what are the two lobes of the liver?

 they are usually unbale to palpate, requires 30% of cardiac output

Incubation period: 2 to 3 weeks

isolation Yes

period of communicability: depends on how fast they are treated. very quickly

symptoms appear: 2-3 weeks

clincial manifestations: fever, look yellow, vomiting

Means of spread: inoculations of infected blood or serum

isolation: yes

incubation period: 28-160 days

period of communicability: any time from 28-160 days

symptoms: 2-3 weeks

Lab tests: antigen postive antibody postive and AST go up

clinical manifestations:vomiting joundice develop joint pain

Route of infection: percutanious, sexual relations

means of spread: blood contamination

incubation period: 14-160 days

isolation: yes

period of communicability: from time of infection

symptoms start in 14-160 days

lab tests: antibody postive

clinical menifestations: vomiting yellow

Viral hepatitis

(pathophysiology)

injury, necrosis scarring of hepatic cells

inflammation--> cholestasis(bile stops) obstruction of bile ducts, venous blood flow

impaired liver funciton

Viral hepatitis

(Clinical manifestations)

prodromal- fatigue, dont feel very good

fever increases, GI symptoms, RUQ abdominal pain.

Jaundice (increase bilirubin), abnormal liver function tests. indirect of bilribin will go up and direct will go down, and will have a lot in your body

Viral hepatitis

(Complications)

Viral hepatitis

( pervention)

Alcohol cirrhosis

(Laennec's)

cirrhosis is a condition of irreversible liver disease due to the chronic inflammatory and toxic effects of ethanol on the liver.

cannot incorporate fatty acids nomally into lipoproteins for export.

• Jaundice
• fever
• enlarged, hard irregular liver
• weakness
• hepatomegaly
• edema everywhere
• gradual weight loss
• changes in bowel functions
• telangiectasis of cheeks and face (red)
• decreased mental function--> hepatic coma

nutritional needs for what:

increase protein and vitamins, small frequent meals, NG tube freeding, hyperalimentation

nutritional needs for what:

decrease proteins, increse calories, decrease sodium, decrease fluids

increase in pressure within the portal vein from obstruction of blood flow--> hepatomegaly and splenomegaly

esophageal varices, ascites, caput medusae and hemorrhoids

proteins convert to urea and ammonia

overall decrease in RBC, clotting factor may have problems bleeding

accumulation of free fluid in the peritoneal cavity, portal hepertension,

hyproalbuminemia-decreased oncotic pressure,

impaired hormone metabolism- increased ADH aldosterone, rennin, Na and water retention

increase liver enzymes, bilirubin, ammonia

decrease- albumin

prolonged prothrombin time

liver biopsy

treatment of the cause- ETOH, gallsotnes, chronic viral infection

surgical managment- procedures to relieve it

medical management- rest diet multivitamins, thiamine, vitamin K ETOH cessation

risk factors:

obestity, middle age, female, native american

clinical manifestations

of cholelithiasis

epigastric pain or RUQ pain, may be referred to mid- upper back, sub scapula, intolerance of fatty foods

color of stool- brown

infirect/direct belirubin may not be changed.

risk factor for what?

ETOH, gallbladder disease, PUD, trauma, hyperlipidemia, drugs, mumps

enzymes

amylase increases, lipase increases, trypsin, chymotrypsin, elastase-- self digestion

C reactive protein increases

demerol, not morphine, beacuse demerol causes less spasm of the sphincter of oddi

NPO

NG for decompression nad reduction of gastic secretion

Avid suppression

clincal manifestiations of what?

jaundice hepatomegaly, abdominal pain, weight loss, anorexia, enlarged gall bladder

for curable lesion fo the head of the pancreas includes:

1. pancreaticojejunostomy

2. choledochojejunostomy

3. gastrojejunostomy