2. Liver Failure Flashcards
What is the most common cause of portal hypertension?
Cirrhosis
Give a cause of pre-hepatic hypertension?
Portal vein thrombosis
Give a cause of non-cirrhosis hepatic portal hypertension?
Schistosomiasis
What are the consequences of portal hypertension?
Varices
Shunting
Ascites and hepatorenal syndrome
Splenomegaly and hypersplenism
What is the treatment for varices?
Drugs to reduce portal blood flow
Band ligation
Non-selective beta blockers
What are the non-cirrhosis causes of ascites?
Ovarian and GI cancers Hypertension Heart failure Pancreatitis TB
What tests can be done after paracentesis of ascites?
Cell count
Micro
Albumin
Cytology
What is the treatment for ascites?
Sodium restriction
Spironolactone
Paracentesis
Avoid NSAIDs
Why are NSAIDs avoided in ascites?
Cause vasoconstriction in the kidney
What is spontaneous bacterial peritonitis?
Infection of ascites fluid with no evidence of a surgically treatable cause
What are the most common pathogens in spontaneous bacterial peritonitis?
E. coli
Klebsiella
What are the symptoms of spontaneous bacterial peritonitis?
Fever
Abdominal pain
Altered mental state
When should spontaneous bacterial peritonitis be treated?
Cell count >250
What results from severe hepatic encephalopathy?
Cerebral oedema
Hypoperfusion
What factors might precipitate encephalopathy in a known cirrhotic liver?
Infection Bleeding Dehydration Drugs and alcohol Constipation
What is the treatment for hepatic encephalopathy?
Reduce ammonia production
Lactulose (laxative to clear toxins from gut)
Non-absorbable antibiotics (remove bacteria from gut)