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CMLFInal Sem2 > Cirrhosis > Flashcards

Cirrhosis Flashcards

1
Q

What is the pathophysiology of pruritis?

A

Elevated levels of bile acids in the skin can act as pruritogens

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2
Q

Lysophosphatidic acid and autotaxin can cause what?

A

pruritis

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3
Q

What level was elevated in patients with pruritis in one study?

A

Studies show patients with cholestatic pruritis had much higher serum LPA levels and autotaxin activity.

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4
Q

What is the treatment for cholestatic pruritis if the patient doesn’t have intrahepatic cholestasis of pregnancy or primary biliary cholangitis?

A

Bile acid sequestrant is 1st line:

–Cholestyramine (Questran) or colestipol (Colestid)

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5
Q

What is 2nd line tx for cholestatic pruritis that reduces autotaxin?

A

Rifampin (Rifampicin)

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6
Q

What is 3rd line tx for cholestatic pruritis?

A

opoid antagonist (naltrexone)

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7
Q

Do antihistamines work for cholestatic pruritis?

A

No

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8
Q

What is the MELD score used for?

A

Used to prioritize patients awaiting liver transplant

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9
Q

What factors does the MELD

score use and what was just recently added?

A
  • serum bilirubin
  • creatinine
  • INR
  • Whether patient has had recent dialysis
  • Na recently added
  • *predicts 3-month survival
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10
Q

__________ is a marker of how bad cirrhosis is and mortality

A

hyponatremia

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11
Q

Each _______ in serum sodium increases mortality by ____%

A

decrease, 5%

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12
Q

What is the management of variceal hemorrhage?

A
  • egd screening/band ligation

- nonselective beta blocker (propanolol)

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13
Q

What is the tx for ascites?

A
  • Diuretics: Spironolactone/furosemide 100:40 ratio
  • Paracentesis
  • Sodium restriction
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14
Q

treatment for Spontaneous Bacterial Peritonitis?

A
  • Empiric antibiotics
  • Cefotaxime
  • Prophylactic antibiotics for patients who have previously had SBP
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15
Q

treatment for Hepatic encephalopathy?

A

Lactulose/lactitol or rifaximin

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16
Q

treatment for Hepatic hydrothorax?

A

Diuretics, sodium restriction

17
Q

treatment for Hepatocellular carcinoma?

A
  • Surgical resection

* Liver transplant

18
Q

treatment for Hepatopulmonary syndrome?

A
  • Liver transplantation

* Long-term oxygen therapy

19
Q

how to screen for esophageal varices?

A

EGD

20
Q

how to screen for HCC?

A

Serial ultrasound

21
Q

how to screen for Hepatic encephalopathy?

A

More detailed neuro exam & testing

22
Q

What score on the CAGE score defines probable alcohol abuse?

A

yes to 2 or more of the questions

23
Q

How do you measure ascites?

A

Should measure waist circumference and weight to monitor ascites

24
Q

How do you treat COPD

A

Tiotropium (Spiriva) & a short-acting rescue inhaler

25
Q

What is HBsAg?

A

Hepatitis B surface antigen (HBsAg) is a blood test ordered to determine if someone is infected with the hepatitis B virus. If it is found, along with specific antibodies, it means the person has a hepatitis B infection.

26
Q

What is anti-HBc?

A

Appears at the onset of symptoms in acute hepatitis B and persists for life. The presence of anti-HBc indicates previous or ongoing infection with hepatitis B virus in an undefined time frame.

27
Q

What is anti-Hbs?

A 
The presence of anti-HBs
is generally interpreted as
indicating recovery and
immunity from hepatitis B
virus infection. Anti-HBs
also develops in a person
who has been successfully
vaccinated against
hepatitis B.
28
Q

What is (IgM anti-HBc)?

A

Positivity indicates recent
infection with hepatitis B
virus (<6 mos). Its presence
indicates acute infection.

29
Q

What is the interpretation of this:
HBsAg: neg
anti-HBc: neg
anti-HBs: neg

A

susceptible

30
Q

What is the interpretation of this:
HBsAg: neg
anti-HBc: pos
anti-HBs: pos

A

immune due to natural infection

31
Q

What is the interpretation of this:
HBsAg: neg
anti-HBc: neg
anti-HBs: pos

A

Immune due to Hep B vaccination

32
Q 
What is the interpretation of this: 
this: 
HBsAg: pos
anti-HBc: pos
anti-HBs: pos
IgM anti-Hbc: neg
A

acute and active

33
Q 
What is the interpretation of this: 
this: 
HBsAg: pos
anti-HBc: pos
anti-HBs: neg
IgM anti-Hbc: neg
A

chronically infected

CMLFInal Sem2 (10 decks)

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