Essentials Of Pathophysiology Concepts of Altered States 4th Edition By Porth
Essentials Of Pathophysiology Concepts of Altered States 4th Edition By Porth
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Chapter 30- Disorders of Hepatobiliary and Exocrine Pancreas Function
Complete Chapter Questions With Answers
Sample Questions Are Posted Below
| 1. | The role Kupffer cells play in removing harmful substances or cells from the portal blood as it moves through the venous sinusoids is known as: | |
| A) | Filters | |
| B) | Channels | |
| C) | Phagocytes | |
| D) | Cytotoxic cells | |
| Ans: | C | |
| Feedback: | ||
| The venous sinusoids are channels lined with two types of cells: the typical endothelial cells and Kupffer cells. Kupffer cells are reticuloendothelial cells that are capable of removing, engulfing, and phagocytizing old and defective blood cells, bacteria, and other foreign material from the portal blood as it flows through the sinusoid. This phagocytic action removes the enteric bacilli and other harmful substances that have filtered into the blood from the intestine. Kupffer cells do not have cytotoxic capabilities. | ||
| 2. | A liver failure client asks, “How does the liver process ammonia in healthy individuals?” The health care provider explains that ammonia is toxic to tissues, especially neurons, so this ammonia is removed from the blood by the liver, which: | |
| A) | Converts it into bilirubin, which is then excreted intestinally | |
| B) | Processes ammonia into nitrogen and hydrogen ions for excretion | |
| C) | Processes it into urea, releasing it into the circulation | |
| D) | Combines it with oxygen to create ammonium oxide | |
| Ans: | C | |
| Feedback: | ||
| The ammonia that is released during the deamination process is rapidly removed from the blood by the liver and converted to urea, which is then released into circulation for removal by the kidneys. | ||
| 3. | A newborn is admitted to the hospital with a high bilirubin level of 13 mg/dL. The assessment data related to this lab value includes: Select all that apply. | |
| A) | Yellowish discoloration of the skin | |
| B) | Colicky, intermittent pain associated with formula feeding | |
| C) | Xanthomas | |
| D) | Yellowing of the sclera of the eye | |
| E) | Dark-colored urine | |
| Ans: | A, D, E | |
| Feedback: | ||
| Jaundice (i.e., icterus) results from an abnormally high accumulation of bilirubin in the blood, as a result of which there is a yellowish discoloration to the skin and deep tissues. Because normal skin has a yellow cast, the early signs of jaundice often are difficult to detect, especially in persons with dark skin. Bilirubin has a special affinity for elastic tissue. The sclera of the eye, which contains a high proportion of elastic fibers, usually is one of the first structures in which jaundice can be detected. Because intrahepatic jaundice usually interferes with all phases of bilirubin metabolism, both conjugated and unconjugated bilirubin are elevated, the urine often is dark because of bilirubin in the urine. Skin xanthomas (focal accumulations of cholesterol) may occur with cholestasis, the result of hyperlipidemia and impaired excretion of cholesterol. Intrahepatic cholestasis, rather than hyperbilirubinemia, causes primary biliary cirrhosis. | ||
| 4. | A client’s long-standing diagnosis of congenital hemolytic anemia often manifests itself with jaundice. What type of jaundice does this client most likely experience? | |
| A) | Prehepatic | |
| B) | Intrahepatic | |
| C) | Posthepatic | |
| D) | Infectious | |
| Ans: | A | |
| Feedback: | ||
| The major cause of prehepatic jaundice is excessive hemolysis of red blood cells. Hemolytic jaundice occurs when red blood cells are destroyed at a rate in excess of the liver’s ability to remove the bilirubin from the blood. Intrahepatic jaundice involves dysfunction of the liver itself, whereas posthepatic causes usually involve obstruction. The classification of jaundice does not include an infectious type. | ||
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