Liver Cirrhosis

Question 1

is a chronic disease characterized by replacement of normal liver tissue with diffuse fibrosis that disrupts the structure and function of the liver.

Answer 1

Cirrhosis

Question 2

Most common causes of Liver Cirrhosis

Answer 2

Alcoholic Liver Disease

Question 3

NAFLD

Answer 3

Non-alcoholic fatty liver

Question 4

Risk factors of Non-Alcoholic Fatty Liver Disease (NAFLD)

Answer 4

-Obesity
- Hyperlipidemia
- Diabetes Mellitus

Question 5

Autoimmune Risk factors

Answer 5

-Primary Biliary Cirrhosis
- Primary Sclerosing Cholangitis

Question 6

Causes an abnormally high iron absorption from the GI Tract

Answer 6

Hereditary Hemochromatosis

Question 7

Causes copper accumulation

Answer 7

Wilson Disease

Question 8

Alcoholic Cirrhosis also known as

Answer 8

Laennec’s Cirrhosis

Question 9

Rubor

Answer 9

Redness

Question 10

Tumor

Answer 10

Swelling

Question 11

Dolor

Answer 11

Pain

Question 12

Calor

Answer 12

Warm

Question 13

What are the cardinal signs of inflammation?

Answer 13

Rubor
Tumor
Dalor
Calor

Question 14

functio laessa

Answer 14

loss of function

Question 15

is a progressive decline in function for six or more months

Answer 15

Chronic Liver Disease

Question 16

Small, dilated blood vessels with a bright red center point and spider-like branches

Answer 16

Spider Angiomas

Question 17

Red area that blanches with pressure

Answer 17

Palmar Erythema

Question 18

Clinical Manifestation of Hepatic Encephalopathy

Answer 18

-Decreasing LOC
- Asterixis
-Apraxia
- Fector Hepaticus
- Hyperventilation, hypothermia

Question 19

Means flapping tremors

Answer 19

Asterixis

Question 20

inability to
construct simple figures

Answer 20

Apraxia

Question 21

Must, sweet breath

Answer 21

Fector hepaticus

Question 22

Early Manifestation of Liver Cirrhosis

Answer 22

F- fever
R- Rapid, unexpected weight loss
A- Anorexia
W- Weakness
N- Nausea

Question 23

Medical Management of Liver Cirrhosis

Answer 23

-Avoidance of alcohol
- S- adenosylmethionine (SAM-e)
-Halt or slow down the progression
-Colchicine
- Angiotension system inhibitors
- Statins
- Diuretics (Spirinolactone)
- Immunosuppresants
- Glitazones

Question 24

The symptomatic treatment of ASCITES

Answer 24

-Sodium-restriction
- Diuretics, as ordered
-Furosemide + Spironolactone

Question 25

The risk factors of Non-Alcoholic Fatty Liver, Chronic Viral Hepatitis and genetics is manifested in

Answer 25

Post-Necrotic Cirrhosis

Question 26

Temporary removal of ascitic fluid from the peritoneal cavity

Answer 26

Paracentesis

Question 27

Position of Paracentesis

Answer 27

Sitting or High-Fowlers position

Question 28

Prevent bleeding and hemorrhage

Answer 28

Esophageal Varices

Question 29

What's the screening test of Esophageal Varices

Answer 29

Upper GI endoscopy

Question 30

The medical Management of Esophageal Varices

Answer 30

-Propanolol (inderal) - Avoid (aspirin, NSAIDS, Alcohol)

Question 31

Management of Bleeding Esophageal Varices

Answer 31

-Ensure patent airway - Assist in stopping the bleeding - Administer Octreotide (Sandostatin), as ordered (first line) -Administer vasopressin + Nitroglycerin, as ordered (second line) -Endoscopy - Ballon tamponade, if bleeding cannot be controlled through endoscopy (sengstaken-blakemore tube and minnesota tube)

Question 32

What's the nursing responsibilities of sengstaken- blakemore tube?

Answer 32

1. Prepare scissors at bedside 2. Label each lumen to avoid confusion 3. Deflate the balloon for 5 minutes every 8- 12 hours per institutional policy

Question 33

How many ports does the Sengstaken- blakemore tube have?

Answer 33

3 ports

Question 34

How many ports does the Minnesota tube have?

Answer 34

4 ports

Question 35

A non surgical procedure wherein a shunt is created between the systemic and portal venous system to redirect portal blood flow

Answer 35

Transjugular Intrahepatic Portosystemic Shunt (TIPS)

Question 36

What is contraindicated of TIPS?

Answer 36

- Severe hepatic encephalopathy - Hepatocellular CA

Question 37

What is the management goal of Hepatic Encephalopathy?

Answer 37

Reduce ammonia function

Question 38

Management of Hepatic Encephalopathy

Answer 38

-Lactulose (Duphalac)- first line - Rifamixin- second line

Question 39

This medication has a laxative effect that expels ammonia with stool and also trap ammonia in the GI Tract

Answer 39

Lactulose (Duphalac)

Question 40

This medication is used in patients who do not respond to lactulose

Answer 40

Rifaximin

Question 41

Diet Therapy for Liver Cirrhosis

Answer 41

-"Butterball Diet" (High-calorie diet (3000 cal/day) with high CHO content and moderate to low levels of fat - Protein restriction only if with hepatic encephalopathy -Low sodium diet if with ascites and edema