Exam 16: Diseases of the Liver Gallbladder and Exocrine Pancreas

_______________ presents as small, brief, intermittent movements of individual fingers and may be seen in patients with hepatic encephalopathy.

The hepatotoxic alcohol threshold at which ALD may develop is 20 g (two drinks) daily for men.

Autodigestion of the pancreas is prevented by storing the digestive enzymes in their inactive forms as zymogens.

_______________ or steatosis occurs in about 25-30% of the general U.S. population and 90% of chronic alcohol abusers.

_______________ is a form of toxic liver injury associated with chronic ethanol consumption.

An estimated dosage range would be _______________ IU of lipase per meal for a patient with chronic pancreatitis.

Nutrition interventions for a client with alcoholic hepatitis include a diet that is:

JB is a 53-year-old male who has recently divorced. He has experienced periods of depression and decreased appetite. His family reports a history of heavy drinking habits and a 15 kg weight loss. He was previously diagnosed with cirrhosis and portal hypertension. Paracentesis and TIPS procedures were performed. JB's condition seems to have worsened; he complains of stomach pains, nausea, and vomiting at times. His abdomen is sore to touch and feels swollen. JB has developed ascites and pedal edema. His urinary output has decreased, and he continues to lose weight. JB also complains of pain when swallowing food. Because of JB's persistent symptoms, he's been admitted to a hospital. A referral to the SLP for an MBS was also ordered and resulted in dysphagia for which pureed diet was recommended. On day 2, JB still complains of nausea and no per os intake has been reported. The MD prescribed a dietary consultation. An RD is required to assess the patient and recommend alternate means of nutrition support, currently NPO. $\mathrm{Ht}: 5^{\prime} 11^{\prime \prime} \quad$ Wt: $145 \quad \#$ UBW: $163 \#$ Dx: End-stage liver cirrhosis, dysphagia PMH: alcoholic cirrhosis, portal hypertension Labs: Na: 134 Cl: 101 BUN: 4 Alb: 2.3 TG: 305 Transferrin: 101 NH4: 53 Glu: 139 AST: 45 ALT 48 Alk Phos: 40 Bilirubin: 2.1 K: 5.2 CO2: 25 Cr: 1.8 H/H: 11/35 Diet: NPO Meds: Neomycin, Aldactone, Lasix, Reglan -The RD recommends sodium restriction because of JB's ascites. How much sodium should the RD initially recommend to JB each day?

A patient with hepatic encephalopathy is being assessed according to the Adapted West Haven Criteria. The patient has marked somnolence, psychomotor agitation, and his speech is difficult to understand. At which stage of the disease is the patient?

Hepatitis C is most commonly transmitted through which route?

Standard medical treatments for hepatic encephalopathy are primarily directed at reducing the amount of circulating ammonia.

A patient with hepatic encephalopathy is being assessed according to the Adapted West Haven Criteria. The patient is unable to perform easy mental tests and is awake but inattentive. The patient's speech is difficult to understand. Identify the stage of encephalopathy that has these characteristics.

JB is a 53-year-old male who has recently divorced. He has experienced periods of depression and decreased appetite. His family reports a history of heavy drinking habits and a 15 kg weight loss. He was previously diagnosed with cirrhosis and portal hypertension. Paracentesis and TIPS procedures were performed. JB's condition seems to have worsened; he complains of stomach pains, nausea, and vomiting at times. His abdomen is sore to touch and feels swollen. JB has developed ascites and pedal edema. His urinary output has decreased, and he continues to lose weight. JB also complains of pain when swallowing food. Because of JB's persistent symptoms, he's been admitted to a hospital. A referral to the SLP for an MBS was also ordered and resulted in dysphagia for which pureed diet was recommended. On day 2, JB still complains of nausea and no per os intake has been reported. The MD prescribed a dietary consultation. An RD is required to assess the patient and recommend alternate means of nutrition support, currently NPO. $\mathrm{Ht}: 5^{\prime} 11^{\prime \prime} \quad$ Wt: $145 \quad \#$ UBW: $163 \#$ Dx: End-stage liver cirrhosis, dysphagia PMH: alcoholic cirrhosis, portal hypertension Labs: Na: 134 Cl: 101 BUN: 4 Alb: 2.3 TG: 305 Transferrin: 101 NH4: 53 Glu: 139 AST: 45 ALT 48 Alk Phos: 40 Bilirubin: 2.1 K: 5.2 CO2: 25 Cr: 1.8 H/H: 11/35 Diet: NPO Meds: Neomycin, Aldactone, Lasix, Reglan -Following the paracentesis, the nutritionist might recommend what component to the nutrition prescription?

Which of the following statements is true of alcoholism in older adults?

Symptoms associated with acute pancreatitis include:

Withdrawal of fluid from the abdomen via a catheter, often used as treatment for ascites, is called _______________.

The _______________ is a surgical procedure for ascites that reroutes blood flow to the liver and reduces pressure in all auxiliary veins.

Which treatment is used in the management of both hepatitis B and hepatitis C?

A patient's eligibility to be placed on the waiting list for a liver transplant is determined based on the _______________ scoring system.

Red blood cells, alkaline phosphatase, and serum glucose are generally elevated with hepatitis.