cirrhosis

Question 1

what is cirrhosis?

Answer 1

a chronic, progressive disease of the liver characterized by the destruction of hepatocytes

Question 2

what diagnostic tests are used for cirrhosis?

Answer 2

1. U/S
2. labs
3. CT
4. biopsy

Question 3

can the liver regenerate itself?

Answer 3

it can regenerate, but not normally. This will cause back flow of blood causing varicies.

Question 4

what are the early stages of cirrhosis?

Answer 4

1. loss of appetite
2. generalized malaise
3. wt loss
4. jaundice (aka icterus)
5. itching (increase bilirubin salts)
6. nausea
7. easy bruising
8. nosebleeds

Question 5

what are the later stages of cirrhosis?

Answer 5

1. ascites (will increase hypotension causing increase fluid in and)
2. peripheral edema
   * *both probably bc of low albumin**
3. vomiting blood
4. black stools
5. muscle wasting
6. spider angiomas
7. dilated blood vessels
8. fever and chills
9. hepatic encephalopathy (increase ammonia crosses BBB= altered LOC)
10. hepatorenal syndrome (10% of people decrease flow to kidneys?)

Question 6

what is the most important cirrhosis treatment?

Answer 6

1. REST! best thing for pt

Question 7

what medications will the pt receive for ammonia level management?

Answer 7

1. lactulose- ammonia will be excreted through stool to help decrease cerebral edema give to pt even if their having loose stools
2. neomycin- will decrease ammonia levels to decrease cerebral edema

Question 8

when should an upper respiratory infection be treated?

Answer 8

promptly

Question 9

should bleeding status be monitored on a pt with cirrhosis?

Answer 9

clotting factors are being affected

Question 10

should a patient with cirrhosis have an NGT?

Answer 10

yes but be very carful, pt may have varicies that can burst

Question 11

how should we manage ascites ?

Answer 11

paracentesis, TIPS procedure

HOB should be 45 degrees but may be difficult for pt.