Hepatic Cirrhosis

Question 1

Hepatic Cirrhosis types?

Answer 1

1. Micronodular

2. Macronodular

Question 2

Micronodular Cirrhosis Etiology?

Answer 2

Alcoholism;
Hemochromatosis;
Wilson disease

Question 3

Macronodular Cirrhosis Etiology?

Answer 3

HBV and HCV; 
Drug-induced hepatitis; 
Biliary cirrhosis; 
Wilson disease; 
α1-antitrypsin deficiency; 
progressed alcoholic micronodular cirrhosis

Question 4

Micronodular Cirrhosis gross fx?

Answer 4

Micronodular cirrhosis has uniform nodules < 3 mm;

Question 5

Macronodular Cirrhosis gross fx?

Answer 5

macronodular cirrhosis has broad fibrous bands dividing liver into irregular nodules > 3 mm

Question 6

Cirrhosis histo fx?

Answer 6

Diffuse fibrosis of the liver followed by nodular regeneration lacking normal hepatic architecture;

Reorganization of vascular architecture

Question 7

Cirrhosis outcome?

Answer 7

increased portal venous pressure, decreased plasma oncotic pressure (hypoalbuminemia),

and decreased degradation of aldosterone,
= resulting in peripheral edema and ascites

Question 8

Cirrhosis Clinical signs?

Answer 8

Weakness; 
weight loss; 
ascites; 
vomiting; 
jaundice; 
fetor hepaticus (corpse-smelling breath); spider nevi (capillary telangiectasias of face); 
gynecomastia; 
loss of sexual hair; 
testicular atrophy;
asterixis (coarse hand tremor); 
ankle edema.

Question 9

Cirrhosis Complications include?

Answer 9

hepatic encephalopathy (ammonia acts as neurotoxin),

hepatorenal syndrome,

increased risk of hepatocellular carcinoma

Question 10

Cirrhosis Lab findings?

Answer 10

Anemia;

prolonged PT (resulting from coagulation-factor deficiency);

hypoalbuminemia;

hyperbilirubinemia;

increased ALT, AST, and ALP;

high blood ammonia levels

Question 11

Cirrhosis Treatment?

Answer 11

Alcohol abstinence;

low-salt diet;

diuretic therapy;

vitamin supplementation