Exam 4 - Liver Cirrhosis

Question 1

Three types of Liver Cirrhosis? Most common and causes?

Answer 1

1. Alcoholic Cirrhosis=most common d/t drinking
2. Post-Necrotic Cirrhosis=d/t Hep B or C in the past
3. Biliary Cirrhosis=least common, d/t chronic obstructed biliary duct

Question 2

Pathophysiology of Liver Cirrhosis?

Answer 2

Inflammation of hepatocytes and hepatomegaly.

Question 3

Hepatic Encephalopathy cause and tx?

Answer 3

Protein rich foods broken down and NH3 crossing BBB into brain.

Tx: Lactulose (first-line), Rifaximin (second-line)

Question 4

Portal HTN cause and tx?

Answer 4

Backup of blood to portal vein causing increased pressure in portal vein. Leads to esophageal varicies.

Tx=BB if varicies and not bleeding. Stop BB if bleeding.

Question 5

Ascities cause and tx?

Answer 5

Fluid third spacing in peritoneal cavity d/t decreased osmotic pressure

Tx=No table salt, less than 1L free water intake per day. Spironolactone and Furosemide.

Question 6

Bacterial Pertonitis cause and tx?

Answer 6

Infection of ascitic fluid in abdomen. Most frequent and life threatening.

Tx=Cefotaxime. Oxafloxacin if allergic. Give Albumin to prevent renal failure.

Question 7

Bacterial Peritonitis prevention?

Answer 7

Severe liver dz=Ceftriaxone

Less severe liver dz=Norfloxacin