GI Exam 3: Hoehns 1

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Across
  1. 5. Product of hemoglobin breakdown that is conjugated with glucuronic acid in the liver before biliary excretion.
  2. 7. Classification of unpredictable drug-induced liver injury that is generally unrelated to dose and may develop days to months after exposure.
  3. 10. Intravenous formulation of acetylcysteine administered in a traditional three-infusion regimen totaling 300 mg/kg over 21 hours.
  4. 11. Endogenous antioxidant involved in detoxifying the reactive metabolite of acetaminophen.
  5. 12. Reactive acetaminophen metabolite formed through cytochrome P450 metabolism that can cause hepatocellular injury when glutathione stores become depleted.
  6. 16. Antidote for acetaminophen poisoning that replenishes glutathione stores through provision of cysteine.
  7. 18. Calculation using ALT and alkaline phosphatase relative to their upper limits of normal to classify the pattern of liver injury.
  8. 19. Enzyme originating from the liver and bone that becomes elevated with impaired biliary tract function and has a half-life of approximately seven days.
  9. 20. Pattern of drug-induced liver injury characterized by predominant ALT elevation and an R-ratio greater than five.
  10. 22. NSAID associated with a five- to tenfold greater risk of hepatotoxicity compared with other medications in its class.
  11. 24. Pattern of drug-induced liver injury involving both ALT and alkaline phosphatase elevations, with an R-ratio between two and five.
  12. 25. FDA reporting system used to document suspected medication-related adverse events, including drug-induced liver injury.
  13. 26. Biliary enzyme without a bone origin that helps determine whether an elevated alkaline phosphatase is hepatic in origin.
  14. 29. Neurologic complication in infants associated with elevated unconjugated bilirubin concentrations.
  15. 30. Nomogram used to assess the need for acetylcysteine treatment based on serum acetaminophen concentration and time after a single acute ingestion.
  16. 31. Analgesic and antipyretic responsible for dose-dependent hepatotoxicity through formation of a reactive metabolite.
  17. 32. Brand-name combination antibiotic associated with cholestatic liver injury and elevated alkaline phosphatase and bilirubin.
  18. 33. Medication class for which the FDA eliminated routine periodic liver enzyme monitoring in 2012, recommending baseline testing and subsequent testing when clinically indicated.
  19. 34. Antituberculosis medication associated with hepatocellular injury, with approximately 15–20% of patients experiencing elevated liver function tests according to the lecture.
Down
  1. 1. Online resource recommended for reviewing medications associated with drug-induced liver injury and their characteristic hepatotoxicity patterns.
  2. 2. Antimetabolite associated with cumulative hepatic toxicity and fibrosis through activation of hepatic stellate cells.
  3. 3. Gastrointestinal decontamination agent described as more effective than gastric lavage for reducing acetaminophen absorption.
  4. 4. Antiarrhythmic medication associated with cumulative-dose hepatotoxicity and drug-induced steatohepatitis.
  5. 6. NSAID associated with an increased risk of hepatotoxicity, typically developing within six to twelve weeks after initiation.
  6. 8. Antifungal medication associated with cholestatic hepatotoxicity, with an estimated incidence of approximately one in 50,000 patients in the lecture.
  7. 9. Aminotransferase found in the liver, heart, kidneys, brain, and muscle, with an AST-to-ALT ratio greater than two suggesting alcoholic liver disease.
  8. 13. Liver-synthesized clotting factor whose associated laboratory measurement helps assess hepatic synthetic function.
  9. 14. Marker of hepatic synthetic function with a relatively short half-life of approximately two days.
  10. 15. Patients who initially develop transient liver injury following medication exposure but subsequently demonstrate biochemical improvement.
  11. 17. Impairment or reduction of bile flow associated with elevated alkaline phosphatase and bilirubin concentrations.
  12. 21. Anticonvulsant associated with mixed-pattern liver injury and immunoallergic hepatotoxicity involving enzyme-drug adducts.
  13. 23. Aminotransferase enzyme more specific for hepatocellular injury than AST, also known as SGPT.
  14. 27. Brand-name acetylcysteine formulation discussed as an antidote for acetaminophen toxicity.
  15. 28. Principle identifying hepatocellular injury accompanied by jaundice as a warning sign for potentially severe or fatal drug-induced liver injury.
  16. 31. Type of reaction associated with intravenous acetylcysteine, occurring in approximately 5–10% of patients according to the lecture.