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Question Bank
- 1What are some complications dentists should consider when treating patients with liver disease?
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Excessive bleeding, acquiring infections, complications with drug metabolism (local anesthetics and pain meds), acquiring and transmission of Hepatitis B & C, and end stage liver disease/hepatocellular carcinoma/liver transplantation. - 2What is the largest internal organ?
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Liver - 3What is the term for the capsule of fibrous connective tissue surrounding the liver?
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Glisson's capsule - 4What are the main functions of hepatocytes?
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• Production of bile, plasma proteins, and amino acids, albumin • metabolism of fat, carbohydrate, and protein • storage of glucose, vitamins, and iron • breakdown of metabolic waste products, drugs, and toxins - 5What is jaundice?
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yellowing of the skin and eyes due to elevated bilirubin levels - 6List the clinical manifestations of liver failure.
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Jaundice, hypoglycemia, weight loss, peripheral edema, encephalopathy, prolonged/excessive bleeding, ascites, and organomegaly. - 7What is the primary cause of jaundice?
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The retention of bilirubin. - 8What symptom is associated with excessive bilirubin deposition?
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Pruritis (itchy skin). - 9Types of jaundice
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Prehepatic Intrahepatic Posthepatic - 10What is pre-hepatic jaundice?
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Increased destruction of RBCs - 11What causes intra-hepatic jaundice?
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Liver disease - 12What is post-hepatic jaundice?
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Decrease in bile released from the liver due to blockage - 13What is peripheral edema?
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Swelling in the lower extremities, especially the ankles and feet. - 14What is ascites?
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Accumulation of fluid in the abdominal cavity. - 15What is the term for the dark, bruise-like area in the image on the left?
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Ecchymosis - 16What is the term for the red, spider-like pattern in the image on the right?
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Spider angioma - 17Types of hepatic diseases
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• viral hepatitis • cirrhosis • drug induced liver failure • Hepatocellular Carcinoma - 18Types of Cirrhosis
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• Alcohol- Induced • Non-Alcoholic Fatty Liver Disease - 19What is Viral Hepatitis?
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A group of liver infections caused by viruses, including Hepatitis A, B, C, D, and E. - 20WHat types of liver disease is associated with Hep A and E
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acute liver disease - 21What types of liver disease is associated with Hep B/C/D
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acute and can become chronic - 22Which hepatitis viruses can cause hepatocellular carcinoma?
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Hepatitis B and C - 23What are the common symptoms of Hepatitis A, B, and C?
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Diarrhea, impaired appetite, fever, pain or discomfort in the abdomen, skin rash, joint pain, nausea, vomiting - 24What are the common symptoms of Hepatitis D?
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Fatigue, loss of appetite, jaundice - 25What are the two vaccines for hepatitis A&B?
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Hepatitis A and B vaccines - 26What are the three steps to avoid high-risk behavior for viral hepatitis?
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Good hygiene practices, don’t share needles, practicing responsible sexual activity - 27Treatment for viral hepatitis?
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Self-limiting Medical treatment with antivirals Transplant with chronic disease - 28What percentage of chronic liver disease in the Western world is caused by excessive alcohol consumption?
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60% - 29What are the characteristics of cirrhosis?
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Formation of fibrous bands and scars parenchymal nodules encircled by fibrous tissue disruption of the liver architecture - 30What is steatosis?
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Accumulation of fat in liver cells - 31What are Mallory bodies?
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Fibrous protein aggregates in liver cells - 32What is portal hypertension
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Increased resistance to portal blood flow - 33What is the dominant intrahepatic cause of portal hypertension?
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Cirrhosis - 34What is fibrosis and where is it deposited in the liver?
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deposition of connective tissue in the perisinusoidal areas & central veins causes compression and resistance to portal blood flow - 35What are esophageal varices?
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Dilated veins that develop within the lining of the lower esophagus. - 36What is the most common complication of esophageal varices?
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Variceal bleeding. - 37What is the cause of esophageal varices?
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A direct complication of portal hypertension. - 38What is Non-Alcoholic Fatty Liver Disease
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Excessive lipid storage in the liver NOT associated with alcohol consumption - 39What is the progression of NAFLD from healthy liver to hepatocellular carcinoma?
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Healthy Liver → NAFL → Nonalcoholic Steatohepatitis → Liver Cirrhosis → Hepatocellular Carcinoma - 40What are the risk factors shown in the slide?
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Type 2 diabetes, high cholesterol, high blood pressure, smoking, obesity, poor diet, and low activity levels. - 41What is the most common cause of drug-induced acute liver failure?
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Acetaminophen - 42Which class of drugs is commonly associated with hepatotoxicity?
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• Analgesics/Antipyretics - Tylenol • Anticancer drugs • Anesthetics • Antibiotics • Antituberculosis drugs • Antiretrovirals • Cardiac medications - 43What is hepatocellular carcinoma?
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A malignant disease of the liver - 44What physical examination finding is associated with hepatocellular carcinoma?
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A palpable mass - 45What are the symptoms of hepatocellular carcinoma?
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Abdominal pain, weakness, weight loss, increased risk of bleeding - 46What is the purpose of a liver transplant?
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To treat patients with end-stage liver disease - 47What are some conditions that can lead to a liver transplant?
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Autoimmune hepatitis, drug-induced hepatitis, viral hepatitis, malignancy - 48How do viral hepatitis and malignancy typically fare with liver transplant?
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Fare less well - 49What is cholestasis?
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Systemic retention of bilirubin, bile salts, and cholesterol. - 50What are the symptoms of cholestasis?
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Jaundice and intense itching due to bile salt deposition. - 51What is xanthelasma?
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Cholesterol deposits from impaired excretion. - 52What is the term for gallstones?
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Cholelithiasis - 53What is the female predilection for gallstones?
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Female predilection - 54At what age does gallstones typically occur?
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25 years of age and up - 55Symptoms and treatment of Cholelithiasis
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stomach pain Gall bladder removal to resolve the disorder - 56What tests should be requested for med consult of liver diseases
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• Aspartate aminotransferase test (AST) • Alanine transaminase test (ALT) • serum albumin • serum alkaline phosphatase • Hepatitis Anti-body serum test • CBC w/diff • Bilirubin levels - 57What is the primary focus of dental modifications?
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Infection control - 58What precautions should be taken with patients who have liver transplants?
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Patients are taking immunosuppressant medications