Cirrhosis Flashcards

1
Q

What is cirrhosis ?

A

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
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2
Q

Alcoholic Cirrhosis

A

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*

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3
Q

Post necrotic cirrhosis

A
Massive necrosis of the liver 
Caused by:
- Industrial chemicals (you see it a lot with industrial chemical exposure)
- metabolic disorders
- viral infections 
- hepatotoxins
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4
Q

Biliary cirrhosis

A
Associated with chronic biliary obstruction & infection 
- liver cancer     - biliary cancer 
- gallbladder cancer 
Diffused fibrosis of liver 
Jaundice main feature
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5
Q

Cardiac cirrhosis

A

Results from long term Right sided HF associated with:

  • cor pulmonary
  • constrictive pericarditis
  • tricuspid insufficiency
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6
Q

Primary biliary cirrhosis

A
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
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7
Q

Non Alcoholic Fatty Liver Disease (NAFLD) cirrhosis

A

Characterized by hepatic stenosis
Fatty changes in hepatocytes
No hx of drinking

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8
Q

Compensated clinical Manifestations

A
  • anorexia - dyspepsia
  • flatulence - N/V
  • palpable liver - change in bowel habits
  • abdominal pain (dull, heavy feeling )
  • Low grade fever
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9
Q

Decompensated clinical manifestations

A
  • Altered LOC, coma
  • (+) babinski
  • Asterixis ( liver flaps)
  • peripheral neuropathy book d/t insufficient thiamine,folic acid, cobalamin
  • jaundice & pruritus
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10
Q

Spontaneous Bacterial Peritonitis (SBP)

A

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

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11
Q

Palmar Erythema

A
  • a red area that blanches with pressure located on the palms of hands

Due to estrogen
Liver can not get rid of estrogen

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12
Q

Spider Angiomas

A
  • 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

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13
Q

Child- Pugh

A
Classification system 
Scoring system to determine likely outcome of disease with cirrhosis 
1. Albumin
2. Ascites 
3. Total Bilirubin 
4. PT
5. Encephalopathy
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14
Q

Child - Pugh scoring system

A
  • 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%*
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15
Q

M.E.L.D

A

Helps determine & prioritize recipient of liver transplant

Developed to predict death within 3 months post-op

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16
Q

M.E.L.D scoring

A
*Higher the M.E.L.D score the LEAST eligible for transplant *
 40 ———— 71.3% mortality/ death
30-39 ——- 52.6% mortality/ death
20-29 ——— 19.6% mortality/ death 
10-19 ———- 6.0% mortality/ death
<9      ———- 1.9% mortality/ death