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In which abdominopelvic quadrant is teh pancreas located?
LLQ
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which vein brings blood full of nutrients from the digestive tract to the liver, before it enters the systemic circulation
hepatic portal vein
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which organ can regenerate itself?
liver
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which organ secretes the enzyme trypsin?
pancreas
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this organ does not secrete digestive enzymes
liver
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which organ secretes bile acids
liver
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what hormones secreted by the pancreas are involved in blood glucose regulation
insulin/glycogon
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which endocrine gastroinstestinal regulatory peptide stimulates gallbladder contractiona and pancreatic secretions in response to peptides, amino acids, and fatty acids in the duodenum and jejunum
cholecystokinin (CCK)
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which endocrine gastrointestinal regulatory regulatory peptide stimulates biliary and pancreatic bicarbonate secretions in response to acid in the duodenum
secretin
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what are liver cells called?
hepatocytes
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what autosomal recessive congenital metabolic disorder is characterized by progressive decline of lung and pancreas function due to abnormal exocrine body secretions plugging up passage ways
cystic fibrosis
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what is hepatomegaly
enlarged liver
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what is hepatitis?
acute/chronic inflammation of liver due to injury
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what is liver steatosis?
excessive fat accumulation causing deteroration "fatty liver"
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what is cirrhosis?
irreversible destruction of the liver
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what is bilirubin?
pigment formed during breakdown of hemoglobin and is excreted in the bile
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what is jaundice?
yellowing of the skin due to elevated bilirubin levels in blood and tissues
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what is encephalopathy?
altering of the brain structure and deteroration of mental function
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what is wernicke's encephalopathy?
inflammation of the brain with hemmorage because of the result of thiamin deficiancy
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what is cholelithiasis?
presennce of cholesterol stones in the gallbladder or bile duct
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what is a gallstone?
lithiasis in the gallbladder or bile duct
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what is cholestasis?
flow bile stop.fail-> becomes concentrated -> stone development
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what is cholecystitis?
inflammation of the gallbladder
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what is a cholecystectomy?
removal of the gallbladder
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what is hemochromatosis?
inheritated disorder that causes absorbtion of excessive amount of iron in tissues and organs
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what is pancreatitis
inflammation of the pancreas
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what is a pancreatectomy?
removal of part or all of the pancreas
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what may trigger the formation of gallstones?
- -bile is supersaturated
- -no fat in diet
- -cholestasis
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what factors and disease conditions are associated with an increase risk of the formation of cholelithiasis (stones in the gallbladder)
- -women
- -over age 40
- -over weight
- -rapid weight loss
- -increased # of pregnancies
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what factors are commonly involved in the pathogenesis of hepatitis?
- -alcoholism
- -viral infection
- -lack of blood flow
- -hemacrotosis
- -toxic agents
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what is the most frequent cause of chronic liver disease?
alcoholism
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what are the clinical manifests of hepatitis?
- anorexia
- nutrient def
- malase
- fever
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what are the complications of hepatitis?
- severe hypoglycemia
- immunosuppressed
- liver failure
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what are the clincal mainfests of cirrohosis?
- anorexia
- nausea
- vomitting
- wt. loss
- jaundice
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purpose of nutrition care in liver disease?
- maintain nutritional status
- prevent condition from getting worse
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why are clients with liver disease at risk of protein-energy malnutrion
- anorexia
- don't digest/absorb
- nausea
- vomiting
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best method to determine the energy needs of clients with liver disease?
- indirect calrimetry
- carbon dioxide/oxygen exchange
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what biochemical data may help identify the presence of liver disease?
AST and ALT levels
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what biochemical measures are useful when assessing nutritional status of clients with liver disease
- low hemoglobin
- low hematacrit
- low mean corpuscular volume
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how is the liver examined for proper diagnosis when liver disease is suspected from sign,symptoms,tests
- abdominal ultrasound
- liver scanning
- liver biopsy
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what is the main dietary recommendation post cholescystectomy?
fat restriction (25-50g)
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how is alcoholic liver disease managed?
- multi team
- promotion of alcohol avoidance
- adequete nutrients
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what diet is recommended for liver disorders such as hepatitis, cirrosis, biliary disease?
- individualized
- high calorie
- high protein
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which clients with liver disease are suseptable to fat maldigestion? require fat restricted diet?
cirrosis
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when are fluid and sodium restrictions necessary in clients with liver disease??
ascites/edema
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which vitamins and minerals may need to be supplemented in clients with liver disease due to status and def. ?
- thiamin
- folacin
- calcium
- vit. D
- vit. B6
- vit. C
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treatment used for hepatic encephalopathy. Acts as a laxative
lactulose
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signs and symptoms of acute pancreatitis?
- LUQ abdominal pain
- nausea
- vomitting
- anorexia
- increased amylase
- increased lipase
- increased AST
- increased blood glucose
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most severe complication of acute pancreatitis
- rapid intense inflammation
- sudden onset
- death of cells in pancreas
- necrotizing pancreatitis
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MNT for clients with chronic pancreatitis
- avoid alcohol
- maintain body wt.
- increase calorie
- increase protein
- 40-60% carb
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MNT for clients with acute pancreatitis?
- NPO
- intravenous fluids and electrolytes
- enternal nutrition
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recurrent insults followed by repair of the liver tissue can cause fiberosis and scarring known as ______, irreversible damage... usually occurs with long term liver dysfunction
cirrosis
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what is the effect of long-term alcohol abuse on the liver
- stores fat -> fatty liver
- hepatitis
- cirrosis
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how hepatic steatosis becomes cirrohosis
- fat builds on liver
- cells become large
- continue behaviors with healing
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hepatitis a,b,c,d,e differences
- hep a - inflammation by virus - transmission = food/water
- hep b- '' '' - '' = blood, semen
- hep c- '' '' - '' = blood products
- hep d- '' '' - '' = serum hepatitis
- hep e- '' '' - '' = water
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what is biliary cirrhosis?
irreversible destruction, damage in bile duct and liver
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how advanced liver disease alters metabolism of carbohydrates?
blood glucose becomes low
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how advanced liver disease alters metabolism of lipids?
- fat buildup
- no lipoproteins
- steatorhea
- vitamin def. = ADEK
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how advanced liver disease alters metabolism of proteins?
- nitrogen buildup of ammonia
- coma
- encephalopathy
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how is hepatic encephalopathy treated?
- lower protein intake
- lactulose
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what are clinical manifests of severe alcoholism
- fat in liver
- cant make lipoprotein
- alcohol toxic to tissue
- impair folate, thiamin, vit. C
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diet therapy for management of cystic fibrosis?
- enteric coating supplement
- high nutrient diet
- multivitamin
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_______ is synthesized by the liver and is the main blood protein, used as a marker of liver function
albumin
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albumin half life?
12-18 days
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complications associated with alcoholic cirrhosis?
- impaired glucose tolerance
- encephalopathy
- steatorrhea
- gallstones
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dietary recommendations for clients with mild chronic cholecystitis with symptomatic gallstones
- low fat diet
- small frequent meals
- avoid food intolerances (gas forming)
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functions of the liver for carbohydrate?
- galactose and fructose from digestion are converted to glucose
- store glucose as glycogen
- synthesis fat from carbohydrate
- produce new glucose from precursers
- maintain blood glucose
- gluconeogensis when fasting
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functions of liver for protein?
- convert amino acids to substrates
- detoxify ammonia by converting it to urea for kidney to excrete
- synthsis of vital body proteins ex. albumin
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functions of liver for fat?
- fatty acids from diet and adipose tissue are converted in liver
- ketone bodies produced
- synthesizes triglycerides and phospholipids, cholesterol, bile acids and lipoproteins
- bile is needed to emulsify fat for digestion
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function of liver for vitamins?
- storage, activation and transportation of vitamins and minerals
- stores all fat soluble vitamins
- OH added to vit. D in process of activation of vit. D
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alcoholism causes what deficiencies?
- folacin
- thiamin
- vit. c
- vit. d
- vit. k
- vit. a
- calcium
- potassium
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function of pulmonary system
- gas exchange
- acid base balance of body
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___________ and _______________ are interdependent
- nutritional status
- pulmonary function
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malnutrition on pulmonary status effects what nutrients?
- vit. c
- vit. a
- protein
- zinc
- vit B6
- decreased surfactant
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symptoms of pulmonary disease?
- full really fast
- anorexia
- wt. loss
- cough
- shortness of breath while eating
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what is COPD?
presence of chronic bronchitis or emphysema leading to airway obstruction
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primary cause of COPD?
smoking
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what is emphysema?
abnormal permanent enlargement of alveoli accompied by destruction of walls
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what is bronchitis?
inflammation of bronchial mucus membrane
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treatment of COPD?
- lifestyle changes
- exercise
- good nutrition
- drugs
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pathophysiology of fatty liver to alcoholism?
- lack of NAD
- fatty acids cant be transported out of liver
- no lipoproteins
- extra ATP built up as fat
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hgb and hct are depressed and MCV is elevated why?
- cant make protein
- folate def.
- megaloblastic cells
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what is hyperbilirubinemia?
high bilirubin levels
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what is ascites?
excess fluid buildup in tissues
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what is hypocalcemia?
low blood calcium
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