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Hugh's MD2 Core Conditions and Presentations > Cirrhosis > Flashcards

Cirrhosis Flashcards

1
Q

What is the pattern of fibrosis in viral hepatitis cirrhosis?

A

Macronodular

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1
Q

What are the best indicators of liver function (blood test results)?

A

Serum albumin <28g/L in cirrhosis

Prothrombin time >6s above normal in cirrhosis

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2
Q

What is the 5 year survival rate for patients with cirrhosis?

A

50%

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2
Q

What might the cause of acute onset ascite be in patient with cirrhosis?

A

High dietary Na

The development of hepatocellular carcinoma

Splanchnic vein thrombosis

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3
Q

What must be considered when percussing for ascites?

A

When turning the patient on their side, avoid the side where organomegaly is present

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4
Q

What are the 12 causes of cirrhosis?

A

Alcohol steatohepatitis

Viral hepatitis (Hep B and C)

NAFLD

Primary billiary cirrhosis

Primary sclerosing cholangitis

Autoimmune hepatitis

Haemochromatosis

Wilson’s Disease

Cardiac cirrhosis (hepatic vein congestion)

Idiopathic

Drugs (eg methotrexate)

Cystic fibrosis

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5
Q

What are the 5 criteria used in the modified Child’s-Pugh classicification?

A

Ascites

Encephalopathy

Bilirubin

Albumin

Prothrombin time

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8
Q

What is the pattern of fibrosis in alcoholic hepatitis cirrhosis?

A

Micronodular

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9
Q

What is the most common cause of cirrhosis in the west?

A

Alcoholic steatohepatitis

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10
Q

What should be measured in young cirrhotic patients?

A

Copper and serum alpha-anti-trypsin

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11
Q

What is the most common cause of cirrhosis worldwide?

A

Viral

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12
Q

What might be found on LFTs in a patient with hepatocellular carcinoma?

A

Raised ALP

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13
Q

What Ix can be performed for cirrhosis?

A

Ultrasound

CT scan

Endoscopy - varices, portal hypertension

MRI - useful for diagnosis of benign tumours

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14
Q

What are some causes of a massive liver?

A

Metastases

Alcoholic liver disease with fatty infiltration

Myeloproliferative disease

Right heart failure

Hepatocellular cancer

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15
Q

What are some precipitants for hepatic encephalopathy in a patient with cirrhosis?

A

Progressive liver injury

Alcohol binge

Acute viral hepatitis

Upper GI bleeding

Hepatocellular carcinoma

Infection

Increased portosystemic shunts (eg new TIPSS)

Zinc deficiency

Dehydration

Constipation

Drugs (eg opiates)

Non-compliance

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Hugh's MD2 Core Conditions and Presentations (67 decks)

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