Cirrhosis

Question 1

Only successful treatment for cirrhosis.

Answer 1

Liver Transplant

Question 2

Causes of Micronodular Vs. Macronodular cirrhosis.

Answer 2

Micro: alcohol, hemochromatosis, cholestatic liver disease, hepatic venous outflow obstruction

Macro: chronic viral hepatitis

Question 3

What is the goal of cirrhosis treatment when a liver transplant is not available?

Answer 3

Maintain the compensated state as long as possible. Worst symptoms begin when the decompensated state begins

Question 4

List the 5 stages of Cirrhosis.

Answer 4

1. Compensated
2. Esophageal Varices appear
3. Ascites occurs
4. GI bleeding
5. Infection w/ renal failure

Question 5

What recommended vaccinations improve cirrhosis outcome?

Answer 5

Hep B, Hep A, pneumococcal, flu

Question 6

Name 4 drug treatments that help prognosis of cirrhosis.

Answer 6

1. Lamivudine (RT inhibitor)
2. Serine Protease inhibitors (entecovir, tenofovir)
3. Statins
4. Vit. D

Question 7

Drug therapies to avoid (5).

Answer 7

1. ARBs
2. ACE-Is
3. Metformin
4. PPIs
5. NSAIDs

Question 8

Recommended screening in patients with cirrhosis.

Answer 8

Check for HCC every six months.
biopsy is best or ultrasound

If lesion is found on ultrasound, recheck every 3 months