Cirrhosis

Question 1

Cirrhosis =

Answer 1

Destruction and regeneration of the liver parenchyma
Fibrosis
Cirrhosis

Question 2

Chronic liver disease

Answer 2

disease of the liver which lasts over a period of six months

Question 3

Examples of chronic liver disease

Answer 3

Fibrosis
Cirrhosis
Chronic Hepatisis
Liver Tumour

Question 4

Cirrhosis Aetiology

Answer 4

Alcohol
Autoimmune disease
Alpha 1 Anti-trypsin Deficiency
Budd-Chiari Syndrome 
Cryptogenic 
Cystic Fibrosis 
Copper overload
Drugs 
Sarcoidosis 
Hepatitis C
Haemocrhomatosis 
NAFLD
Vascular problems

Question 5

Cirrhosis Complications

Answer 5

Hepatocellular Carcinoma

Altered Liver Function (decreases synthesis of plasma proteins/clotting factors)

Portal Hypertension (Spleenomegaly
& Oesophageal Varices).

Question 6

Cirrhosis Presentation:

HAJ VD:

Answer 6

Hepatic Encephalopathy
Ascites
Jaundice
Variceal Haemorrhage Dullness in flanks and shifting dullness.

Question 7

Signs of Cirrhosis: ABCDEFGHIJ

Answer 7

Ascites/Asterixis/Ankle Oedema
Bruising
Clubbing/Colour change of nails (Leuconychia)
Dupuytren's Contracture
Encephalopathy
Foetor Hepaticus
Gynaecomastia
Hepatomegaly
Increases size of parotids Jaundice.

Question 8

Cirrhosis Investigations:

Answer 8

Transient Elastography
(investigation of choice to detect liver cirrhosis;
measures liver stiffness)
Ultrasound (after a diagnosis, it is recommended
to do this every 6 months to check for liver cancer)
Others: CT, MRI, Liver Biopsy etc…

Question 9

Cirrhosis Treatment:

Answer 9

TIPS
Acquaretics

Liver Transplantation
(prioritise using the MELD score, UKELD score, and Child’s Pugh Score - involves bilirubin, albumin, PT, encephalopathy, and ascites)

Large volume paracentesis (removal of >5L of fluid)
Diuretics
Treat the underlying cause.