Cirrhosis Flashcards
secondary prophylaxis of variceal hemorrhage?
Banding AND beta-blocker
Candidates for preemptive “early” TIPS?
Child C (score 10-13) or Child Class B with active hemorrhage at endoscopy
contraindications to TIPS?
advanced age, hepatocellular carcinoma, heart failure, or significant encephalopathy
High SAAG, High Protein: etiologies?
cardiac ascites, Budd-Chiari and veno-occlusive disease (hypothyroidism)
low SAAG and high protein: etiologies?
tuberculous peritonitis and malignant
The only clear indications for antibiotic prophylaxis in patients with cirrhosis?
GI hemorrhage
Prior SBP
The most common cause of acute kidney injury in cirrhosis?
albumin responsive azotemia
Milan criteria?
1) three lesions each measuring less than three centimeters
2) single lesion less than five centimeters without evidence of vascular invasion or extrahepatic disease
Sorafenib is reserved for those patients with
advanced HCC who are not candidates for locoregional treatment and have good liver function
special conditions whereby patients can receive MELD exception points?
-HCC
-hepatopulmonary syndrome, -portopulmonary hypertension,
-familial amyloid polyneuropathy, -polycystic liver disease,
-primary hyperoxaluria
When does Hepatopulmonary syndrome qualify for exception points?
paO2 less than 60 mmHg
RV-related values that are related to liver transplant?
MPAP (mean pulmonary artery pressure) must be less than 35 mmHg and pulmonary vascular resistance less than 400 dynes.s.cm-5
When is a TIPS procedure recommended for GOV1?
Failure to control bleeding or in the event of a recurrent bleeding
single tumors that are this size can be treated by either resection or ablation
less than 2.5 cm
Cirrhotic with PVT on RUQUS - next step? Why?
MRI for extension of clot.
When thrombus involves the main portal vein or is progressing into the mesenteric vein, the consequence is intestinal ischemia or infarction and anticoagulation should be initiated
