Cirrhosis Flashcards
What is cirrhosis ?
Chronic progressive disease of the liver
- book* is the end- stage of lover disease
- characterized by extensive degeneration and destruction of liver cells
- 75-80% of liver is gone and they are symptomatic
Alcoholic Cirrhosis
ETOH abuse
Accumulation of fat in the liver cells
Fatty changes are potentially reversible
* stop drinking during the fatty liver stage your liver cells can regenerate. Once liver cells are destroyed & become fibrotic then they are done*
Post necrotic cirrhosis
Massive necrosis of the liver Caused by: - Industrial chemicals (you see it a lot with industrial chemical exposure) - metabolic disorders - viral infections - hepatotoxins
Biliary cirrhosis
Associated with chronic biliary obstruction & infection - liver cancer - biliary cancer - gallbladder cancer Diffused fibrosis of liver Jaundice main feature
Cardiac cirrhosis
Results from long term Right sided HF associated with:
- cor pulmonary
- constrictive pericarditis
- tricuspid insufficiency
Primary biliary cirrhosis
Chronic inflammatory condition T- cell mediated attack of the small bile duct epithelial cells which leads to blockage of bile flow which leads to cirrhosis & liver fibrosis No hx of drinking & genetic issues Women 45-65 yrs old Genetic & environmental factors
Non Alcoholic Fatty Liver Disease (NAFLD) cirrhosis
Characterized by hepatic stenosis
Fatty changes in hepatocytes
No hx of drinking
Compensated clinical Manifestations
- anorexia - dyspepsia
- flatulence - N/V
- palpable liver - change in bowel habits
- abdominal pain (dull, heavy feeling )
- Low grade fever
Decompensated clinical manifestations
- Altered LOC, coma
- (+) babinski
- Asterixis ( liver flaps)
- peripheral neuropathy book d/t insufficient thiamine,folic acid, cobalamin
- jaundice & pruritus
Spontaneous Bacterial Peritonitis (SBP)
Bacterial infection of ascetic fluid
Due to translocation of the intestinal flora
SBP 2/2 Ascites 2/2 Albumin deficiency 2/2 ⬇️ability of liver to synthesis albumin
Palmar Erythema
- a red area that blanches with pressure located on the palms of hands
Due to estrogen
Liver can not get rid of estrogen
Spider Angiomas
- are small dilated blood vessels with a bright center
Compressed liver causes blood to be shunted somewhere else. Blood is shunted/ redirected to vascular ares that are low- pressure, small veins.
- esophagus, face, and trunk
Child- Pugh
Classification system Scoring system to determine likely outcome of disease with cirrhosis 1. Albumin 2. Ascites 3. Total Bilirubin 4. PT 5. Encephalopathy
Child - Pugh scoring system
- The lower the score the HIGHER chances of disease outcome*
Class A: 5-6. (5 yr prognosis)
Class B: 7-9. (5 yr prognosis)
Class C: > 9 - 10 or more prognosis of 1 year survival being about 50%*
M.E.L.D
Helps determine & prioritize recipient of liver transplant
Developed to predict death within 3 months post-op