Cirrhosis

Question 1

What is cirrhosis

Answer 1

Result of end stage liver disease
Irreversible
Loss of hepatic function
Liver can no longer regenerate

Question 2

Result of liver being unable to regenerate

Answer 2

Reduced liver blood flow
Reduced metabolic functions
Reduced plasma proteins

Question 3

Circulation changes

Answer 3

Kidneys detect low plasma volume and RASS system is activated leading to aldosterone release.
This ultimately results in ascites

Question 4

Pathology of the cirrhotic liver

Answer 4

Bands of fibrosis

Liver is shrivelled, shrunken, hard

Question 5

Causes of cirrhosis

Answer 5

Alcohol
NAFLD
Drugs 
Gallstones 
Autoimmune liver disease 
Liver failure

Question 6

Compensated cirrhosis - clinical presentation

Answer 6

No symptoms related to cirrhosis

Incidental finding - imaging abnormalities

Question 7

Compensated cirrhosis - clinical signs

Answer 7

Spider naevi
Palmar erythema
Clubbing
Gynaecomastia
Hepatosplenomegaly

Question 8

Decompensated cirrhosis - clinical presentation

Answer 8

Symptomatic complications related to cirrhosis

Question 9

Decompensated cirrhosis - clinical signs

Answer 9

Jaundice
Ascites
Encephalopathy
Bruising

Question 10

Complications of cirrhosis

Answer 10

Ascites
Portal hypertension
Liver failure

Question 11

Management

Answer 11

Remove liver - transplant
Treat underlying cause
Frequent meals and snacks