Cirrhosis Flashcards
What is the definition of cirrhosis
Irreversible damage to the liver resulting in loss of normal liver structure with fibrosis and nodular regeneration. It is the final stage of any chronic liver disease
What are the common causes of cirrhosis
Chronic Hep C
Alcoholic liver disease
Non-alcoholic fatty liver disease (steatohepatitis)
Chronic Hep B
What are some other less common causes of cirrhosis
Metabolic disorders:-
Haemochromatosis
Wilson’s disease
Alpha 1-antitrypsin deficiency
Autoimmune conditions:-
Primary biliary cirrhosis
Primary sclerosing cholangitis
Autoimmune hepatitis
Drugs:-
Amiodarone
Methotrexate
What are signs of chronic liver disease
Spider naevi Palmar erythema Gynecomastia Testicular atrophy Clubbing Anaemia Prominent umbilical veins Malnutrition/weight loss
What are come complications of cirrhosis
Liver failure (decompensation)
Portal hypertension
Hepatocellular carcinoma
Hepatorenal syndrome
What is hepatorenal syndrome
Development of renal failure in patients with advanced chronic liver disease
What are the effects of portal hypertension
Splenomegaly
Oesophageal varices
Caput medusae
What blood tests would you want to do in a patient with cirrhosis
FBC U+Es Coagulation LFTs - reduced albumin with progressive liver damage Hepatitis screen
How do you classify the severity of liver disease
Child-Pugh classification
Clinical and biochemical measures of liver disease. Graded into group A-C
What is looked at in the Child-Pugh classification
Serum Albumin Serum Bilirubin Clotting: PT time or INR Distension: Ascites Encephalopathy
What is class A on the Child-Pugh classification
5-6 points
100% 1-year survival
What is class B on the Child-Pugh classification
7-9 points
81% 1-year survival
What is class C on the Child-Pugh classification
Greater than or equal 10 points
45% 1-year survival
What medication is used for pruritus in cirrhosis
Cholestyramine
What is cholestyramine
Bile acid sequestrant