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Nurse Practitioner (NP)
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Pathology
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Liver Disorders

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Pathology | Nurse Practitioner (NP) School Study Aid

Liver Disorders
13 Picmonics to Learn | 30 mins
Cirrhosis Assessment
Mechanism
Degeneration and Destruction of Liver Cells
Signs and Symptoms
Jaundice
Fatigue
Palmar Erythema
Spider Angiomas
Hepatosplenomegaly
Edema
Gynecomastia
Change in LOC
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2 mins
Cirrhosis Interventions
Interventions
Maintain Nutrition
Paracentesis
Esophageal and Gastric Varices
Drug Therapy
Endoscopic Band Ligation or Sclerotherapy
Balloon Tamponade
Transjugular Intrahepatic Portosystemic Shunt (TIPS)
Hepatic Encephalopathy
Lactulose
Antibiotics
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2 mins
Complications of Cirrhosis
Portal Hypertension
Ascites
Esophageal Varices
Coagulation Defects
Portal-Systemic Encephalopathy
Hepatorenal Syndrome
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1 min
Hepatitis A (HAV) Assessment
Transmission
Fecal-Oral
Ingestion of Contaminated Food or Water
Incubation
4 Weeks
Assessment
Fever
General Malaise
Hepatomegaly
Considerations
Self-Limiting
Proper Hand Washing
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2 mins
Hepatitis B (HBV) Assessment
Transmission
Bodily Fluids
Blood Transmission
People Who Use IV Drugs
Incubation
Variable 1-6 Months
Assessment
Fever
Nausea and Vomiting
Hepatomegaly
Chronic Disease
Cirrhosis
Hepatocellular Carcinoma
Considerations
Vaccination
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2 mins
Hepatitis C (HCV) Assessment
Transmission
Blood Transmission
High Risk Sex (rare)
IV Drug Users
Incubation
7 Weeks
Chronic Disease
Cirrhosis
Considerations
Barrier Protection
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2 mins
Gilbert's Syndrome
Pathophysiology
Decreased UDP-Glucuronosyltransferase Activity
Decreased Bilirubin Conjugation
Signs and Symptoms
Often Asymptomatic
Jaundice (Mild)
Fasting
Stress
Alcohol Intake
Labs
Increased Unconjugated Bilirubin
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2 mins
Crigler-Najjar Syndrome Type 1
Pathophysiology
Autosomal Recessive
Absent UDP-glucuronosyltransferase
Symptoms
Neonatal Jaundice
Kernicterus
Diagnosis
Normal Liver Function Tests
Elevated Unconjugated Bilirubin
Treatment
Phototherapy
Plasmapheresis
Calcium Phosphate and Orlistat
Death often by Age 2
Considerations
No Response to Phenobarbital
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3 mins
Budd-Chiari Syndrome
Causes
Pregnancy and Postpartum
Hematologic Disorders
Tumors
Chronic Infections
Mechanism
Thrombosis of Major Hepatic Veins
Centrilobular Congestion and Necrosis
Symptoms
Abdominal Pain
Ascites
Hepatomegaly
Nutmeg Liver
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3 mins
Acute Cholangitis Characteristics and Clinical Features
Characteristics
Biliary Tract Infection
Biliary Tract Obstruction
Clinical Features
Charcot's Triad
Fever
Jaundice
Abdominal Pain
Reynold's Pentad
+ Hypotension
+ Altered Mental Status
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2 mins
Ascending Cholangitis Diagnosis and Treatment
Imaging
ERCP
CT Scan
Ultrasound
Biliary Duct Dilation and/or Stones
Labs
Hyperbilirubinemia
Elevated Alkaline Phosphatase
Elevated GGT
Treatment
Broad Spectrum Antibiotics
Biliary Drainage
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4 mins
Hepatic Encephalopathy
Characteristics/Definition
Seen in the Setting of Cirrhosis
Hyperammonemia
Altered Mental Status
Coma
TIPS
Asterixis
Management
Lactulose
Rifaximin
Liver Transplant
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3 mins
Spontaneous Bacterial Peritonitis
Characteristics
Cirrhosis
Ascites
Monomicrobial
Clinical Features
Often Asymptomatic
Change in Mental Status
Abdominal Pain
Diagnosis
Paracentesis
PMN >250/mm3
Management
3rd Generation Cephalosporin
Albumin
Antibiotic Prophylaxis
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2 mins

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