HC. 2 Functie van de lever en gevolg, beh. cirrose Flashcards

1
Q

Wat zijn andere mogelijke benamingen van levercirrose?

A

Internationaal: Hep. B/C
Nederland: Vetcirrose/Alcholische leverlijden

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2
Q

Wat zijn complicaties van levercirrose?

A
  • Varices (spataderen slokdarm en maag)
  • ascites (door portale ht)
  • Encephalopathy
  • Hepatocellulaire carinoom (cancer)
  • Infectie
  • Ondervoeding
  • Sarcopenie, spierafbraak voor glucose
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3
Q

Wanneer is er sprake van micronodulair en wanneer macronodulair?

A

Micronodulair: <3mm
Macronodulair:: >3 mm

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4
Q

Welke ziektes zijn sterk gekoppeld aan het krijgen van leverkanker en levercirrose?

A

Hepatitis B en C

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5
Q

Wanneer is er sprake van chronische hepatitis?

A

> 6 maanden

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6
Q

Hoe ontstaat non-alcholische steato-hepatitis?

A

Door:
- Overgewicht
- Diabetes type 2
- Insuline resistentie
- Hypertensie

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7
Q

Wat zorgt voor ontsteking en littekenvorming in de hepar?

A

Vetstapeling

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8
Q

Oorzaken levercirrose?

A
  1. Alcohol
  2. Virale hepatitis
  3. NASH
  4. Medicijnenen en toxicaties
  5. Galsteen
  6. Autoimmuun (PBC, PSC, AIH)
  7. Idiopatisch
  8. Hemochromatosis (ijzerstapeling)
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9
Q

Welke stages van levercirrose?

A
  • Compensated
  • Decompensated
  • Hepatocullular carcinoom
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10
Q

Complicaties bij compensated en decompensated levercirrose?

A
  • Compensated: geen
  • Decompensated:
    + Geelzucht, ascited, variceale bloeding, encephalophy
    + Spontane bacteriele perionitis, hepatorenale syndroom, slechte nutrional status
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11
Q

Mortaliteit bij decompensatie levercirrose?

A

30%

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12
Q

Fysieke bevindingen bij levercirrose?

A
  • Hepatomegaly
  • Jaundice
  • Ascites
  • Spider angioma
  • Splenomegaly
  • Palmar erythema
  • Verhoogde LFts
  • Thrombocytopenie
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13
Q

Hoe hepatische encephalopathie testen?

A

Animal name testing (<12) of flapping tremor

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14
Q

Wat is de MELD Score?

A

Score om transplantatie te screenen:

MELD score (Tx screening) (Bij 15 = transplantatie, eronder nog ruimte voor andere mogelijkheden)
Bilirubine
INR
Creatinine

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15
Q

Wat is CHILD-PUGH score

A

Prognose van levercirrose
- Encephalopathy grade
- amount of ascites
- Bilirubine
- Albunine
- PT (INR)

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