Cirrhosis

Question 1

What are causes of cirrhosis

Answer 1

alcohol
non-alcoholic fatty liver disease
viral hepatitis - B and C

Question 2

What symptoms are associated with cirrhosis

Answer 2

fatigue
jaundice
ascites
hepatic encephalopathy
loss of appetite

Question 3

What is present on examination in a ptient with cirrhosis

Answer 3

hepatomegaly
ascites
spider nevi
signs of hepatic encephalopathy

Question 4

What are investigations for cirrhosis

Answer 4

Transient elastography for people
-with Hep C
-men who drink over 50 units a week
-women who drink over 35 units a week
-people diagnosed with alcohol related liver disease

Upper endoscopy to check for varices

Liver ultrasound everu 6 months

AFP for hepatocellular cancer

Question 5

What classification is used for cirrhosis

Answer 5

Child pugh classification

Summation of scores allows severity to be graded either A, B OR C

<7 = A
7-9=B
>9=C

Question 6

What is management of cirrhosis

Answer 6

Lifestyle modications - weight loss and alcohol abstinence

Treatment of complications can include medications

Referral to specialist services - such as hepatology / transplant services

End of life care for those with advanced liver cirrhosis

Question 7

Why do we not usually look at liver enzymes to assess liver function

Answer 7

In cirrhosis liver enzymes are usually low anyways whereas coagulation and albumin are better measures

Question 8

What is the best indicator for the functional capacity of the liver in patients with cirrhosis

Answer 8

Albumin