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Kumar > Ciroza > Flashcards

Ciroza Flashcards

1
Q

Cauze comune de ciroza

A
  1. Alcool
  2. Hepatite: B (+/- D), C
  3. NAFLD
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2
Q

Cauzele cirozei micronodulare

A

Alcool, boli ale tractului biliar

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3
Q

Cauza cirozei macronodulare

A

Hepatita cronica virala

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4
Q

Cei mai buni indicatori ai functiei hepatice

A

Albumina si TP

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5
Q

Concentratia creaininei serice ca marker de prognostic nefavorabil

A

> 130 micromol/ L (>1,5 mg/dL)

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6
Q

Valoare alfa-fetoproteina sugestiva pt CHC

A

> 200 mg/mL

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7
Q

La ce pacienti nu se poate folosi Fibroscan

A

Cu ascita si obezitate morbida

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8
Q

Standardul de aur in ciroza

A

Biopsia hepatica

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9
Q

Parametri folositi in scorul Child-Pugh

A
  1. Ascita
  2. Encefalopatie
  3. Bilirubina
  4. Albumina
  5. TP
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10
Q

Parametri folositi in scorul MELD

A
  1. BIlirubina
  2. Creatinina
  3. INR
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11
Q

Contraindicatii absolute in transplantul de ficat

A
  1. Sepsis activ (altundeva decat in arborele biliar)
  2. Tumori maligne extrahepatice
  3. Metastaze hepatice (exceptie neuroendocrine)
  4. Lipsa angajament pacient
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12
Q

Din ce se formeaza vena porta

A

Venele mezenterica sup + splenica

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13
Q

Presiunea normala in vp

A

5-8 mmHg

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14
Q

Principalele locuri de apartie ale colateralelor

A
  1. Jonctiunea gastro-esofagiana
  2. Rect
    3, Vena renala stg
  3. Diafragm
  4. Retroperitoneu
  5. Perete abd ant (v ombilicala)
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15
Q

Caracteristici gastropatie si colopatie hipertensiva portala

A

Eritem punticform si eroziuni care pot sangera

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16
Q

Cauze tromboza vena porta

A
  1. Anomalii congenitale
  2. Sepsis nn al v ombilicale
  3. Afectiuni protrombotice mostenite (fV Leiden)
    4, Boli mieloproliferative primare
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17
Q

Cel mai bun tratament in varicele gastrice

A

Injectarea endoscopica de cianoacrilat

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18
Q

Contraindicatii si RA Terlipresina

A

!!! Boala cardiaca ischemica

RA: Colici abdominale, scaun ?, paloare faciala

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19
Q

Instrumentul folosit in tamponamentul cu balon

A

Sonda Sengstaken-Blakemore

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20
Q

Complicatiile tamponamentului cu balon

A
  1. Pneumonia de aspiratie
  2. Ruptura esofag
  3. Ulcerarea mucoasei
21
Q

Beta blocante neselective in varice

A

Propranolol, carvedilol

22
Q

Complicatia suntului portosistemic chirurgical

A

Encefalopatia hepatica

23
Q

Factori in patogenia ascitei

A
  1. Retentia de sodiu si apa
  2. HT portala
  3. Scaderea albuminei serice
24
Q

Gradient albumina - ascita in HTp

A

> 11 g/L

25
Q

Gradient albumina - ascita < 11 g/L in

A
  1. Carcinomatoza peritoneala
  2. TBC peritoneala
  3. Pancreatita
  4. Sd nefrotic
26
Q

Tratament in PBS

A

Atb cu spectru larg -> se schimba dupa cultura + perfuzii cu sol albumina

27
Q

Mecanismul principal in encefalopatia portosistemica

A

Alterarea dezechilibrului neurotransmitatorilor cerebrali de amoniac

28
Q

Semne clinice in encefalopatia portosistemica

A
  1. Fetor hepaticus
  2. Flapping tremor
  3. Apraxia constructiva
  4. Scaderea calitatii functiei intelectuale
29
Q

Atb in encefalopatia portosistemica

A

Rifaximina
Metronidazol
NU Neomicina

30
Q

Unde apare sd hepatorenal

A
  1. Ciroza avansata
  2. HT portala
  3. Icter
  4. Ascita
31
Q

Ce precipita sd hepatorenal

A
  1. Diureticele excesive
  2. AINS
  3. Diaree
  4. Paracenteza
  5. Infectie (PBS)
32
Q

Colangita biliara primitiva

A

Distrugere progresiva a canalelor biliare interlobulare

33
Q

Atc si atg in ciroza biliara primitiva

A

Atc anti-mitocondriali (AMA) -> aproape toti
Atc anti-gp210 -> 50% -> progrsia spre insuf hep

Atg mitocondrial M2 -> specific

34
Q

Cel mai precoce simptom in ciroza biliara primitiva

A

Prurit

35
Q

Maniestari asociate colangita biliara primitiva

A
  1. Autoimune - Ssj, Sclerodermie, tiroidita
  2. Keratoconj sicca
  3. Acidoza tubulara renala, GN membranoasa, boala celiaca, pneumonie interstitiala
36
Q

Colangita biliara primitva - histologie specifica

A

Infiltrat in spatiile porte cu Ly, Pl, granuloame

37
Q

Unde se mai gasesc granuloamele hepatice

A
  1. Sarcoidoza
  2. TBC
  3. Schistosomiaza
  4. Reactii med
  5. Bruceloza
  6. Paraziti (Strongiloidoza)
38
Q

Colangita sclerozanta primitiva

A

Distrugerea inflamatorie fibrozanta a canalelor biliare intra + extra hepatice

39
Q

Atc in colangita sclerozanta prrimitiva

A

ANCA -> se asociaza cu CU

40
Q

Simptome in colangita sclerozant primitiva

A
  1. Prurit fluctuant
  2. Icter
  3. Colangita
41
Q

Transmiterea tipurilor de hemocromatoza

A

1, 2, 3 - autozomal recesiv

4 - autozomal dominant

42
Q

Triada clasica in hemocromatoza

A
  1. Pigmentarea bronzata a pielii
  2. Hepatomegalie
  3. DZ
43
Q

Manif cardiace in hemocromatoza

A
  1. Insuf cardiaca

2. Aritmii

44
Q

Unde se absoarbe cuprul

A

Stomac si int subtire proximal

45
Q

Unde se depune cuprul in boala Wilson

A
  1. Ficat
  2. Nucleii de la baza creierului
  3. Cornee
46
Q

Semn specific in boala Wilson

A

Inelul Kayser-Fleischer = depunerea de cupru in mem Descemet

47
Q

Tratament in boala Wilson

A

Penicilamina

Trientina, acetat de zinc

48
Q

Aspectul de coaja de ceapa la ex hp apare in

A

Colangita sclerozanta primitiva

49
Q

Nivelul normal de Fe din organism

A

3-4 g

Kumar (8 decks)

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