Cirrhosis & Portal Hypertension Flashcards Preview

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Flashcards in Cirrhosis & Portal Hypertension Deck (14):

What is cirrhosis?

nodules of regenerating hepatocytes surrounded by bands of fibrous tissue that is diffuse and irreversible


What are the causes of cirrhosis?

all forms of chronic liver disease including ASH, NASH, chronic hepatitis B and C, autoimmune hepatitis, chronic biliary disease, Wilson’s disease, haemchromatosis, drugs


What is the pathogenesis of cirrhosis?

in chronic inflammation stellate cells are activated to a myofibroblast phenotype so contract and produce collagen


What are the 3 types of complication of cirrhosis?

parenchymal liver failure, endocrine disturbance, portal hypertension


What are the features of parenchymal liver failure?

hepatic encephalopathy, jaundice, coagulopathy, low albumin


What are the features of endocrine disturbance?

gynaecomastia, spider naevi, testicular atrophy


What are the features of portal hypertension?

ascites, splenomegaly, varice at sites of portosystemic anatomoses


What are the clinical signs of chronic liver disease?

jaundice, hepatomegaly, splenomegaly, ascites, caput medusae, spider naevi, palmar erythema, gynaecomastia, testicular atrophy, digital clubbing, dupytrens contracture, metabolic flap


Which types of chronic liver disease are most at risk of hepatocellular carcinoma?

alcohol, chronic viral hepatitis, haemochromatosis


What is portal hypertension?

an absolute increase in blood pressure within the portal vein greater than 8mmHg or increase in pressure gradient between the portal vein and the hepatic vein greater than 5mmHg


What is the commonest cause of portal hypertension?



What is a cause of pre sinusoidal portal hypertension?

portal vein thrombosis


What is a cause of post sinusoidal portal hypertension?

hepatic vein thrombosis


What are the 4 factors that cause portal hypertension in liver cirrhosis?

increased portal blood flow causing vasoreactive contraction, nodules compressing sinusoids, scar tissue compressing sinusoids, shunting between hepatic artery and portal vein