Portal Hypertension Flashcards Preview

Internal Medicine 1: Hepatology > Portal Hypertension > Flashcards

Flashcards in Portal Hypertension Deck (21)
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1
Q

The portal vein is formed of both?

A

Splenic and superior mesenteric vein

2
Q

The portal vein enters the liver at?

A

Ports hepatitis

3
Q

The normal portal venous pressure is between…?

A

5-10mmHg

4
Q

How do we measure the HVPG (hepatic venous pressure gradient)?

A

Via hepatic catheterization

5
Q

What’s the normal HVPG?

A

Smaller than or equal to 5

6
Q

What is the HVPG value where we deem clinically significant portal hypertension?

A

Greater than 10

7
Q

What is WHVP?

A

Wedged hepatic venous pressure, it’s an estimate of pressure within the portal venous system

8
Q

A rise in portal venous pressure but normal WHVP and HVGP mean?

A

Presinusoidal PH

9
Q

What are the 2 most common symptoms of Portal Hypertension?

A

Upper GI bleeding and dyspepsia (discomfort after meals)

10
Q

PH should be suspected when we see…?

A

GI bleeding, ascites, or splenomegaly

11
Q

The diagnosis of PH is established when we find?

A

Dilated abdominal wall veins or varices

12
Q

What’s a Doppler ultrasound?

A

Measures the blood flow in the portal and hepatic veins to detect stenosis or thrombosis

13
Q

When there’s upper GI bleeding what do we do?

A

An upper GI endoscopy

14
Q

In terms of lab tests, there is one most consistently associated with PH of any cause, what is it?

A

A reduced platelet count, due to the hypersplenism induced by splenomegaly

15
Q

Vasoconstrictors are the first treatments for PH, targeting the increased splanchnic blood flow, which one do we prescribe?

A

Terlipressin

16
Q

Terlipressin and its sister octreotide are prescribed to treat what complication of PH?

A

Acute bleeding episode

17
Q

What do we prescribe to treat PH more long term like to prevent variceal bleeding to begin with?

A

NSBBs

18
Q

Contraindications of Terlipressin?

A

Severe arterial hypertension and coronary heart disease

19
Q

What is Octreotide’s method of working?

A

It inhibits the hormones that induce splanchnic vasodilatation

20
Q

What are the NSBBs we prescribe?

A

Propranolol and nadolol

21
Q

When should NSBBs be discontinued?

A

Patients with cirrhosis