Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Clinical Alimentary System > 3.3. Liver + Biliary Tree Disease - Portal Hypertension and Variceal Haemorrhage > Flashcards

3.3. Liver + Biliary Tree Disease - Portal Hypertension and Variceal Haemorrhage Flashcards

1
Q

What causes Variceal Haemorrhage?

A

Hepatic Portal Hypertension

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What are the 3 types of Hepatic Portal Hypertension?

A
  1. Pre-Hepatic Portal Hypertension
  2. Intrahepatic Portal Hypertension
  3. Post-Hepatic Portal Hypertension
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What is the cause of Pre-Hepatic Portal Hypertension?

A

A Portal Vein Thrombosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What are the causes of Intrahepatic Portal Hypertension?

A
  1. Liver Cirrhosis
  2. Non-Cirrhotic Portal Hypertension
  3. Schistosomiasis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What are the causes of Post-Hepatic Portal Hypertension?

A
  1. Inferior Vena Cava Obstruction
  2. Constrictive Periarditis
  3. Right Heart Failure
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What is the Overall Pathology of Portal Hypertension?

A

An increase in Intrahepatic Blood Pressure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What is the method of action of a Pre-Hepatic Portal Hypertension?

A

The Blockage of the Hepatic Portal Vein, before the Liver, means there is a back-up of pressure throughout the entire Portal System

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What is the method of action of a Intrahepatic Portal Hypertension?

A

The Distortion of the Liver architecture results in the obstruction of blood flow, and the back-up of pressure throughout the entire Portal System

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is the method of action of a Post-Hepatic Portal Hypertension?

A

Due to a the back up of pressure as the blood leaves the Liver, there is a back up of pressure throughout the Portal System

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

How does Liver Cirrhosis distort the Liver (Intrahepatic)?

A

The is a restricted path for the blood flow, but the same volume of blood passing through

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

How does Non-Cirrhotic Portal Hypertension distort the Liver (Intrahepatic)?

A

There is mild Portal-Tract Fibrosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

How does Schistosomiasis distort the Liver (Intrahepatic)?

A

This is a disease caused by parasitic Flatworms, which causes extensive “Pipe-Stem” fibrosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

How does Inferior Vena Cava Obstruction cause a back up of pressure within the Liver (Post-Hepatic)?

A

There is a reduced outflow from the Hepatic Veins, and the pressure backs up from there

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

How does Constrictive Pericarditis / Right Heart Failure cause a back up of pressure within the Liver (Post-Hepatic)?

A

There is a Reduced intake from the Heart, and the pressure backs up from there

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What are the Clinical Features of Portal Hypertension?

A
  1. Asymptomatic (Until Rupture)
  2. Splenomegaly
  3. Ascites
  4. Encephalopathy
  5. Breathlessness
  6. Haematemesis
  7. Melena
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What causes Splenomegaly?

A

The Portal Hypertension also causes a back-log of pressure onto the Spleen

17
Q

What causes Ascites?

A

Blood entering into the Peritoneal Cavity upon a rupture (Variceal Hemorrhage)

18
Q

What causes Encphalopathy?

A

The Livers inability to deal with Noxious Substances to the Brain

19
Q

What causes Breathlessness?

A

The Porto-Pulmonary Hypertension (Hepatopulmonary Syndrome)

20
Q

What causes Haematemesis / Melena?

A

Blood entering into the Alimentary Lumen upon a rupture (Variceal Hemorrhage)

21
Q

What is the Best Management of Portal Hypertension?

A

Prophylactic Measures against Bleeding

22
Q

What is included in the Prophylactic Measures?

A
  1. Beta-Blockers
  2. Variceal Banding
  3. Transjugular Intrahepatic Portocaval Shunt
23
Q

Does a Beta-Blocker prevent Varicies from forming?

A

No

24
Q

What is the Management of an Acute Variceal Bleed?

A

1a) Vasoconstriction Therapy
OR
1b) Resuscitation (+ Ascitic Tap, Prophylactic Antibiotics etc)
2. Urgent Endoscopy with Banding (or Injection Sclerotherapy)

25
Q

What happens if there is an early re-bleed?

A

Repeat Endoscopic Therapy

26
Q

If the Bleeding stops after the Repeated Endoscopic Therapy (After the Re-Bleed), what happens next?

A

There will be assessment for Prophylactic Measures

27
Q

What happens if the Endoscopic Therapy Fails (After the Re-Bleed)?

A
  1. A Sengstaken Tube is temporarily inserted
    2a) Transjugular Intrahepatic Portocaval Shunt is inserted
    OR
    2b) Surgery with an Injectable Adhesive is used

Clinical Alimentary System (64 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions