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Z Year3 Gastro Conditions > Ascites > Flashcards

Ascites Flashcards

1
Q

What is ascites?

A

pathological collection of fluid in the peritoneal cavity

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2
Q

What are the most common causes of ascites?

A
  1. cirrhosis
  2. congestive heart failure
  3. Malignant ascites
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3
Q

What are the 2 types of non-peritoneal causes of ascites?

A
  1. Conditions that cause portal hypertension

2. Conditions that cause hypo-albuminaemia

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4
Q

What are examples of conditions that cause portal hypertension leading to ascites?

A
  1. cirrhosis
  2. alcoholic liver disease
  3. fulminant hepatitis (e.g., due to paracetamol toxicity)
  4. subacute hepatitis
  5. hepatic veno-occlusive disease
  6. massive liver metastasis
  7. congestive heart failure
  8. constrictive pericarditis
  9. Budd-Chiari syndrome
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5
Q

What are examples of conditions that cause hypo-alubminaemia that lead to ascites?

A
  1. Nephrotic syndrome

2. Protein losing enteropathy

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6
Q

What are other non-peritoneal causes of ascites?

A
  1. myxoedema
  2. ovarian tumours (cancer, benign tumours and ovarian hyperstimulation syndrome)
  3. pancreatic ascites
  4. chylous ascites and biliary ascites
  5. urogenital surgical trauma
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7
Q

What are the malignant peritoneal causes of ascites?

A
  1. peritoneal mesothelioma
  2. peritoneal carcinomatosis
  3. ovarian cancer
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8
Q

What are the infectious peritonitis causes of ascites?

A
  1. tuberculosis
  2. Chlamydia trachomatis
  3. fungal and parasitic infections
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9
Q

What is an autoimmune cause of ascites?

A

SLE

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10
Q

What is primary peritonitis caused by?

A

spread of an infection from the blood and lymph nodes to the peritoneum and is rare

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11
Q

What is secondary peritonitis caused by?

A

infection from the gastrointestinal or biliary tracts

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12
Q

What are the common differential diagnosis in ascites?

A
  1. Hep C
  2. Alcoholic liver disease
  3. Congestive heart failure
  4. Nephrotic syndrome
  5. Pancreatitis
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13
Q

What investigations do you carry out in ascites?

A
  1. US
  2. Bloods
  3. Serological tests for hepatitis A, B, and C
  4. Aspirate ascitic fluid: cytology, culture and albumin
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14
Q

What is grade I-III of US ascites?

A
  • Grade 1: mild ascites detectable only by ultrasound
  • Grade 2: moderate ascites with moderate symmetrical distention of abdomen
  • Grade 3: large or gross ascites with marked abdominal distention
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15
Q

What scores can you use in ascites?

A

MELD + Child Pugh

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16
Q

What is the management of ascites?

A
  • Fluid restriction
  • Low salt diet
  • Spironolactone:100mg/24h
17
Q

What are some complications of ascites?

A

spontaneous bacterial peritonitis

Z Year3 Gastro Conditions (48 decks)

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