63. Budd-Chiari syndrome Flashcards Preview

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Flashcards in 63. Budd-Chiari syndrome Deck (9)
1

defintion / mechanism

thrombosis or compression of hepatic veins with centrilobular congestion and necrosis --> congestive liver

2

symptoms / findings

1. hepatomegaly 2. ascites 3. varices
4. abdominal pain 5. Liver failure 6. may cause nutmeg liver ( mottled appearance )
ABSENCE OF JVD

3

causes of budd- chiari syndrome

1. hypercoagulable states
2. polycythemia vera
3. postpartum state
4. hepatocellular CA
5. paroxysmal noctural hemoglobinuria

4

• The liver of your patient with hepatic vein thrombosis is mottled, similar to nutmeg. If this condition persists, what outcome might occur?

Centrilobular congestion and necrosis can be expected, possibly leading to cirrhosis if it persists (this is Budd-Chiari syndrome)

5

• In Budd-Chiari syndrome, there is occlusion of the ____ vena cava and/or the ____ veins.

Inferior; hepatic

6

• What liver region becomes congested and necrotic in Budd-Chiari syndrome?

The centrilobular region

7

• A patient with polycythemia vera develops new-onset ascites, abdominal pain, and elevation of liver enzymes. What do you suspect?

Congestive liver failure secondary to Budd-Chiari syndrome

8

• What medical conditions are often associated with Budd-Chiari syndrome?

Polycythemia vera, pregnancy (postpartum state), hypercoagulable states, hepatocellular carcinoma

9

• A patient with known hypercoagulability has developed ascites with visible abdominal and back veins. What exam finding can rule out HF?

Absence of JVD would support Budd-Chiari syndrome (the occlusion is distal) instead of HF

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