Cirrhosis & Liver Diseases-B

Question 1

CLINICAL FEATURES OF CIRRHOSIS & LIVER FAILURE

Answer 1

CIRRHOSIS
Diffuse hepatic fibrosis & nodule formation
CAUSES
- Alcohol // chronic viral hepatitis // non-alcoholic fatty liver disease

CLINICAL FEATURES
- Hepatomegaly
- Jaundice (X metabolize bilirubin-hepatocellular) (clog bile ducts- obstruction)
- Ascites
- Spider naive
-Palmar erythema
- Gynaecomastia// testicular atrophy
- portal hypertension
- Anaemia

Question 2

DIAGNOSTIC TEST

Answer 2

HEPATIC CELL DESTRUCTION
AST//ALT//LDH// ALKALINE PHOSPHATE (INCREASE)
BILIRUBIN & AMMONIA (INCREASE)
PROTHROMBIN TIME (INCREASE)

Question 3

COMPLICATIONS OF LIVER CIRRHOSIS

Answer 3

1. Portal hypertension
2. Coagulation defect & bleeding
3. Jaundice
4. Hepatic encephalopathy
5. hepato-renal syndrome

Question 4

FACTORS PRECIPATING HEPATIC ENCEPHALOPATHY

Answer 4

SYMPTOMS
-Sleep pattern changes
- behaviour changes
- flapping tremor
- ugi bleeding
- dehydration

Question 5

MANAGEMENT PRINCIPLES IN ACUTE VARICEAL BLEEDING

Answer 5

1. ESOPHAGOGASTRIC BALLOON TAMPONADE
2. BLOOD TRANSFUSION
3. MEDICATION
   - Beta-blockers (decrease HR and BP)
   - Vasopressin
   4.

Question 6

DEFINE ASCITES & COMMON CAUSE & MANAGEMENT

Answer 6

ASCITES (accumulation of fluid in the peritoneal cavity)

CAUSE
- Increase portal pressure
- Hypoproteinaemia
- increase hydrostatic pressure

MANAGEMENT
*Paracentesis
*Shunts
- Le Veen Shunt
- Denver Shunt

Question 7

signs of improvement

Answer 7

1. no bleeding
2. decrease ascites
3. decrease in edema
4. BP normal