Cirrhosis Flashcards
What are the complications of cirrhosis?
Ascites Variceal bleeding Encephalopathy Hepatocellular carcinoma Portal Hypertension
How does cirrhosis cause variceal bleeding?
Increased portal blood pressure causes portal anastomoses to become enlarged and may rupture
Can cirrhosis be classed as a vascular disease?
Yes it affects the vascular system, eventually causing ascites
What are the 3 main causes of cirrhosis?
Alcohol
Hep C
None Alcoholic Fatty Liver Disease
What are the two types of cirrhosis?
Compensated cirrhosis Decompensated cirrhosis (More severe)
What are the signs of compensated cirrhosis?
Spider naevi Palmar erythema Clubbing Gynaecomastia (Moobs) Hepatomegaly Splenomegaly or NONE?
What are the signs of decompensated cirrhosis?
Jaundice
Ascites
Encephalopathy
Bruising
What is the treatment for decompensated cirrhosis?
Remove/treat underlying cause
Find and treat any infections
Treat abnormal physiology e.g Salt retention
Increase nutrtional intake
When should a patient have Vitamin B supplemented
Thiamine should be supplemented in excess alcohol intake
Which bone diseases are common in cirrhosis and how do you prevent them?
Osteoporosis and ostemalacia. Supplement 1000mg calcium and 20microg Vitamin D
How do you treat ascites?
No NSAIDS Reduce salt intake Maintain nutrition Diuretics - Spironolactone Paracentesis Transplant TIPSS procedure
What is the TIPSS procedure
Transjugular Intrahepatic PortoSystemic Shunt
Stent inserted to relieve pressure from portal circulation
How do you treat encephalopathy?
Treat underlying cause Lactulose Rifaxamin Small frequent meals Consider transplant in spontaneous cases
How can you prevent a first time variceal bleed?
B-Blockers
Variceal ligation
