CIRRHOSIS

Question 1

What is Cirrhosis?

Answer 1

End-stage of any chronic liver disease - characterised by fibrosis and conversion of normal liver structure to abnormal regenerative nodules

Question 2

What are common causes of cirrhosis?

Answer 2

Hep. B and C
Wilson’s disease
Primary Biliary Cholangitis
Alcohol-related liver disease

Question 3

What are the signs of Cirrhosis?

Answer 3

Jaundice
Hepatomegaly 
Splenomegaly 
Spider Naevi
Palmar Erythema
Gynaecomastia
Bruising
Ascites
Capital Medusae
Asterixis

Question 4

What are the symptoms of Cirrhosis?

Answer 4

Asymptomatic

Weight loss, Fatigue and Weakness (non-specific)

Question 5

Which blood test are done for Cirrhosis?

What are the expected results?

Answer 5

LFT - high ALT, AST>ALP
BILIRUBIN - high 
ALBUMIN - low
FBC - low WCC and Platelets (hypersplenism)
PT/INR - high

Question 6

Which scan is done to investigate cirrhosis?

Answer 6

Abdominal Ultrasound + duplex

It will show a small liver, hepatomegaly, splenomegaly, nodularity, or evidence of ascites

Question 7

How is cirrhosis managed?

Answer 7

Treat underlying chronic liver disease

Lifestyle changes - avoid alcohol, NSAIDs, quit smoking, lose weight, good hygiene and vaccination

Give Spironolactone if Ascites (Aldosterone Receptor Antagonist)