Term
| Diffuse process characterized by fibrosis and conversion of normal hepatic architecture into structurally abnormal nodes |
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Definition
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|
Term
| Increased amounts of fibrotic tissue → |
|
Definition
increased resistance to blood flow → portal HTN and developement of
varices and ascites |
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Term
| Cirrhosis = _____ in Greek |
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Definition
Kirrhus (orange colored) → refers to orange hue on liver seen by pathologist |
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Term
|
Definition
Alcohol Chronic HepB and HepC |
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Term
| Cirrhosis affects _____ of US adults and is responsible for _____ deaths/yr |
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Definition
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Term
After diagnosis 50% of cirrhosis patients who develop ________ die within ______ |
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Definition
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Term
Why might medications need to be eliminated or adjusted? |
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Definition
| Because liver plays a major role in the biotransformation of medications |
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Term
| Portal HTN and varices defined as: |
|
Definition
| Alternate blood flow routes/pathways from the portal to the systematic circulation which bypass the liver |
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Term
| Variceal bleeding occurs when: |
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Definition
| Portal venous pressure is 12mmHg greater than the vena cava pressure |
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Term
| Hemorrhage occurs in ____% of pts with cirrhosis and each episode carries a ___% risk of death |
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Definition
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|
Term
Re-bleeding can occur in ___% of pts within _____ |
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Definition
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Term
| 4 major steps in treatment of cirrhosis |
|
Definition
1. Eliminate the cause of cirrhosis where possible 2. Assess the risk for variceal bleeding 3. Evaluate the pt for clinical signs of ascites 4. Manage complications like spontaneous bacterial peritonitis and hepatic encephalopathy |
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|
Term
Begin prophylaxis for variceal bleeding with ____; goal is to ______ |
|
Definition
•non-selective B blockers •reduce HR by 20-25%, thus reducing overall pressure |
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Term
| ______ may be considered in younger patients or patients with resistant portal HTN |
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Definition
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Term
| Acute variceal hemorrhage is managed by: |
|
Definition
Medications like octreotide or somatosatin Inhibit vasodilatory proteins → mesenteric vasoconstriction → increased vascular tone in the GI tract |
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|
Term
|
Definition
Diuretic therapy of: spironolactone (K sparing diuretic) and furosemide (loop, K wasting diuretic) |
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Term
| Functional constipation defined as: |
|
Definition
2+ of the following complications for at least 12 months in the absence of laxative use: • Straining at least 25% of the time •Lumpy or hard stools at least 25% of the time •Feeling of incomplete evacuation at least 25% of the time •2 or less BM's in a week |
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Term
As many as ____% of pts report having constipation over the age of 65 |
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Definition
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Term
Constipation is not a disease, but a _____ and treatment should begin with ______. |
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Definition
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|
Term
Treatment of constipation (3 steps) |
|
Definition
1. Dietary changes (increase dietary fiber consumed and increase exercise, especially after supper and fluid intakes) 2. Rule out any conditions such as hypothyroidism 3. Discontinue or switch possible offending medications
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|
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Term
|
Definition
•Bulk producing laxatives •Emollient, lubricating or stool softeners (surfactants) •Irritants or stimulants •Saline or hyperosmotic cathartics |
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Term
|
Definition
| An increased frequency and decreased consistency of fecal d/c as compared to an individual's normal bowel patterns |
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|
Term
| Avg. person living in US experiences ____ episodes of diarrhea yearly. |
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Definition
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|
Term
| Diarrhea is most often a ____discomfort, ____life threatening, and usually ______. |
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Definition
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|
Term
| _____ organisms account for most episodes of infectious diarrhea and includes _____. |
|
Definition
Viral and bacterial Shigella Salmonella Campylobacter Staphylococcus E. Coli |
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Term
| Acute viral infections are attributed mostly to the _____ groups. |
|
Definition
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|
Term
|
Definition
•Manage the diet •Prevent excessive water, electrolyte, and acid-base disturbances (rehydration and maintenance of water and electrolytes are primary treatment goals until episode ends) •Provide symptomatic relief •Treat curable causes •Manage secondary disorders causing diarrhea
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|
|
Term
|
Definition
•Recommend discontinuing consumption of solid foods and dairy products for 24 hours •After 24 hrs a bland diet is started •Feeding should continue in children with acute bacterial diarrhea
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