Cirrhosis Flashcards
What is cirrhosis?
Hepatocyte cells in space of Disse change due to chronic inflammation, liver becomes fibrosed and shrinks
What does liver shrinkage and fibrosis result in?
Reduced liver blood flow
Reduced metabolic function
Reduced plasma proteins
Result of reduced metabolism of liver?
Low albumin (low plasma volume by kidneys) Increased plasma aldosterone Endothelin and oestrogen
Effect of cirrhosis on liver can cause?
Hepato-renal syndrome which can cause kidneys to give up
Who gets cirrhosis?
People with liver disease
How does cirrhosis present?
Liver and kidney congestion- reduced function
Heart failure- due to low plasma proteins
Presentation of compensated cirrhosis?
Palmar erythema Clubbing Gynaecomastia Spider naevi Hepatomegaly Splenomegaly Can be asymptomatic
Cause of spider naevi?
Due to high oestrogen
Presentation of decompensated cirrhosis?
Jaundice
Ascites
Encephalopathy
Bruising
How is cirrhosis diagnosed?
Ascites - shifting dullness and US
How is severity of cirrhosis graded?
Childs-Turcotte-Pugh
How is cirrhosis treated?
- Remove/treat underlying cause
- Spironolactone for ascites + loop if not fully effective
- Possible transplantation
- Treat infection
- Nutrition to be considered
Complications of liver cirrhosis?
Ascites Encephalopathy Variceal bleeding Liver failure Hepatocellular carcinoma SBP- spontaneous bacterial peritonitis
