Cirrhosis, Portal HTN, Liver failure

Question 1

End stage of chronic liver diseases where much of the functional liver tissue has been replaced by fibrous tissue and scaring

Answer 1

Cirrhosis

Question 2

Main association with cirrhosis

Answer 2

alcoholism

Question 3

Other disorders that can develop cirrhosis

Answer 3

viral hepatitis
autoimmune rxn
NAFLD
biliary dz
metabloic disorders causing mineral deposits

Question 4

Iron deposition in the liver

Answer 4

Hematochomatosis

Question 5

Copper deposition in the liver

Answer 5

Wilson disease

Question 6

Complications of cirrhosis

Answer 6

deficits in protein synthesis (clotting and albumin)
problems with fluid balance (albumin),
coagulation (clotting factors), and immune response (kupffer cells)
deficits in detoxification
deficits in metabolism of lipids and carbohydrates
ascities
hepatic encephalopathy
esophageal varicies (collateral vessels)
gynecomastasia
thrombocytopenia due to splenomegaly

Question 7

Definitive diagnosis for cirrhosis

Answer 7

liver biopsy

Question 8

Treatment of cirrhosis involves

Answer 8

correction of manifestations

liver transplant in advanced disease

Question 9

Increased resistance to flow in portal venous system and increase portal venous pressure

Answer 9

Portal Hypertension

Question 10

What is portal hypertension associated with

Answer 10

cirrhosis
hepatitis
right sided heart failure

Question 11

Complications of portal HTN

Answer 11

portosystemic shunts-espohageal varicies
ascities
splenomegaly

Question 12

Cause of portosystemic shunts

Answer 12

obstruction of blood flow increases portal venous pressure causing large collateral vessels to form between portal and systemic veins

Question 13

What is concern with collateral vessels?

Answer 13

they can easily rupture and lead to life threatening hemorrhage

Question 14

Fluid accumulation in the peritoneal cavity

Answer 14

ascites

Question 15

Ascites is associated with

Answer 15

the decreaed albumin production lowering colloidal osmotic pressure and contributing to fluid shift

Question 16

Treatment for ascites

Answer 16

reduce sodium intake
diuretics
paracentesis

Question 17

The shunting of blood into splenic vein causing spleen enlargement

Answer 17

splenomegaly

Question 18

Consequences of splenomegaly

Answer 18

anemia
thrombocytopenia
leukopenia

Question 19

Define liver failure

Answer 19

loss of 80-90% liver function

loss of liver’s synthesis, storage, metabolic, and elimination functions

Question 20

Complications of liver failure

Answer 20

anemia
thrombocytopenia
coagulopathy
leukopenia
endocrine disorders: loss estrogen,testosterone,aldosterone
fluid imbalances

Question 21

What is hepatorenal syndrome

Answer 21

terminal stage of liver failure
ascites
azotemia
increased creatinine
oliguria
hepatic encephalopathy

Question 22

A very early sign of hepatic encephalopathy of a flapping tremor

Answer 22

asterixis

Question 23

Totality of central nervous sytems manifestation of liver failure resulting in neural disturbances ranging from lack of mental alertness to confusion, coma, and convulsions

Answer 23

Hepatic encephalopathy

Question 24

Drug given for hepatic encephalopathy

Answer 24

lactulose

Question 25

What is the suspected neurotoxin in hepatic encephalopathy

Answer 25

ammonia