CIRRHOSIS

Question 1

What is cirrhosis

Answer 1

Irreversible fibrosis of the liver

Question 2

Causes of Cirrhosis

Answer 2

HEPATITIS B, C
ALCOHOL
AUTOIMMUNE
HEMOCHROMATOSIS
WILSON’S DISEASE
ALPHA 1 ANTITRYPSIN DEFICIENCY
NON ALCOHOLIC FATTY LIVER DISEASE
DRUGS
RIGHT HEART FAILURE
BUDD CHIARY SYNDROME
PRIMARY BILIARY CHOLANGITIS (PBC)
PRIMARY SCLEROSING CHOLANGITIS

Question 3

Clinical manifestations of cirrhosis

Answer 3

Jaundice
Abdominal Distension
Shifting dullness
Mild fever
Weight loss
Palmar Erythema
Spider angioma
Ascites
Caput Medusae
Umbilical hernia
Edema
Gynecomastia
Hyperammonemia
Hypoglycemia
Hypoalbuminemia
Coagulopathy (loss of clotting)

Question 4

Complications of cirrhosis

Answer 4

UPPER GI BLEEDING
HEPATIC ENCEPHALOPATHY
HEPATORENAL SYNDROME
HEPATO PULMONARY SYNDROME (HYPOXIA)
PRIMARY LIVER CANCER

Question 5

Diagnosis of cirrhosis

Answer 5

LFTs
CBC
Abdominal US
Liver biopsy
Paracentesis (SBP)
Child Pugh test
MELD SCORE

Question 6

Common decompensated cirrhosis symptoms

Answer 6

Hepatic encephalopathy
Hepatorenal syndrome
Spontaneous bacterial peritonitis
Esophageal varices
Ascites

Question 7

TREATMENT OF CIRRHOSIS

Answer 7

1) SODIUM RESTRICTIONS
<2mg/ day
2) 3RD GEN CEPHALOSPORINS
- Treat infection
3) ANTI HBV/ HCV
4) SPIRONOLACTONE/ FUROSEMIDE
Block sodium water retention
5) TRANS JUGULAR INTRAHEPATIC PORTSYSTEMIC SHUNT (TIPS)
Bypass btn portal vein and hepatic vein to reduce portal hypertension
6) LACTULOSE
- To reduce ammonia
- Treats hepatic encephalopathy
7) OCTREOTIDE
- To treat hepatorenal syndrome and variceal bleeding
- Decreases splanchnic vasodilation
8) ALBUMIN REPLACEMENT
- treat hepatorenal syndrome
9) LIVER TRANSPLANT

Question 8

Components of CHILD PUGH TEST

Answer 8

ABCDE
ALBUMIN
BILIRUBIN
COAGULOPATHY
DECOMPENSATED ABDOMEN
ENCEPHALOPATHY

Question 9

Categories of the MELD SCORE

Answer 9

BIND C
BILIRUBIN
INR
Na
DIALYSIS
CREATININE