Notes in 34 Liver

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Published	12/13/2023	{{c2::Glycogenolysis}} is the conversion of {{c1::glycogen to glucose}}
Published	12/13/2023	Lipids are stored as energy in the form of {{c1::triglycerides}}.
Published	12/13/2023	The normal RBC lifespan is {{c1::120}} days.
Published	12/13/2023	At the right midaxillary line, the liver extends from the {{c1::6th}} → {{c1::10th}} intercostal spaces.
Published	12/13/2023	Hepatic {{c1::lobules}} are anatomical units of the liver arranged around a {{c2::centrilobular}} vein.
Published	12/13/2023	Hepatic {{c1::acinus}} are functional units of the liver served by the {{c2::hepatic}} arteries.
Published	12/13/2023	Which zone of hepatic cells are best oxygenated?{{c1::Zone 1}}
Published	12/13/2023	The {{c1::sinusoidal channels}} serve as capillaris feeding the hepatic cells.
Published	12/13/2023	What cells produce bile?{{c1::Hepatocytes}}
Published	12/13/2023	In the liver, lymph and proteins drain into the {{c1::space of Disse}} → lymphatic duct.
Published	12/13/2023	What organ is responsible for ~50% of total lymph production?{{c1::Liver}}
Published	12/13/2023	What is the normal sinusoidal pressure (liver)?{{c1::0 mmHg}}
Published	12/13/2023	What portal vein pressure is diagnostic for portal hypertension?{{c1::> 20 mmHg}}
Published	12/13/2023	What sinusoidal pressure is diagnostic for portal hypertension?{{c1::> 5 mmHg}}
Published	12/13/2023	Portal perfusion pressure = {{c1::portal vein pressure - hepatic vein pressure}}
Published	12/13/2023	Hepatic artery perfusion pressure = {{c1::MAP - hepatic vein pressure}}
Published	12/13/2023	How does SNS stimulaltion affect hepatic blood flow?{{c1::Decreased (via increased splanchic vascular resistance)}}
Published	12/13/2023	How does positive-pressure ventilation affect hepatic blood flow?{{c1::Decreased (via increased CVP)}}
Published	12/13/2023	What β-blocker can reduce hepatic blood flow?{{c1::Propanolol}}
Published	12/13/2023	What cells produce von Willebrand factor?{{c1::Vascular endothelial cells}}
Published	12/13/2023	What cells produce factor III?{{c1::Vascular endothelial cells}}
Published	12/13/2023	Where is plasminogen synthesized?{{c1::Liver}}
Published	12/13/2023	How do decreased levels of proteins (e.g. liver disease) affect the volume of distribution?{{c1::Increased}}
Published	12/13/2023	How do decreased levels of plasma proteins (e.g. liver disease) affect the vascular oncotic pressure?{{c1::Decreased}}
Published	12/13/2023	{{c1::Gluconeogenesis}} is the conversion of {{c2::non-carbohydrates}} to glucose.
Published	12/13/2023	Conjugated bilirubin is eliminated in the {{c1::stool}}.
Published	12/13/2023	A normal albumin level is {{c1::3.5}}-{{c1::5.0}} g/dL.
Published	12/13/2023	A normal AST is {{c1::10}}-{{c1::40}} units/L.
Published	12/13/2023	A normal ALT is {{c1::10}}-{{c1::55}} units/L.
Published	12/13/2023	An elevated {{c1::AST or ALT}} is suggestive of hepatitis.
Published	12/13/2023	A normal bilirubin level is {{c1::0}}-{{c1::11}} units/L.
Published	12/13/2023	What is the most specific indicator of biliary duct obstruction?{{c1::5'-nucleotidase (5'-NT)}}
Published	12/13/2023	What type of liver disease is characterized by elevated AST and ALT?{{c1::Hepatocellular injury}}
Published	12/13/2023	How does hepatocellular injury affect the prothrombin time?{{c1::Increased}}
Published	12/13/2023	How does hepatocellular injury affect the bilirubin?{{c1::Increased conjugated}}
Published	12/13/2023	How does cholestatic injury affect the bilirubin?{{c1::Increased conjugated}}
Published	12/13/2023	What is the route of transmission for hepatitis A?{{c1::Oral-fecal}}
Published	12/13/2023	What is the route of transmission for hepatitis B?{{c1::sexual contact, blood}}
Published	12/13/2023	What is the route of transmission for hepatitis D?{{c1::blood}}
Published	12/13/2023	What is the recommended prophylaxis after exposure to blood from a hepatitis A positive patient?{{c1::pooled gamma globulin a…
Published	12/13/2023	What is the recommended prophylaxis after exposure to blood from a hepatitis C positive patient?{{c1::interferons + ribavirin…
Published	12/13/2023	What serum marker is seen in early hepatitis A?{{c1::IgM}}
Published	12/13/2023	What serum antibody is seen in late hepatitis A?{{c1::IgG}}
Published	12/13/2023	What serum antibody is seen in hepatitis B?{{c1::HbsAg}} and {{c2::Anti-HBcAg}}
Published	12/13/2023	What serum antibody is seen in hepatitis C?{{c1::Anti-HCV}}
Published	12/13/2023	What serum antibody is seen in hepatitis D?{{c1::Anti-HDV}}
Published	12/13/2023	What type of hepatitis primarily occurs as a co-infection with hepatitis B?{{c1::Hepatitis D}}
Published	12/13/2023	What drugs induce CYP-2E1?{{c3::Alcohol}}, {{c2::isoniazid}}, and {{c1::phenobarbital}}
Published	12/13/2023	Alcohol hepatitis is characterized by {{c1::hepatomegaly}} on physical exam.
Published	12/13/2023	What renal disease may be caused by chronic hepatitis?{{c1::Glomerulonephritis}}
Published	12/13/2023	What cardiac disease may be caused by chronic hepatitis?{{c1::Myocarditis}}
Published	12/13/2023	Chronic hepatitis decreases platelet {{c1::quantity (thrombocytopenia)}}.
Published	12/13/2023	Which volatile anesthetic reduces hepatic blood flow the most?{{c1::Desflurane}}
Published	12/13/2023	How does PEEP affect hepatic blood flow?{{c1::Decreased}}
Published	12/13/2023	How does liver failure affect succinylcholine?{{c1::Increased duration of action (theoretically)}}
Published	12/13/2023	How does liver failure affect rocuronium?{{c1::Decreased biliary excretion}}
Published	12/13/2023	Alcohol inhibits {{c1::NMDA}} receptors.
Published	12/13/2023	Disulfiram is {{c1::hepato}}-toxic.
Published	12/13/2023	Disulfiram inhibits {{c1::dopamine β-hydroxylase::enzyme}}.
Published	12/13/2023	Disulfiram causes {{c1::hypo}}-tension.
Published	12/13/2023	{{c1::Right}}-sided heart failure can cause cirrhosis.
Published	12/13/2023	The presence of {{c1::nodules}} due to liver cirrhosis causes {{c2::portal hypertension}}.
Published	12/13/2023	Cirrhosis is characterized by a decreased number of {{c1::hepatocytes}}.
Published	12/13/2023	What Child-Pugh score is considered optimized for surgery?{{c1::Class A/B}}
Published	12/13/2023	What is the effect of cirrhosis on peripheral blood flow?{{c1::Increased (shunting)}}
Published	12/13/2023	What is the effect of cirrhosis on vasopressor responsiveness?{{c1::Increased}}
Published	12/13/2023	Cirrhosis causes {{c2::diastolic}} dysfunction of the heart.
Published	12/13/2023	Does cirrhosis cause respiratory alkalosis or acidosis?{{c1::Respiratory alkalosis}}
Published	12/13/2023	What effect does cirrhosis have on renal function?{{c1::Decreased GFR}}
Published	12/13/2023	What is the definitive treatment for hepatorenal syndrome?{{c1::Liver transplant}}
Published	12/13/2023	What is the major complication for a TIPS procedure?{{c1::Hemorrhage}}
Published	12/13/2023	What TEE views should be avoided in a patient with esophageal varices?{{c1::Transgastric}}
Published	12/13/2023	Just before {{c1::clamping the IVC}} during liver transplantation, the CVP should be increased to {{c2::10 cm H2O}}.
Published	12/13/2023	What IVC clamp technique produces the most preload reduction during the anhepatic phase of liver transplantation?{{c1::Bicaval clamp}}
Published	12/13/2023	What IVC clamp technique produces the partial preload reduction during the anhepatic phase of liver transplantation?{{c1::Piggyback clamp}}
Published	12/13/2023	What hepatic isolation technique decreases the risk of hemodynamic instability during the anhepatic phase of liver transplantation?{{c1::Ven…
Published	12/13/2023	What sites are cannulated for venovenous bypass for liver transplantation?Outflow:: {{c1::femoral}} vein, {{c1::portal}} veinInflow: {{c2::axillary}} …
Published	12/13/2023	How does IVC clamping affect the preload?{{c1::Decreased}}
Published	12/13/2023	How does IVC clamping affect the cardiac output?{{c1::Decreased}}
Published	12/13/2023	What phase of liver transplantation surgery is associated with no liver function?{{c1::Anhepatic phase}}
Published	12/13/2023	What is the maximum warm ischemic time for a donor liver?{{c1::60 minutes}}
Published	12/13/2023	{{c1::Post-reperfusion}} syndrome in the neohepatic phase is defined as hypotension > {{c2::30}}% from baseline for at least 1 minute during the fi…
Published	12/13/2023	What type of neuraxial anesthesia is used for liver transplant patients?{{c1::None - due to risk of coagulopathies}}
Published	12/13/2023	What is the primary risk associated with antirejection medications (transplant)?{{c1::Infections}}
Published	12/13/2023	What phase of liver transplantation is associated with a high risk of pulmonary aspiration?{{c1::Pre-anhepatic phase}}
Published	12/13/2023	Obstruction of what duct can cause distension of the gallbladder?{{c1::Cystic duct}}
Published	12/13/2023	Obstruction of what duct can cause cholecystitis, jaundice, and pancreatitis?{{c1::Common bile duct}}
Published	12/13/2023	What biliary complication is associated with rapid weight loss?{{c1::Cholesterol gallstone}}
Published	12/13/2023	Risk factors that increase the risk of {{c4::gallstones}} can be memorized by the "Three F's"{{c1::Fat}}{{c2::Female}}{{c3::Forty (40)}}
Published	12/13/2023	How do biliary pathologies (e.g. cholecystitis) affect amylase levels?{{c1::Increased}}
Published	12/13/2023	Prolonged NPO status increases the likelihood of {{c2::gallstone}} formation due to lack of {{c1::cholecystokinin}} release.
Published	12/13/2023	What paralytics should be used for patients with hepatic dysfunction?{{c1::Benzylisuoquinolines (Atracurium, cisatracurium)}}
Published	12/13/2023	How does glucagon affect PONV?{{c1::Increases risk for PONV}}
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