Gastro Flashcards
how does liver cirrhosis affect the portal system
portal hypertension
causes of liver cirrhosis
NAFLD
alcoholic liver disease
hep B
hep C
size of liver in cirrhosis
can be small or large
nail change in cirrhosis and why
leukonychia due to hypoalbuminaemia
what test is used for assessing extent of fibrosis in NAFLD
enhanced liver fibrosis blood test
examination signs of liver disease
jaundice
bruising
palmar erythema
spider naevi
gynacomastia
ascites
splenomegaly
asterixis
caput medusae
leukonychia
what happens to platelets in cirrhosis
thrombocytopenia
what is transient elastography
test for assessing degree of liver fibrosis
components of child pugh score pneumonic and scoring
ABCDE
albumin
bilirubin
clotting (INR)
dilated (ascites)
encephalopathy
each scored 1-3 so max score 15
what score is used in cirrhosis patients to assess mortality
how often is it done
MELD score
done every 6 months
how often should cirrhosis patients have an endoscopy
every 3 yrs
dietary advice in cirrhosis
high protein and high calorie diet (pts have appetite loss and protein metabolism is affected)
reduced sodium intake
avoid alcohol
what organ is enlarged as a result of portal hypertension
spleen
what type of ascites do you get in cirrhosis
transudate
what prophylactic abx are given for ascites and when
cipro or norfloxacin
when protein in fluid <15g
hepatic encephalopathy mx
lactulose
abx (rifaximin)
nutritional support (NG feeds)
stages of alcoholic liver diease
alcoholic fatty liver
alcoholic hepatitis
cirrhosis
recommended alcohol intake and over what time
no more than 14 units/ week
spread out over 3 or more days
not more than 5 units a day
dietary advice for alcoholic liver disease
thiamine supplementation
high protein diet
CAGE questions
cut down- do you feel the need to down
annoyed- do you get annoyed at people for commenting about your drinking
guilty- do you feel guilty about how much you drink
eye opener- do you ever drink first thing in the morning
AUDIT questionnaire is used for
screening for harmful alcohol use
AUDIT questionnaire score above what is concerning
8
in alcohol withdrawal when do people get hallucinations
12-24 hrs after last drink
in alcohol withdrawal when do people get seizures
24-48 hrs after last drink
in alcohol withdrawal when do people get delirium tremens
24-72 hrs after last drink
what receptors does alcohol stimulate
GABA
what receptors does alcohol inhibit
glutamate