Flashcards in Cirrhosis Deck (27):
What happens to a stellate cells when inflamed?
It becomes a mega-fibro-blast
What is cirrhosis
Disruption of vasculature
generation of abnormal signalling
What is the portal system?
Superior mesenteric + Splenic vein+ gastric + part from inferior mesentric = Portal vein
What does the portal vein carry outflow from?
5.) Small and large intestine
What is the hepatic blood flow?
Nutrient rich deoxygenated blood from hepatic portal vein
Oxygenated blood from hepatic artery
Inferior vena cava
What are the anastomosis of the portal vein?
Esophageal and gastric venous plexus
umbilical vein from the left portal vein to the epigastric venous system
retroperitoneal collateral vessels
the hemorrhoidal venous plexus
What may occur to the portal vein collaterals in cirrhosis?
In cases of portal hypertension these anastamoses may become engorged, dilated, or varicosed and subsequently rupture
What is portal hypertension?
Portal vein pressure above the normal range of 5 to 8 mm Hg
Increased resistance to portal flow (R)
Increased portal venous inflow (Q)
What vasodilator can be used for cirrhosis?
Cirrhosis is a vascular disease
Vasodilators: No,CO, CGRP,Glucagon
What are the causes of portal hypertension ?
Prehepatic: Blockages/ Thrombosis
Intrahepatic: Blockages within
What is hepatic carcinogenesis?
Recurrent hepatocyte death
What is compensated cirrhosis?
Lab test or imaging abnormalities
Portal Hypertension may be present
What is decompensated cirrhosis?
End stage Liver disease
“run out of liver”
What are the signs of compensated liver cirrhosis?
What are the signs of decompensated liver cirrhosis?
What is leukonychia
The full white of the nail have move over the entire nail
What are the complications of cirrhosis?
What is the nutrition for a decompenstaed liver cirrhosis?
energy intake of 35-40 kcal/kg and a protein intake of 1.2-1.5g/kg are recommended.
Small frequent meals
What type of defiencies do live disease patients get?
Why does ascites occur?
Retention of sodium and water
Hydrostatic pressure is higher in the abdomen.
Oncotic pressure is high in the abdomen, due to albumen being high
What is the treatment for ascites?
Improve underlying liver disease
TIPS - Trans jugular intrahepatic poro systemic shunt
What does Trans-jugular Intra-hepatitc Porto-systemic Shunt do?
It removes portal hypertension
What infection can you get from ascites?
Spontaneous bacterial peritonitis
What is the treatment of spontaneous bacterial peritonitis?
Antibiotics and Alba
Maintain renal perfusion
HRS development very poor prognosis
What is encephalopathy?
What is the diagnosis of encephalopathy?