Decompensated Cirrhosis Flashcards
What is Decompensated Cirrhosis?
Acute deterioration in liver function in a Cirrhosis pt
Why is Decompensated Cirrhosis dangerous?
Can lead to significant morbidity + mortality
What are the CF of Decompensated Cirrhosis? (6 things)
- Hepatic Encephalopathy (confusion)
- Jaundice
- GI bleeding
- Ascites
- Hepatorenal syndrome
- Coagulopathy
Why do you get Hepatic Encephalopathy in Decompensated Cirrhosis?
Poor detoxification of harmful substances
Why do you get Jaundice in Decompensated Cirrhosis?
Impaired breakdown of bilirubin
Why do you get GI bleeding in Decompensated Cirrhosis?
Increased portal pressure –> varices
Why do you get Ascites in Decompensated Cirrhosis?
Poor albumin synthesis + increased portal pressure
Why do you get Coagulopathy in Decompensated Cirrhosis?
Reduced clotting factor synthesis
How does Coagulopathy in Decompensated Cirrhosis present? (2 things)
- Bruising
- Abn coagulation tests
What scoring system is used for the Severity of Decompensated Cirrhosis?
Child-Pugh score
What is the Child-Pugh score for Decompensated Cirrhosis?
What does the Child-Pugh score tell you about the Decompensated Cirrhosis
Estimated 1 year survival
What is the estimated 1 year survival for each class of the Child-Pugh score?
- Class A: 100% (mild)
- Class B: 80% (moderate)
- Class C: 45% (severe)
What initial investigations should you for sus Decompensated Cirrhosis? (6 things)
- FBC
- UnEs
- LFTs
- Liver screen (including AFP)
- Glucose
- Coag screen
What further investigations should you for Decompensated Cirrhosis? (2 things)
- US abdomen
- Diagnostic ascitic tap