answer Elevated LFT

Acute or chronic liver disease - Answer alanime transaminase (ALT) & Aspartate transaminase (AST),
Alk Phos, Total Bilirubin, Direct Bilirubin, occurs in acute or chronic liver disease

H&P for transaminitis - Answer Helps to determine acute or chronic

Cirrhosis risk factors - Answer IV drug use: Intranasal cocaine - the straws used when using intranasal
cocaine causes breakdown in the nasal mucosa and that is how the viruses are transmitted, Needle sticks
such in health care providers,

HD patients - Answer higher risk for contracting Hep B

Blood transfusion prior to 1991/1992 - Answer pt could have contracted hep C before we knew to test
for hep C

Acute liver Failure Work up for Transaminitis - Answer Viral Serologies (hep ABC), Autoimmune marker

Doppler US of liver want to look at the plumbing of the liver - Answer hepatic veins and arteries

MRI/MRCP - Answer MR that focuses on the biliary tree and bile ducts, intrahepatic and extrahepatic
ductal dilatation) Liver biopsy

,↑↑Aminotransferases (AST/ALT), +/- ↑ in Bilirubin, AK - Answer Labs for Severe viral Hepatitis,
Acetaminophen overdose, Ischemia, Wilson's disease, AIH; related to liver injury

↑↑ Alkaline Phosphate, GGT, Bilirubin, +/- ↑ AST/ALT - Answer Labs for Biliary Obstruction,
Choledocholithiasis, cholangiocarcinoma, pancreatic cancer, Intrahepatic cholestatis, Sepsis, PBC, Sex
Horm., Biliary Epitheleal Damage; related to cholestatic injury

Synthetic Function/Hepatic Function - Answer how well is the liver working. INR, albumin (low albumin
can represent chronic problems were as normal albumin problem is more acute), and total bilirubin

Hepatitis A, B, C Full serologic work up - Answer Hep A IgM, Hep A total, Hep B surface antigen, Hep B
surface antibody, Hep B core IgM, Hep B core total, and Hep C antibody. ANA, smooth muscle antibody
(one or both can be elevated), Serum gamma globulins - can also be elevated, ANCA can be present,
Anti-LKM1

Hepatotoxic Drugs - Answer Dilantin, Tylenol Accutane, Allopurinol, HAART, Statin, Methotrexate, INH
(TB med), Risperidone, Zoloft, Valproic acid, psych meds, Estrogen, Augmentin, Sulfonamides

Hepatotoxic Herbs - Answer Noni juice, Chinese remedies & teas, Valerian, Mistletoe, Herbalife.

Hepatoxic Toxins - Answer , , ETOH

Acute Liver injury AST/ALT ratio - Answer 2:1

Acute Liver Injury abdomen ultrasound shows - Answer steatosis, cirrhosis, or focal lesions, Result in
alcoholic fatty liver disease

Vascular Liver Disorders - Answer Budd-Chiari Syndrome, Obstruction of hepatic vein (thrombus)

Vascular Liver Disorders Work up - Answer US of liver & hypercoagulable work up

Congestive Hepatopathy - Answer Related to right sided HF; Echo to look at heart function

,Causes of Congestive Hepatopathy - Answer Ischemic (hypotension) (e.g. OR prolonged hypotensive)
Shocked liver (suspected from prolonged Hypotensive Episodes)

Alpha 1 antitrypsin - Answer inherited disorder (rare) that affect lung, liver and skin.

Alpha antitrypsin Labs - Answer antitrypsin phenotype (send out to Mayo Clinic)

Primary Biliary Cirrhosis - Answer Autoimmune disorder that affect middle aged women

Primary Biliary Cirrhosis Labs - Answer Alk phos or Total bilirubin, anti-mitochondrial antibody and IgM
(all

elevated) - Answer

Hemochromatosis - Answer Autosomal recessive disease; Caucasians & Western European decent,
resulting in very elevated Iron saturation or ferritin

Hemochromatosis - Answer Autosomal recessive Labs: Iron, Ferritin, TIBC, Retic count (If iron studies
elevated, send HFE gene mutation)

Wilson's disease - Answer Often has psych related problem growing up

Patho of Wilson's - Answer Excessive deposits of cooper both in liver & brain

Wilson's Labs - Answer serum Ceruloplasmin, If Serum Ceruloplasmin + get 24 hr urine for cooper

Evaluate for thrombosis - Answer need doppler US of liver

, Rhabdo - Answer seen extreme excises, strained muscle or working construction in the heat; increased
LFTs)

Hep A - Answer Fecal Oral Route

Hep A Incubation - Answer 2-6 weeks

Hep A S/S - Answer ↓ appetite, malaise, fever, NV, RUQ pain

Hep A labs - Answer Hep A IgM, Hep A antibody total (IgG)

If IgM is positive and the IgG is negative - Answer acute hepatitis A

IgM - Answer immediate disease

IgG - Answer Long gone" prior exposure nt now gone

Hep A Prevention - Answer vaccination, children are vaccinated to hepatitis A and are immune. People
that didn't get vaccinated as children can get the series and get immunity.

Hepatitis B Transmission - Answer Blood transfusion or contact, sexual activity, perinatal

Hep B Incubation - Answer 6 wks-6 months

Hep B Labs - Answer Hep B surface antibody/antigen & Hep B core antibody total (IgG), IgM.

IgM - Answer Immediate

IgG - Answer Long gone

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