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GI > Cirrhosis > Flashcards

Cirrhosis Flashcards

1
Q

What is it?

A

irreversible liver damage

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2
Q

What is it?

A

irreversible liver damage

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3
Q

What histological changes are observed?

A

loss of normal hepatic architecture
bridging fibrosis
nodular regeneration

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4
Q

What are the signs of cirrhosis?

A 
Hand changes:
- Leuconychia
- Terrys nails
- Clubbing
- Palmar erythema 
- Hyperdynamic circulation 
- Dupuytrens
- spider naevi
- Xanthelasma
- Gynaecomastia
Atrophic testes
Loss of body hair 
Parotid enlargement 
Hepatomegaly 
Ascites
Splenomegaly
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5
Q

What are the signs of cirrhosis?

A 
Hand changes:
- Leuconychia
- Terrys nails
- Clubbing
- Palmar erythema 
- Hyperdynamic circulation 
- Dupuytrens
- spider naevi
- Xanthelasma
- Gynaecomastia
Atrophic testes
Loss of body hair 
Parotid enlargement 
Hepatomegaly 
Ascites
Splenomegaly
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6
Q

What tests would u do

A 
Bloods
Liver US and duplex
MRI
Ascitic tap - MC + S
Liver biopsy 
Transient elastography - measures stiffness of liver, proxy for fibrosis
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7
Q

what is the general management?

A 
good nutrition
no alcohol 
avoid NSAIDs, sedatives, opiates
Colestyramine for pruritus
US + AFP every 6m for HCC
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8
Q

What is the specific management of cirrhosis?

A

High dose ursodeoxycholic acid in PBC

Penicillamine for Wilsosn

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9
Q

What are the complications of cirrhosis?

A
  1. hepatic failure
  2. portal HTN
  3. HCC
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10
Q

What tests would u do

A 
Bloods
Liver US and duplex
MRI
Ascitic tap - MC + S
Liver biopsy
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11
Q

what is the general management?

A 
good nutrition
no alcohol 
avoid NSAIDs, sedatives, opiates
Colestyramine for pruritus
US + AFP every 6m for HCC
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12
Q

What is the specific management of cirrhosis?

A

High dose ursodeoxycholic acid in PBC

Penicillamine for Wilsosn

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13
Q

What is the management of ascites?

A 
Fluid restriction 
Low salt diet 
Spironolactone 
add furosemide if poor response 
Therapeutic paracentesis w concomitant albumin infusion
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14
Q

When should abx prophylaxis be given to pts w ascites?What abx are given?

A

pts w an episode of SBP
flid protein <15g/l + either Child-pugh score of at least 9 or hepatorenal syndrome
ciprofloxacin

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15
Q

What are the features of SBP?

A

Ascites
abdo pain
fever
Sudden deterioration in pt w cirrhosis

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16
Q

How is SBP diagnosed?What is the most common organism?

A

Paracentesis w neutrophil count >250 cells/ul

E. coli

17
Q

what is the management of SBP?

A

IV cefotaxime or tazocin

18
Q

When should abx prophylaxis be given to pts w ascites?

A

pts w an episode of SBP

flid protein <15g/l + either Child-pugh score of at least 9 or hepatorenal syndrome

19
Q

What is the definitive treatment for cirrhosis?

A

liver transplant

20
Q

What is the child Pugh classification used for?

A

classify severity of liver cirrhosis

21
Q

What is the model for end stage liver disease ?

A

uses a combination of bilirubin, creatinine and INR to predict survival (3 month mortality)

GI (16 decks)

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