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ICC2 > liver cirrohsis > Flashcards

liver cirrohsis Flashcards

1
Q

what are the two vessels supplying blood to the liver ?

A

the hepatic artery

the portal vein

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2
Q

what is the vessel draining blood from the liver ?

A

the hepatic vein

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3
Q

what is liver cirrhosis ?

A

chronic diffuse irreversible liver disease characterized by the loss of architecture of the hepatic cells

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4
Q

what are the distinctive colour changes in each type of cirrhosis ?

A

yellow in cases of nutritional or alcoholic cirrhosis
green in cases of biliary cirrhosis
dark brown in cases of hematochromatosis

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5
Q

what is the size of the liver like in cirrhosis ?

A

reduced in size but may be enlarged in cases of biliary cirrhosis

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6
Q

what can the history of cirrhosis be vaguely divided into ?

A

compensated and decompensated cirrhosis

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7
Q

what is the HVPG like in compensated cirrhosis ?

A

5-12 mmhg

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8
Q

what are the features of compensated liver cirrohsis ?

A

mainly there is no ascites or varicies however varicies may start to form with an increase in portal pressure

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9
Q

what is the normal HVPG ?

A

5 mmhg

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10
Q

what turns a patient from having compensated liver cirrhosis to uncompensated liver cirrhosis ?

A

a decompensating event such as a surgery that was not important

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11
Q

what is the HVPG like in decompensated liver cirrohsis ?

A

> 12 mmhg

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12
Q

what are the features of uncompensated liver cirrhosis?

A

bleeding
ascites
hepatic encephalopathy
there is rapid decompensation

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13
Q

what is the result of a patient with decompensated liver cirrhosis ?

A

either dead in months if not gone under OLT ( liver transplantation)

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14
Q

what histological features are specific to cirrhosis ?

A

fibrous bands and nodules

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15
Q

how do we make a diagnosis of liver cirrhosis ?

A

imaging ( US and CT)
fibroscan
liver biopsy

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16
Q

why do sipder navei appear ?

A

due to a lack of breakdown of nitrous oxide ( which normally occurs in the liver)

17
Q

why would we see gynectomasia in liver cirrhotic patient ?

A

due to the lack of breakdown of oestrogen in the liver

18
Q

how does a fibroscan work ?

A

by measuring the transmission of waves through the liver and fibrous tissue

19
Q

what score is used to classify the severity of liver cirrhosis ?

A

child-pugh score

20
Q

what are the 5 parameters used in the child-pugh score ?

A 
ascites 
bilirubin
albumin 
INR 
encephalopathy
21
Q

what do each of the child scores indicate ?

A

child A - well compensated disease
child B - significant functional compromise
child c - decompensated disease

22
Q

what are the liver function tests?

A

INR
albumin
Bilirubin

23
Q

what are the transaminases ?

A

ALT AST

24
Q

which cells are responsible for bilirubin ?

A

cholangiocytes

25
Q

how do we detect ann obstruction from lab results ?

A

high levels of GGT and ALP along with hyperbilirubinemia (mainly direct)

26
Q

is both ALT and AST specific to the liver ?

A

ALT only is specific to the liver whilst AST isn’t

27
Q

what is the advantage of using the MELD score ?

A

combines both kidney and liver function

28
Q

what are the complications of liver cirrhosis?

A

-portal HTN and varicies
-spontaneous bacterial
peritonitis
-ascites
-hepatocellular carcinoma

29
Q

what are the complications of portal hypertension ?

A

varicies
ascites
hepatic encephalopathy

30
Q

what does the encephalopathy happen due to ?

A

accumulation of ammonia

31
Q

what are the nutritional advice for cirrhotic patients ?

A

not advised to fast
plant protein> animal protein
frequent meals

32
Q

what are the advise for compensated cirrhosis ?

A

decrease fat and carbs carefully

33
Q

what are the nutritional advise for decompensated cirrhosis ?

A

increase protein esp vegetable protein

ICC2 (42 decks)

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