Cirrhosis

Question 1

What is Cirrhosis?

Answer 1

Cirrhosis is a diffuse pathological process, characterised by fibrosis and conversion of normal liver architecture to structurally abnormal nodules known as regenerative nodules

Question 2

What are the risk factors for cirrhosis?

Answer 2

alcohol misuse
intravenous drug use
unprotected intercourse
obesity
country of birth

Question 3

What is the epidemiology of cirrhosis?

Answer 3

Liver disease is the third biggest cause of premature mortality in the UK

Question 4

What are the signs and symptoms of cirrhosis?

Answer 4

Abdo distension
Jaundice and pruritis
Haematemesis and melaena
Peripheral stigmata of liver disease
Constitutional symptoms
Lower extremity swelling
Hepatic fetor
Muscle wasting
Peripheral oedema

Question 5

What investigations would you do for cirrhosis?

Answer 5

Bloods
> LFTs (deranged)
> GGT (Elevated)
> Serum albumin (Decreased)
> Serum sodium (Decreased)
> PT (Prolonged)
> Plt count (Decreased)
> Hep C antibodies (Present)
> Hep B antigens (Present)

Question 6

What is the management of cirrhosis?

Answer 6

> Treatment of underlying condition
Monitor for complications
Sodium restriction/ diuretics
Liver Transplant

Question 7

What are the complications of cirrhosis?

Answer 7

Ascites
Gastro oesophageal varices
Hepatocellular carcinoma
Bleeding and thrombosis
SBP
Hepatic hydrothorax
Portosystemic encephalopathy
AKI-HRS
Hepatopulmonary syndrome
Portopulmonary syndrome
Feminisation
Hepatic osteodystrophy

Question 8

What is the prognosis of cirrhosis?

Answer 8

The overall median survival of patients with cirrhosis is approximately 10 years, but prognosis depends on the stage of the disease. (Higher stage, higher mortality)