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GastroIntestinal (GI) > Cirrhosis > Flashcards

Flashcards in Cirrhosis Deck (27):
1

What happens to a stellate cells when inflamed?

It becomes a mega-fibro-blast

2

What is cirrhosis

Dysfunction
Disruption of vasculature
generation of abnormal signalling

3

What is the portal system?

Superior mesenteric + Splenic vein+ gastric + part from inferior mesentric = Portal vein

4

What does the portal vein carry outflow from?

1.) Spleen
2.) Oesophagus
3.) Stomach
4.) Pancreas
5.) Small and large intestine

5

What is the hepatic blood flow?

Nutrient rich deoxygenated blood from hepatic portal vein
Oxygenated blood from hepatic artery
Liver sinusoids
Central vein
Hepatic vein
Inferior vena cava
Right atrium

6

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

7

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

8

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)

9

What vasodilator can be used for cirrhosis?

Cirrhosis is a vascular disease

Vasodilators: No,CO, CGRP,Glucagon

10

What are the causes of portal hypertension ?

Prehepatic: Blockages/ Thrombosis
Intrahepatic: Blockages within

11

What is hepatic carcinogenesis?

Cellular hyperplasia
Recurrent hepatocyte death
Inflammation

12

What is compensated cirrhosis?

Clinical normal
Incidental finding
Lab test or imaging abnormalities
Portal Hypertension may be present

13

What is decompensated cirrhosis?

Liver failure
Acute –on-chronic
Infection
Insult
SIRS
End stage Liver disease
Insufficient hepatocytes
“run out of liver”

14

What are the signs of compensated liver cirrhosis?

Spider naevi
Plamar erythema
clubbing
gynaecomastia
Hepatomegaly(?)
Spleenomegaly

15

What are the signs of decompensated liver cirrhosis?

Jaundice
Ascites
Encephalopathy
bruising

16

What is leukonychia

The full white of the nail have move over the entire nail

17

What are the complications of cirrhosis?

Ascites
Encephalopathy
Variceal bleeding
Liver Failure

18

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

19

What type of defiencies do live disease patients get?

Vitamin B
Thiamine
Oesteoporosis

20

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

21

What is the treatment for ascites?

Improve underlying liver disease
Paracentsis
TIPS - Trans jugular intrahepatic poro systemic shunt

Diuretics: Spironolactone

22

What does Trans-jugular Intra-hepatitc Porto-systemic Shunt do?

It removes portal hypertension

23

What infection can you get from ascites?

Spontaneous bacterial peritonitis

24

What is the treatment of spontaneous bacterial peritonitis?

Treatment
Urgent
Antibiotics and Alba
Vascular instability-terlipressin
Maintain renal perfusion
HRS development very poor prognosis

25

What is encephalopathy?

Microglial inflammation

26

What is the diagnosis of encephalopathy?

Flap confusion
Alcohol withdrawl

27

What is the treatment for encephalopathy?

Lactulose to clear the gut
Rifaxamin