High-Yield Concepts in Complications of Liver Cirrhosis (Gastrointestinal Diseases)

Question 1

Portal Hypertension (HPN)

Answer 1

Elevation of hepatic venous pressure gradient (HVPG) to >5 mm Hg

Question 2

Portal Hypertension (HPN)

Answer 2

Elevation of hepatic venous pressure gradient (HVPG) to >5 mm Hg

Question 3

Most common cause of Portal HPN in the US

Answer 3

Cirrhosis

Question 4

3 primary complications of Portal HPN

Answer 4

Gastroesophageal varices with hemorrhage
Ascites
Hypersplenism

Question 5

First indication of Portal HPN in Liver Cirrhosis

Answer 5

Hypersplenism with thromboocytopenia

Question 6

Palliative procedure for Portal HPN

Answer 6

Transjugular Intrahepatic Portosystemic Shunt (TIPS)

Question 7

First-line treatment to control Acute Variceal Bleeding

Answer 7

Endoscopic intervention

Question 8

Most common cause of ascites

Answer 8

Portal HPN related to cirrhosis

Question 9

Laterality of Hepatic Hydrothorax

Answer 9

More common on the right side

Question 10

Recommended Sodium Restriction for Small Amounts of Ascites

Question 11

Most common organisms causing Spontaneous Bacterial Peritonitis (SBP)

Answer 11

Escherichia coli and other gut bacteria

Question 12

Presumed mechanism for development of SBP

Answer 12

Bacterial translocation

Question 13

Most common antibiotic for SBP

Answer 13

Cefotaxime

Question 14

Hepatic Encephalopathy (Portosystemic Encephalopathy)

Answer 14

Alteration in mental status and cognitive function occuring in the presence of liver failure

Question 15

Asterixis or Liver Flap

Answer 15

Sudden forward movement of the wrist after it is bent back on an extended arm; cannot be elicited if patient already comatose

Question 16

Mainstay of treatment for Hepatic Encephalopathy

Answer 16

Lactulose, to promote 2-3 soft stools per day

Question 17

Hepatorenal Syndrome (HRS)

Answer 17

Functional renal failure without renal pathology in patients with advanced cirrhosis or acute liver failure

Question 18

Type 1 HRS

Answer 18

Progressive impairment in renal function and significant reduction in creatinine clearance within 1-2 weeks

Question 19

Type 2 HRS

Answer 19

Reduction in GFR with an elevation of serum creatinine level, but fairly stable (better outcome than Type 1 HRS)

Question 20

Best Therapy for HRS

Answer 20

Liver transplantation

Question 21

Phenotype of A1AT Deficiency with Greatest Risk for Developing Chronic Liver Disease

Answer 21

ZZ phenotype

Question 22

Most common cause of Portal HPN in the US

Answer 22

Cirrhosis

Question 23

3 primary complications of Portal HPN

Answer 23

Gastroesophageal varices with hemorrhage
Ascites
Hypersplenism

Question 24

First indication of Portal HPN in Liver Cirrhosis

Answer 24

Hypersplenism with thromboocytopenia

Question 25

Palliative procedure for Portal HPN

Answer 25

Transjugular Intrahepatic Portosystemic Shunt (TIPS)

Question 26

First-line treatment to control Acute Variceal Bleeding

Answer 26

Endoscopic intervention

Question 27

Most common cause of ascites

Answer 27

Portal HPN related to cirrhosis

Question 28

Laterality of Hepatic Hydrothorax

Answer 28

More common on the right side

Question 29

Recommended Sodium Restriction for Small Amounts of Ascites

Question 30

Most common organisms causing Spontaneous Bacterial Peritonitis (SBP)

Answer 30

Escherichia coli and other gut bacteria

Question 31

Presumed mechanism for development of SBP

Answer 31

Bacterial translocation

Question 32

Most common antibiotic for SBP

Answer 32

Cefotaxime

Question 33

Hepatic Encephalopathy (Portosystemic Encephalopathy)

Answer 33

Alteration in mental status and cognitive function occuring in the presence of liver failure

Question 34

Asterixis or Liver Flap

Answer 34

Sudden forward movement of the wrist after it is bent back on an extended arm; cannot be elicited if patient already comatose

Question 35

Mainstay of treatment for Hepatic Encephalopathy

Answer 35

Lactulose, to promote 2-3 soft stools per day

Question 36

Hepatorenal Syndrome (HRS)

Answer 36

Functional renal failure without renal pathology in patients with advanced cirrhosis or acute liver failure

Question 37

Type 1 HRS

Answer 37

Progressive impairment in renal function and significant reduction in creatinine clearance within 1-2 weeks

Question 38

Type 2 HRS

Answer 38

Reduction in GFR with an elevation of serum creatinine level, but fairly stable (better outcome than Type 1 HRS)

Question 39

Best Therapy for HRS

Answer 39

Liver transplantation

Question 40

Phenotype of A1AT Deficiency with Greatest Risk for Developing Chronic Liver Disease

Answer 40

ZZ phenotype