Portal Hypertension

Question 1

What is are the 7 causes of cirrhosis?

Answer 1

1. Chronic alcoholism
2. Hepatitis B
3. Hepatitis C
4. Hemochromatosis
5. Wilson’s disease
6. Biliary cirrhosis
7. Sclerosing cholangitis

Question 2

What is cirrhosis?

Answer 2

Disease where the liver becomes hard, shrunken, scarred, and laced with thick bands of fibrotic tissue.

Question 3

What is hemochromatosis?

Answer 3

Iron overload

Question 4

What is Wilson’s Disease?

Answer 4

Altered copper metabolism

Question 5

What are the 3 major complications of cirrhosis?

Answer 5

1. Metabolic abnormalities
2. Portal hypertension
3. Hepatic encephalopathy

Question 6

What 2 metabolic abnormalities occur in cirrhosis?

Answer 6

1. Albumin and cholesterol levels fall

2. Prothrombin time increases

Question 7

What is the cause of metabolic abnormalities in cirrhosis?

Answer 7

Inability of the liver to manufacture proteins in the coagulation cascade

Question 8

Decreased plasma K+ and Na+ levels usually lead to the onset of? What is the name of this syndrome?

Answer 8

Renal failure. This is called hepatorenal syndrome.

Question 9

How does cirrhosis affect blood flow?

Answer 9

It causes increased resistance to the blood flow coming into the liver.

Question 10

When does portal hypertension arise? (2)

Answer 10

1. Portal venous pressure rises.

2. Increased pressure in splanchnic capillaries.

Question 11

What is the end result of portal hypertension?

Answer 11

Abdominal edema

Question 12

What is the advanced stage of abdominal edema?

Answer 12

Ascites

Question 13

What is ascites?

Answer 13

Fluid accumulation in the peritoneal cavity

Question 14

As the portal pressure rises, a portion of the portal blood begins to flow through and dilate the?

Answer 14

Portal anastomoses

Question 15

Where are the anastomoses located?

Answer 15

1. Esophagus
2. Umbilicus
3. Rectum
4. Retroperitoneum

Question 16

What is esophageal varices?

Answer 16

When dilation of the vessels in the esophagus leads to burst and cause hemorrhage.

Question 17

What is sclerotherapy?

Answer 17

Injection of sclerosing agents in someone with esophoageal varices.

Question 18

What are the 4 complications/side effects of sclerotherapy?

Answer 18

1. Perforation
2. Stricture formation
3. Infection
4. Aspiration

Question 19

How can you prevent rupture of varices is some patients?

Answer 19

Place a hepatic portosystemic shunt

Question 20

How do you put in a hepatic portosystemic shunt?

Answer 20

1. Go through jugular vein
2. Go into liver
3. Put stent between branch of hepatic and portal veins

Question 21

What is the end result of a hepatic portosystemic shunt?

Answer 21

Allow portal blood to flow into the vena cava

Question 22

What is portacaval shunt?

Answer 22

A shunt linking the portal vein and the vena cava.

Question 23

What is a downside of a portacaval shunt?

Answer 23

Hepatic encephalopathy

Question 24

What is a splenorenal shunt?

Answer 24

A shunt that diverts only a portion of the blood away from the liver. (most popular method)

Question 25

Which organ is important for the removal and inactivation of toxic metabolites?

Answer 25

The liver

Question 26

If toxins build up in the plasma, what can happen?

Answer 26

They can pass through the blood brain barrier and cause acute delirium.