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GI Final > Cirrhosis and Complications (Quiz 3) > Flashcards

Cirrhosis and Complications (Quiz 3) Flashcards

1
Q

what is cirrhosis

A
  • normal architecture of liver replaced by hepatic nodules separated by fibrosis
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2
Q

how does cirrhosis occur

A
  • stellate cell activation leads to accumulation of scar
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3
Q

what can also activate stellate cels

A
  • Kupffer cells
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4
Q

how does cirrhosis cause jaundice and scleral icterus

A
  • liver can’t process bile
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5
Q

how does cirrhosis cause pruritus

A
  • bile pigments deposited in skin
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6
Q

how does cirrhosis cause coagulopathy

A
  • liver cannot produce clotting factors
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7
Q

how does cirrhosis cause ascites and edema

A
  • liver cannot make albumin
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8
Q

_____________ is the root cause in many of the complications of cirrhosis

A
  • portal hypertension
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9
Q

normal portostystemic pressure gradient is ______ mmHg

clinical symptoms of portal hypertension seen when gradient exceeds ________ mmHg

A
  • 5

- 12

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10
Q

what two things is portal pressure related to

A
  • venous inflow

- resistance to outflow

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11
Q

portal venous inflow is controlled by the tone of __________

A
  • mesenteric arterioles
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12
Q

in normal portal circulation, blood flows from _________ to the ________ circulation and then, back to the _______ circulation

A
  • mesenteric arterioles
  • portal venous circulation
  • systemic venous circulation
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13
Q

what is the inflow in portal hypertension

A
  • increased due to mesenteric arteriolar dilation
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14
Q

what is the outflow in portal hypertension

A
  • elevated resistance through cirrhotic hepatic sinusoids
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15
Q

once a patient develops complications of cirrhosis they have __________ disease

A
  • decompensated
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16
Q

what is the most devastating complication of cirrhosis and portal hypertension

A
  • variceal hemorrhage
17
Q

what is the most common variceal hemorrhage

A
  • esophageal varices
18
Q

treatment of variceal hemorrhage

A
  • ligation banding

- TIPS

19
Q

to prevent variceal hemorrhage, all patients with cirrhosis need a screening

A
  • EGD
20
Q

what medications can reduce portal hypertension

A
  • non selective beta blockers
21
Q

procedure for gastric varices management

A
  • BORTO
22
Q

how do we grade ascites

A
  • serum-ascites albumin gradient (SAAG)
23
Q

diet changes for ascites treatment

A
  • low sodium
24
Q

medications for ascites treatment

A
  • duretics
25
Q

what does the TIPS procedure do

purpose

A
  • place shunt between hepatic veins and portal vein

- reduce portal hypertension

26
Q

spontaneous bacterial peritonitis caused by

A
  • bacterial translocation from gut

- E. coli

27
Q

what do you see in peritoneal fluid with spontaneous bacterial peritonitis

A

> 250 PMNs

28
Q

what medication do you treat spontaneous bacterial peritonitis with

A
  • 3rd generation cephalosporin
29
Q

what is hepatorenal syndrome

what happens

A
  • acute renal failure in a patient with cirrhosis

- reduced perfusion of kidneys

30
Q

which hepatorenal syndrome has a 50% reduction of plasma creatinine clearance to a level below 20 mL/min or doubling of serum creatinine in less than 2 weeks and is rapidly fatal

A
  • type I
31
Q

which hepatorenal syndrome has a more indolent course and is primarily characterized by diuretics refractory ascites

A
  • type II
32
Q

best treatment for hepatorenal syndrome

A
  • liver transplant
33
Q

what is the most important etiologic factor worldwide for hepatocellular carcinoma

A
  • hep B
34
Q

how to diagnose hepatocellular carcinoma

A
  • alpha feto protein > 200

- MRI

35
Q

what is hepatic encephalopathy

A
  • disturbance in CNS function due to hepatic insufficiency
36
Q

what is the characterized neurotoxin in hepatic encephalopathy

A
  • ammonia
37
Q

criteria for hepatic encephalopathy

A
  • west haven criteria
38
Q

for liver transplantation, patient are listed according to the severity of their ______ score

A
  • MELD-Na

GI Final (27 decks)

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