Cirrhosis Flashcards
What is cirrhosis?
Cirrhosis is the severe scarring of the liver and poor liver function seen at the terminal stages of chronic liver disease.
The scarring is most often caused by long-term exposure to toxins such as alcohol or viral infections. The liver is located in the upper right side of the abdomen below the ribs
What are essential functions of the liver?
- producing bile, which helps your body absorb dietary fats, cholesterol, and vitamins A, D, E, and K
- storing sugar and vitamins for later use by the body
- purifying blood by removing toxins such as alcohol and bacteria from your system
- creating blood clotting proteins
What is the result of cirrhosis in the liver?
Portal Hypertensionn
Cirrhosis causes the liver to shrink and harden. This makes it difficult for nutrient-rich blood to flow into the liver from the portal vein. The portal vein carries blood from the digestive organs to the liver. The pressure in the portal vein rises when blood can’t pass into the liver.
What are causes of cirrhosis?
Alcohol, Hep B, Hep C, Hep D, autoimmune conditions, medications
What are the signs and symptoms of cirrhosis?
Cirrhosis can take quite a long time to develop, and symptoms may be slow to emerge
Early symptoms may include tiredness, weakness, loss of appetite, unexplained weight loss, nausea and sickness, and discomfort in one’s upper right abdomen
With declining liver function, other signs and symptoms may develop such as cognitive impairments, confusion, memory loss, sleep disorders, and changes in personality
Further symptoms include spider naevi, oedema, ascites, jaundice, pruritus, dark urine
What is the pathophysiology behind of cirrhosis?
The pathological hallmark of cirrhosis is the development of scar tissue that replaces normal tissue. This scar tissue blocks the portal flow of blood through the organ, raising the blood pressure and disturbing normal function
Damage to the liver tissue from inflammation leads to the activation of stellate cells, which increases fibrosis through the production of myofibroblasts, and obstructs hepatic blood flow. n addition, stellate cells secrete TGF beta 1, which leads to a fibrotic response and proliferation of connective tissue. GF-β1 have been implicated in the process of activating hepatic stellate cells
How is cirrhosis diagnosed?
Liver biopsy
What are the best predictors of cirrhosis?
Spider naevi
Ascites
Platelet count < 160000/mm^3
Histologically, what defines cirrhosis?
(1) the presence of regenerating nodules of hepatocytes
(2) the presence of fibrosis, or the deposition of connective tissue between these nodules
How can cirrhosis be prevented?
Key prevention strategies for cirrhosis are population-wide interventions to reduce alcohol intake (through pricing strategies, public health campaigns, and personal counseling), programs to reduce the transmission of viral hepatitis, and screening of relatives of people with hereditary liver diseases.
Can cirrhosis be reversed?
No
What are the aims of treatment?
Delay further progression and reduce complications
How is cirrhosis managed?
Healthy diet
Antibiotics for infections
Abstinence from alcohol
Vaccination for Hep A and Hep B
If complications cannot be controlled or when the liver ceases functioning, liver transplantation is necessary.
What are the complications of cirrhosis?
Ascites (salt restrictionn, diuretics)
Esophageal and gastric variceal bleeding (give beta blockers to reduce portal hypertension)
Hepatic encephalopathy
