Ascites Flashcards
1
Q
Definition
A
Collection of fluid in peritoneal cavity
2
Q
Etiology
A
Hepatitis C Alcoholic hepatitis CHF Nephrotic syndrome Pancreatitis
Other causes of cirrhosis Schistosomiasis Constrictive pericarditis Ovarian tumors SLE Protein losing enteropathy
3
Q
History
A
Presence/risks of cirrhosis Risks of hepatitis C Family history SOBOE, PND, orthop->CHF Malignancy Pancreatitis Autoimmune disease
4
Q
Physical examination
A
General Stigmata of cirrhosis JVP distension Abdominal Peripheral edema
5
Q
Investigations
A
USS
FBC, LFT, UEC, albumin
Coagulation
Calculate MELD/Chigh Pugh
Serology for hepatitis B, A, C->determine status and need for immunisations
Abdominal paracentesis->cell count, differential, albumin, protein, culture, glucose, LDH, amylase, gram stain, TB smear/culture, cytology
Liver biopsy
6
Q
What in the ascitic fluid suggests non-cirrhotic cause
A
ascitic fluid albumin gradient is high Diagnosis based on SAAG: >1.1g/dL: portal hypertension Cirrhosis Portal vein thrombosis Budd chiari CHF Corrective pericarditis
7
Q
Risks with paracentesis
A
Hematoma 1%
