Exam III: Portal Hypertension

Question 1

Portal Hypertension is diagnosed by a SAAG > _______ or _______.

Answer 1

1.1 grams/dL
EGD–> Look for presence of varices.

Question 2

______ is an abnormally enlarged blood vessel.

Answer 2

Varices.

Question 3

When should non-selective beta-blockers be used to treat portal hypertension?

Answer 3

Only if varices are present.

Question 4

What are the non-selective beta-blockers used to treat portal hypertension?

Answer 4

1. Coreg (Carvedilol)
2. Inderal (Propranolol)
   3 Nadolol

Question 5

What is the starting dose of Coreg?

Answer 5

3.125 mg BID

Question 6

Which non-selective beta-blocker is likely the best and why?

Answer 6

Coreg (carvedilol) due to alpha activity.

Question 7

What is the starting dose of inderal?

Answer 7

20-40 mg BID (propranolol)

Question 8

What is the starting dose of nadolol?

Answer 8

20-40 mg QD

Question 9

B1 Blockade is responsible for _______.

Answer 9

Decreased HR —> Decreased CO —> Decreased portal pressure

Question 10

B2 blockade is responsible for _____.

Answer 10

Blocking splanchnic vasodilation

Question 11

The HR target for beta blockade is ____.

Answer 11

60 BPM.

Question 12

When should you hold beta-blocker therapy?

Answer 12

1. SBP <90
2. DBP <60
3. Decompensated States: Hepatorenal syndrome, refractory ascites, SBP.