AMMONIA LEVELS IF ELEVATED IN LIVER FAILURE ,CIRRHOSIS,HEPATIC ENCEPHALOPATHY

10-80 UG/DL

INDIRECT BILLIRUBIN

0.2-0.8 MG/DL

DIRECT BILLIRUBIN

0.03 MG/DL

TOTAL BILIRUBIN

0.2-1.2 MG/DL

ALP

40-120

LIVER ENZYMES ALT

15-40 UL

WHAT TEST FOCUS ON LIVER

BILLARY TEST

LIVER ENZYMES AST

10-40 UL

PHOSPHOROUS

2.5-4.5

CL-

98-106

MG2+

1.5-2.5

CA2+

8.2-10.2

ELECTROLYTES K+

3.5-5.O

ELECTROLYTES NA +

135-145

Prothrombin time (pt)

10-13 seconds elevated on billiary obstruction, cirrhosis AND VITAMIN K DEFICIENCY AND FOR THOS ON WARAFIN 9 ANTICOAG THERAPY

platelets testing for bruising

150,000 -400,000

hematocrit bleeding in body

female

37-47 percent

Hematocrit any bleeding body for men

42-52 percent

Hemoglobin female

12-16

Hemoglobin Male

42-52 percent

rbc female

4.2 to 5.4

rbc male

4,7-6.1

wbc

5,00-10,000

when fatty meals get released to duodenum when bad can develope jaundice

which you end up being in pain from greasy pizza

when a resident has a decreased appetite and everything is rule out

think of depression

synthesis of plasma proteins

The liver synthesizes albumin,clotting factors, and globulin.Albumin is the most abundant plasma protein; it maintains osmotic balance.

when you have to much diarhea what happens to body

dehydration and electrolytes and potassium levels get low

nsaids , aleeve and asprin does what

Gives uclers

black stool

upper gi bleed or different medication can make it greenish black

peptobismol does what

turns stool black

bright red bleeding in bm

lower gi bleed or hemroids

opiod and iron does what

constipate

diverticulosis

as you age most of the time in large colon develope little pockets

the liver stores what

adek and fat soluble

phagpcytosis by kuffer cells

fixed macropages of the liver phagocytize worned formed elements and pathogens

ERCP (endoscopic retrograde cholangiopancreatography)

Endoscope through stomach if their are stones it will crush them !

colonoscopy

scope light, Gi doctor will go through the rectum Must be bowel prep Miralax and gatorade

no blue,red or purple dies,invasive procedure must have consent iron and coagulants physician may stop you must have a driver and you are put to sleep clear liquid diet

must monitor rectal bleeding and you want patient to pass gas

why they do Edg

to check for cancer,ulcers, gerd

globulin functions

include becoming part of lipoproteins,acting as carriers and acting as antibodies

edg

massive procedure upper scope/fast, need conscious consent anything invasive you need consent must have a driver 12 to 24 hours no food or drink

what happens when ast is in the liver, pancreas what disease could happen

acute hapatitis especially viral hepatocellular disease, shock, and acute pancreatitis.

moderately in billary tract obstruction,cirrhosis,chronic hepatitis, and liver tumors

aspartate aminotransferase -AST

enzyme found in large amounts in the liver and myocardial tissue, and smaller amounts in the pancreas muscles, kidneys, red blood cells, and brain it is release into bloodstream with tissue damage levels reflect with degree of damage

blood in stool

may indicate hemorrhoids, signs of cancer, or inflamatory diseases suchas ulcerative colitis

nausea,vomiting,bloating, excess gas

can be associated with gi disorders

fatty stools

pancreatic disease

clay colored stool

liver or gallbladder disease

clotting factors

produced by the live include prothrombin and fibrinogen which circulate the blood untill need for coagulation.

black colored stools

bleeding

hepatobillary scan

liver and gallbladder Npo must stay still

barium enema radiographic test

Goes up the rectum to high descending colon must have laxatives the day before to be cleaned out npo after testing force fluids encouraged fluids

Radiographic tests

barium swallow

you drink barium drink must be npo after procedure as long as they are not on fluid restriction force fluid clients may have white stools after and may need to order laxatives

lipid metabolism

the liver forms lipoproteins for transport of lipids of the blood to the other tissues.Liver also synthesize cholesterol and excretes excess cholesterol into bile to be excreted

essential amino acids are acquired by

diet

Amino acid Metabolism

The liver regulates the blood levels of amino acids based on tissue needs for protein synthesis of 20 amino acids needed to produce human protein the liver is able to sythesize 12.

carbohydrate metabolism

The liver regulates the blood glucose level by storing excess glucose as glycogen and performing glycogenolysis when blood glucose level is low.

If a person has messed up teeth

be aware of aspiration

aging and gastrointestinal system

decreased hcl, decreased mucous secretions,decreased elasticity to the rectal wall, weakness of intestinal wall

ALCOHOL AND GALLBLADDER ISSUES

Are specific for Gallbladder issues

aging and gastrointestinal system

weaker gag reflex / hcl backup,tooth loss, saliva production decreased

esophagus motility is less empty slower

AMYLASE and Lipase

WHEN HIGH CAN MAYBE HAVE PANCRIATITIS

BROKEN DOWN RED BLOODCELLS

TURNS INTO BILLIRUBIN

NEPHROLYSTATIS

KIDNEYSTONES

CHOLESTIAS

GALLSTONES

WHAT VITAMINS METABOLIZE MEDICATION

ADEK

IF YOUR BILLIRUBIN IS HIGH

HIGH IS FOR JAUNDICE

THE LIVER ACTIVATES WHAT

VITAMIN D

WHERE IS BILLI RUBIN MADE

LIVER AND SPLEEN

BILE IS STORE IN THE GALLBLADER AND MADE WHERE

THE LIVER

THE REASON WHY HYDROCLORIC ACID DONT EAT AT THE STOMACH

THE MUCOUS LINES IT

WHATS THE CLOTTING MECHANISM FOR THE STOMACH

BLOODVESSELS CONSTRICT PLATELETS GATHER TO FORM A PLUG AND COAGULANTS CASCADE CREATES A STABLE FIBRIN MESH

WHAT DOES TRYPSIN DO WHEN RELEASED FROM PANCREAS

CONVERTS POLYPEPTIDES TO PEPTIDES

WHAT DOES LIPASE DO WHEN RELEASED FROM FROM PANCREAS

CONVERTS EMULSIFIED FATS TO FATTY ACIDS AND GLYCEROL

WHAT DOES AMYLASE FROM PANCREAS WHEN RELEASED FROM PANCREAS

CONVERTS STARCH TO MALTOSE

bile salts in liver

emulsify fats

where is the liver and gallbladder, what side of the body.

Located on the right side of the body.

how many click sounds for a normal bm

5 to 30

how many click sounds for a hyperactive bm

30 plus

how many clicks for a hypoactive bm sound

fewer then 5 sounds per minute

how long should you ausultate

5 mins in total

carbohydrates are mostly digested where

the stomach

what happens when pyloric sphincter contracts

the stomach churns and relaxes at intervals so small amounts of chyme can go into the duodenum

what is the lumen surrounded by

The lower esophageal sphincter which relaxes to allow food bolus to enter stomach and contracts to prevent backflow of stomach contents

what happens if to much bile comes out

You can become Jaundice

where does most digestion occur

duodenum

what does the liver produce

It produces bile to break down fats

the end products of digestions goes where

absorbed back into the blood and lymph

The pylorus sphincter

guards entry to duodenum which is part of the small intestine

hepatopancreatic ampulla vater

is the entrance of the common bile duct and the pancreatic duct

The presence of food stimulates what

The parasympathetic sympathetic response which releases gastrin by gastrin mucosa which increases gastric juice

what does the pyloric sphincter do