Chronic Liver Disease Flashcards
(32 cards)
How long does a person have liver disease before it is classified as chronic liver disease?
6 months
What are some of the causes of cirrhosis?
Alcohol
Autoimmune conditions
Haemochromatosis
Chronic viral hepatitis
Non-alcoholic fatty liver disease
Drugs
Cystic fibrosis
Vascular problems
Give some examples of autoimmune conditions which can cause cirrhosis.
Autoimmune hepatitis
Primary Biliary Cholangitis
Primary Sclerosing Cholangitis
Which two types of hepatitis are more likely to be chronic viral hepatitis?
B and C
Describe the pathological changes to the liver in cirrhosis.
Production of collagen and fibrinogen blocks off openings prevents blood flow and nutrients.
What is ascites?
Accumulation of fluid in the abdomen
How would ascites be identified?
Physical exam- dullness in flanks
Confirmed by Ultrasound
What are some of the symptoms which are suggestive of ascites?
Spiders, palma erythema, abdominal veins, fetor hepaticus
Umbilical nodule
JVP elevation
Flank haematoma
How is ascites diagnosed?
Fluid must be tested (diagnostic paracentesis)
What must fluid from ascites be tested for?
Protein and albumin concentration
Cell count
Serum-ascites albumin gradient
What would a serum-ascites albumin gradient of >1.1g suggest?
Portal hypertension related
What would a serum-ascites albumin gradient of <1.1g suggest?
Non portal hypertension related
What are some of the treatment options for ascites?
Diuretics
Large volume paracentesis (removing large volumes of liquid)
TIPSS
Aquaretics
Liver transplant
What may there be excess of in those with hypertension?
Nitric oxide
What happens in hepatorenal syndrome?
Portal hypertension causing splanchnic vasodilation which reduces effective blood volume.
->more info in recording, idk what to write on the flashcard sorry!
What are some of the treatment options for hepatorenal syndrome?
Volume expansion w albumin
TIPSS
Vasopressors e.g. teripressen or octreotide
Liver transplant
What causes variceal haemorrhage?
Portal hypertension
What is variceal haemorrhage?
When blood cannot flow through the liver, it finds alternative paths through the GIT, like the skin, oesophagus, rectum, posterior wall or stomal
What happens if a variceal haemorrhage starts to bleed?
Bleeds like a tap!
What should you do the patient if they have a variceal haemorrhage?
Resuscitate them
Ensure good IV access
Blood transfusion if required
Emergency endoscopy
What is the management option for a variceal haemorrhage?
Endoscopic band ligation to stop bleeding.
Which drug would be added for control after a variceal haemorrhage?
Terlipressen
What may get inserted if there is uncontrolled bleeding?
Sengstaken-Blakemore tube
What can be given for rebleeding after band ligation for variceal haemorrhage?
TIPSS
