Exam 16: Diseases of the Liver Gallbladder and Exocrine Pancreas

Forty percent of acute pancreatitis cases are due to a gallstone passing into the bile duct and temporarily lodging at the sphincter of Oddi.

_______________ causes a liver disorder that is uncommon in the United States and requires HBV to replicate.

Which group of people is most commonly infected with chronic hepatitis B virus in the United States?

Astrocytes are the specialized phagocytic cells of the reticuloendothelial system found on the luminal surface of the hepatic sinusoids.

Ammonia is absorbed and transported in the intestinal venous blood to the liver, where it is metabolized into which substance?

Which medication is most commonly used in the treatment of hepatic encephalopathy?

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 -How would the registered dietitian determine JB's caloric needs in this situation?

What complication most commonly occurs with folate deficiency?

Define the functions of the gallbladder.

Which type of hepatitis is most commonly transmitted through the fecal-oral route?

_______________ is the formation of calculi within the gallbladder or biliary duct system.

Briefly describe the impairment of neurotransmission involved with hepatic encephalopathy.

When steatorrhea associated with pancreatitis occurs, what intervention should follow?

The liver is the source of bile, but bile's composition is further modified by the _______________.

_______________ is a manifestation of thiamin deficiency usually seen in individuals suffering from alcoholism.

Describe the differences between hepatitis A, B, and C, including their methods of transmission, clinical manifestations, and modes of treatment.

Increased destruction of red blood cells with rapid release of bilirubin into the blood is known as:

Prolonged parenteral nutrition and short bowel syndrome can cause biliary stasis and therefore increase the risk of gallstones.

Which condition is most commonly associated with nonalcoholic steatohepatitis (NASH)?

List three different causes of cirrhosis found in the United States.