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Abdo Medicine > Cirrhosis > Flashcards

Cirrhosis Flashcards

1
Q

What is the definition of cirrhosis

A

Irreversible damage to the liver resulting in loss of normal liver structure with fibrosis and nodular regeneration. It is the final stage of any chronic liver disease

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2
Q

What are the common causes of cirrhosis

A

Chronic Hep C
Alcoholic liver disease
Non-alcoholic fatty liver disease (steatohepatitis)
Chronic Hep B

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3
Q

What are some other less common causes of cirrhosis

A

Metabolic disorders:-
Haemochromatosis
Wilson’s disease
Alpha 1-antitrypsin deficiency

Autoimmune conditions:-
Primary biliary cirrhosis
Primary sclerosing cholangitis
Autoimmune hepatitis

Drugs:-
Amiodarone
Methotrexate

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4
Q

What are signs of chronic liver disease

A 
Spider naevi
Palmar erythema
Gynecomastia
Testicular atrophy
Clubbing
Anaemia
Prominent umbilical veins
Malnutrition/weight loss
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5
Q

What are come complications of cirrhosis

A

Liver failure (decompensation)
Portal hypertension
Hepatocellular carcinoma
Hepatorenal syndrome

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6
Q

What is hepatorenal syndrome

A

Development of renal failure in patients with advanced chronic liver disease

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7
Q

What are the effects of portal hypertension

A

Splenomegaly
Oesophageal varices
Caput medusae

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8
Q

What blood tests would you want to do in a patient with cirrhosis

A 
FBC
U+Es
Coagulation
LFTs - reduced albumin with progressive liver damage
Hepatitis screen
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9
Q

How do you classify the severity of liver disease

A

Child-Pugh classification

Clinical and biochemical measures of liver disease. Graded into group A-C

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10
Q

What is looked at in the Child-Pugh classification

A 
Serum Albumin
Serum Bilirubin
Clotting: PT time or INR
Distension: Ascites
Encephalopathy
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11
Q

What is class A on the Child-Pugh classification

A

5-6 points

100% 1-year survival

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12
Q

What is class B on the Child-Pugh classification

A

7-9 points

81% 1-year survival

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13
Q

What is class C on the Child-Pugh classification

A

Greater than or equal 10 points

45% 1-year survival

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14
Q

What medication is used for pruritus in cirrhosis

A

Cholestyramine

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15
Q

What is cholestyramine

A

Bile acid sequestrant

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16
Q

How would you treat a patient with hepatorenal syndrome?

A

IV albumin and terlipressin
Haemodialysis- supportive
Liver transplant- treatment of choice

17
Q

What is the prognosis for hepatorenal syndrome?

A

Type 1: Rapidly progressive, less than 2 weeks survival

Type 2: Steady deterioration, ~6 weeks survival

Abdo Medicine (14 decks)

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