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Clinical Alimentary System > Effects of Cirrhosis > Flashcards

Effects of Cirrhosis Flashcards

1
Q

After what time frame does acute liver disease become chronic liver disease

A

6 months

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2
Q

What happens to the liver in end stage chronic liver disease

A

Cirrhosis

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3
Q

What conditions can occur in the body as a result of liver cirrhosis (x5)

A 
Ascites 
Heptorenal syndrome 
Variceal bleeding 
Hepatic encephalopathy 
Hepatocellular carcinoma
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4
Q

What can cause liver cirrhosis (x10)

A 
Alcohol 
Autoimmune disease
Haemochromatosis 
Viral hepatitis B and C 
Cryptogenic 
Non-alcohol fatty liver disease 
Drugs 
Cystic fibrosis
Vascular problems 
Sarcoidosis
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5
Q

What is Ascites

A

Abnormal build up of fluid in the abdomen

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6
Q

What volume of fluid is present in ascites and what cavity does it lie

A

> 25ml

Peritoneal cavity

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7
Q

What are the presenting symptoms of ascites

A

Ballooning belly
Rapid weight gain
Feel full all the time

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8
Q

What investigations are used for ascites

A

Percussion/auscaltation

Ultrasound - for confirmation

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9
Q

What does ascites sound like on percussion/ausciltation

A

Dullness in flanks

Shifting dullness

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10
Q

What procedure needs to be carried out on patient with new onset ascites

A

Paracentesis

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11
Q

What can be checked by doing a paracentesis

A

Cell count
albumin
Protein
SAAG (serum ascites albumin gradient)

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12
Q

What does a SAAG of >1.1g/dl sugest

A

Portal hypertension
Chronic heart failure
Pericarditis

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13
Q

What does a SAAG of <1.1g/dl sugest

A

Malignancy

Tuberculosis

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14
Q

What are treatment options available for people with Ascites

A 
Diuretics 
Large volume paracentesis 
TIPS
Aquaretic drugs 
Liver transplant
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15
Q

What does TIPS stand for

A

Transjugular intrahepatic portosystemic shunt

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16
Q

What are aquaretic drugs

A

Drugs that promote water loss without the loss of electrolytes

17
Q

What is hepatorenal syndrome

A

Hepatorenal syndrome (HRS) is a type of progressive kidney failure seen in people with severe liver damage, most often caused by cirrhosis. As the kidneys stop functioning, toxins begin to build up in the body. Eventually, this leads to liver failure.

18
Q

How does hepatorenal syndrome increase salt and water absorption

A

Damage to the liver causes it to release a vasodilator. This dilates blood vessels and creates hypotension.
The kidneys loses blood pressure and so increases the RAAS system - increasing salt and water absorption

19
Q

What is the treatment for heptorenal syndrome

A

Volume expansion with albumin
Vasopressers
TIPS
Liver transplant

20
Q

What are two vasopressor drugs called

A

Terlipressin

Octreotide

21
Q

What is a variceal haemorrhage

A

The bursting of a varisces

22
Q

What is a varices

A

Dilated blood vessels in the oesophagus or stomach caused by portal hypertension

23
Q

What are the symtoms of a variceal haemorrhage

A

Vomitting lots of blood
Loss of conciousness
Black, tary or blood stools
Lightheadedness

24
Q

What is the treatment/management of variceal haemorrhage

A

Resuscitate
Get IV access
Blood transfusion
Emergency band ligation

25
Q

What is Hepatic encephalopathy

A

Confusion and brain damage due to liver disease
The Liver cant remove toxins (ammonia) in the blood and they build up in the blood and enter the brain via the blood brain barrier

26
Q

How is Hepatic encephalopathy graded

A

Graded 1-4

27
Q

What are the symtoms of Hepatic encephalopathy

A

Confusion
Forgetfulness
Asterixis

28
Q

What is the treament for Hepatic encephalopathy

A

Treat underlying cause
Give laxatives to help remove toxins and prevent buildup.
Liver transplant

29
Q

What hepatitis virus(s) can cause an hepatocellular carcinoma

A

Hep B and C

30
Q

What are the symptoms of hepatocellular carcinoma

A 
Classic liver disease symtoms 
Abdominal mass 
abdominal pain 
Weight loss
Bleeding
31
Q

What investigations are done for hepatocellular carcinoma

A

Bloods (look for tumour marker)
US
CT
MRI

32
Q

What tumour marker is looked for in hepatocellular carcinoma

A

Alpha Feto protein

33
Q

What treatment options are available for hepatocellular carcinoma

A

Hepatic resection
Liver transplant
Chemotherapy
Hormonal therapy

Clinical Alimentary System (64 decks)

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