Cirrhosis and Liver Failure

Question 0

Pathophysiology of Cirrhosis

Answer 0

Degeneration ➡️ Fibrosis ➡️ Fibrovascular membranes ➡️ Nodules ➡️ Rearrangement of blood circulation ➡️ Cirrhosis

Question 1

Definition of cirrhosis

Answer 1

Irreversible injury of the hepatic parenchyma, include enxtensive fibrosis and formation of regenerative nodules

Question 2

Major etiologic agents in the Philippines

Answer 2

Viruses ➡️ posthepatic cirrhosis

Alcohol ➡️ Laennec’s cirrhosis

Question 3

[T/F]

Macronodular cirrhosis has a poorer prognosis than micronodular cirrhosis.

Answer 3

F

Question 4

Complications of Cirrhosis

Answer 4

Portal hypertension
Ascites
Hepatic encephalopathy
Hepatocellular carcinoma

Question 5

Manifestations of Portal Hypertension

Answer 5

Caput medusa
Varices in the esophagus and fundus of stomach
Ascites

Question 6

Treatment of portal hypertension

Answer 6

Reduction of pressure in the portal hypertension - beta adrenergic blocker, vasoconstrictors, surgical decompression, TIPS

Treatment of variceal bleeding - management of blood loss, control of bleeding

Question 7

Pathogenesis of Ascites

Answer 7

Low albumin: decreased oncotic pressure

High albumin: increased hydrostatic pressure

Question 8

Reversible neuropsychiatric abnormalities

Characterized by asterixis and abnormal EEG

Answer 8

Hepatic Encephalopathy

Question 9

Management of hepatic encephalopathy

Answer 9

Identify and correct precipitating factor
Decrease NH3 and other toxin in the blood
Metronidazole, branched amino acids, flumenazil