Hepatobiliary and Pancreatic Disorders Flashcards

A patient with cirrhosis develops confusion, asterixis, and an elevated ammonia level. Which intervention is the priority?

Answer: Administer lactulose as ordered

Lactulose reduces ammonia absorption in the colon by acidifying the gut lumen, making it the first-line treatment for hepatic encephalopathy.

Which finding on a liver biopsy is most characteristic of primary biliary cholangitis (PBC)?

Answer: Granulomatous destruction of bile ducts

PBC is characterized by autoimmune granulomatous destruction of interlobular and septal bile ducts, which is pathognomonic for this condition.

A patient presenting with severe epigastric pain radiating to the back, elevated lipase, and grey-Turner sign most likely has which condition?

Answer: Acute hemorrhagic pancreatitis

Grey-Turner sign (flank ecchymosis) indicates retroperitoneal hemorrhage, which combined with elevated lipase and epigastric pain is consistent with acute hemorrhagic pancreatitis.

Which lab abnormality pattern is most consistent with obstructive jaundice from a common bile duct stone?

Answer: Elevated direct bilirubin, markedly elevated ALP and GGT

Obstruction of bile flow leads to conjugated (direct) hyperbilirubinemia along with marked elevation of cholestatic markers ALP and GGT.

During ERCP for suspected choledocholithiasis, the nurse notices the patient's oxygen saturation drops to 88%. What is the first action?

Answer: Notify the physician and apply supplemental oxygen

Desaturation during ERCP is a sedation-related adverse event; the nurse must immediately notify the physician and apply supplemental oxygen to prevent hypoxic injury.

A patient with autoimmune hepatitis is most likely to have which serologic marker?

Answer: Anti-smooth muscle antibody (ASMA)

Anti-smooth muscle antibody (ASMA) is the hallmark serologic marker of type 1 autoimmune hepatitis, often accompanied by elevated IgG levels.

Which complication of acute pancreatitis involves liquefied necrotic pancreatic tissue enclosed in a fibrous wall?

Answer: Walled-off necrosis (WON)

Walled-off necrosis (WON) is a mature, encapsulated collection containing both liquid and solid necrotic debris that develops after necrotizing pancreatitis, distinct from a pseudocyst which contains only fluid.