NUR 631 Exam 1 Test 2
- When differentiating dyspepsia from heartburn, the NP knows that heart- burn (2)
Answer 1) is commonly relieved by the ingestion of alkali (antacids)
2) is precipitated and aggravated by supine position.
- What are the 4 most common causes of dyspepsia?
- medication-induced (salicylates, corticosteroids, NSAIDs, erythromycin, theophylline)
Answer
- pylori
- Gardiasis
- Carcinoma
- When do you refer a patient with dyspepsia to a gastroenterologist?
Answer When other symptoms are present such as unexplained weight loss.
- What causes Jaundice?
Answer an accumulation of bilirubin in the blood
- jaundice is apparent when the serum bilirubin rises above what value?
Answer -
2.5-3.0 (normal = 0.3 - 1.0)
- Hyperbilirubinemia may be caused by a number of conditions / diseases such as anemias,
thalassemia, polycythemia, lead poisoning, CHF, contrast agents, neonatal liver, rare syndromes, hepatitis, pancreatitis, pancreatic can- cer, and many drugs. But the most common causes are directly due to (2) 1 / 3
Answer
- Cholestasis, either because of impaired bile formation and/or bile flow, which can be the
result of
1) extrahepatic biliary tract obstruction 2) hepatic parenchymal disease
- Initial bilirubin is unconjugated and NOT . Wh
and conjugated with glucuronic acid.
Answer water soluble
- Only bilirubin, by nature of its water solubility, is found in the
urine.
Answer CONJUGATED (direct)
- Serum levels of these transaminases are good indicators of hepatocyte damage from a
variety of causes
Answer aspartate aminotransferase (AST), normal = 5-60 alanine aminotransferase (ALT), normal = 5-43
- Because AST is also found in non-hepatic tissues such as skeletal muscle, heart, and brain
tissue, it is not as specific of a marker for hepatocyte damage as
Answer ALT
- When AST & ALT are elevated, but AST is higher, think
Answer "Acetaminophen, Statins, Tequila" 2 / 3
- Levels of AST & ALT below 300 U/L are nonspecific; however, some ex- treme
elevations can be diagnostic. For example, ALT/AST > 1,000 occur in patients with (3)
Answer
- acute viral hepatitis
- toxin or drug-induced hepatitis
- ischemic liver injury
- If the ratio of AST to ALT is 3-5x the norm, it generally indicates severe hepatic necrosis,
most often caused by
Answer alcoholic hepatitis
(or skeletal muscle injury secondary to seizure, protracted immobilization)
- The liver panel test includes AST, ALT, bilirubin and which other 4 labs?
Answer -
albumin, alkaline phosphatase, PT/INR, aPTT
- Simply stated, a serum bilirubin test shows if the liver is able/not able to
Answer rid itself of byproducts
- Jaundice + Pruritus + Dark Urine + Light-colored Stools + RUQ pain => intra or extra
hepatic cholestasis such as
Answer
- Cholelithiasis (gallstones)
- Cirrhosis
- Other biliary obstruction
- An enlarged but non-painful gallbladder + jaundice is called what sign?
- / 3
Answer