Hepatology Flashcards
SBP - Monitoring
S/Sx infection, SCr
HE - When to treat?
Confusion +/- inc ammonia (rule out other causes)
Esophageal Varices - Monitoring
S/Sx bleeding, HR (goal 55-60), BP (goal >90mmHg)
Esophageal Varices - 1st Line Tx
+/- Transfusion + Octreotide + Ceftriaxone + EVL
Esophageal Varices - When to treat?
Active variceal hemorrhage (VH)
HE - When to use PTx
Secondary: after occurrence of HE
(no primary prevention)
Esophageal Varices - 1st line PTx
NSBBs or EVL
SBP - When to treat?
Confirmed positive culture OR PMNs >250k
SBP - 1st Line Tx
Ceftriaxone + albumin day 1 and 3
HE - Monitoring
BMs, mental status
Ascites - When to treat?
Ascites present (Abd distention, abd pain, SOB, nausea)
Ascites - 1st Line Tx
Spironolactone Furosemide (100mg:40mg)
- Max 400mg:160mg
- spiro best if need MonoTx
HE - 1st Line Tx
Lactulose (target ≥2 BMs/day)
HE - 1st Line PTx
Lactulose
Ascites - Prophylaxis
No Primary Prevention
- Secondary/Treatment: aimed at preventing need for paracentesis
SBP - When to use PTx
- Primary: active VH
- Secondary: after, SBP, indefinite Tx
SBP - 1st Line PTx
Bactrim QD
- AE: AKI, photosensitivity, inc K, dec Na, Stevens Johnson)
Ascites - Monitoring
S/Sx ascites, SCr, K
Esophageal Varices - When to use PTx
Secondary: after VH, indefinite as long as BP tolerates
- (don’t need to know primary)
Ascites - 2nd Line Tx
Paracentesis
- admin 6-8g Albumin per liter removed (if >5L removed)
