-
symptoms over the past three weeks
- tired and weak
- appetite is good
- sore under right ribcage (mostly when jogging)
-
4 occurences that could be used to rule out possible causes of the hepatitis
- motor vehicle accident in 1996 (requiring a blood transfusion) - 1992 act to screen blood
- cholecystitis & cholecystectomy -
- no recent international travel
- no unprotected sex or with anyone dx'd with viral Hep
- drinking a 6-pack of beer on the weekend
- large tattoos on forearms, lower legs and back
-
functional unit of the liver
lobule
-
what surrounds the plates of hepatocytes
sinusoids
-
lobules recieve blood from where
- portal vein
- hepatic artery
-
cells that are star shaped, store lipids & vitamin A, contractile and remove foreign substances from blood & trap bacteria
lipocytes
-
lymphatics drain lymph from where in the lobules
disse space
-
capillaries between plates of hepatocytes that
drain towards the central vein
surrounded by highly permeable endothelial cells
lined with phagocytic Kupffer cells
sinusoids
-
4 main liver functions
- digestion
- synthesis
- metabolism
- detoxification
-
test that reflect loss of normal function
- digestion - impaired lipid digestion
- synthesis - loss of normal proteins
- metabolism - drugs not metabolized
- detoxification - inability to clear and/or conjugate drugs or endogenous factors
-
5 plasma chemistries and which direction they go in liver disease
- aminotransferases (AST,ALT) increase
- LDH - increase
- bilirubin - increase
- ptt - increase
- plasma proteins, albumins,globulins decrease
-
hepatic synthetic functions
- fat processing
- protein processing
- CHO
-
6 hepatic metabolic functions
- plasma proteins
- ast
- alt
- ldh
- alkaline phosphatase
- ggt
-
where are gamma globulins synthesized
lymph node cells
-
controls the flow of pancreatic juices
sphincter of Oddi (major duodenal papilla)
-
primary bile acids
cholic acid & chenodeoxycholic acids
-
process of bile secretion
cholerisis
-
choleretic agents/stimuli
- high concentration of bile salts
- secretin
-
which hepatitis is DNA
hep B
-
-
which hep affects children and young adults
hep A
-
5 stages of viral hepatitis
- incubation
- prodromal
- icteric
- recovery
- chronic
-
strongest risk for hep C
IV drug use
-
70-90% of hep c patients develop what
- chronic hepatitis
- and many are at risk of cirrhosis
-
3 low lab values
- vitamin A
- albumin
- protein, total
-
3 high labs
- lymphocytes
- monocytes
- all liver enzymes except (unconjugated, indirect bilirubin)
-
2 positive lab results
- IgG anti-HCV antibody
- HCV RNA
-
which lab test is a big indicator hor hep C
HCV genotype - type 1
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