Cirrhosis

Question 1

chance of varices bleeding better correlates with

Answer 1

the size of the varices

Question 2

therapy of bleeding varices

Answer 2

Primary therapy of bleeding varices is endoscopic sclerotherapy or banding. “TIPS” is used for cases that rebleed,
The best therapy appears to be IV infusion of somatostatin or its analog, octreotide, both of which are splanchnic vasoconstrictors

Question 3

What drug is associated with decreased rebleeds?

Answer 3

Propranolol, with or without isosorbide dinitrate, decreases rebleeds and may delay or prevent the occurrence of the first variceal bleed, Therefore, give propranolol to any patient who has bled from varices

Question 4

which drug should be given to all cirrhotic patients with bleeding varices or ascitis?

Answer 4

prophylactic antibiotics (3rd generation cephalosporin) to prevent spontaneous bacterial peritonitis (SBP) or sepsis

Question 5

Hepatic encephalopathy may be precipitated by:

Answer 5

• GI bleed
• azotemia
• increased dietary protein
• constipation
• hypokalemia
• sedatives
• tranquilizers
• infections (pneumonia, bacteremia, urosepsis, and spontaneous bacterial peritonitis-SBP)
• alkalosis

Question 6

treatment of Hepatic Encephalopathy

Answer 6

protein restriction and lacrulose