Liver

Question 1

what level of MELD can get someoner on tx list?

Answer 1

15

Question 2

3 diagnostic signs for hepatopulmonary syndrome?

Answer 2

cirrhosis, widened Aa gradient, intrapulmonary vasodilation

Question 3

signs for intrapulmonary vasodilations?

Answer 3

microbubbles on TTE within 3-6 cardiac cycles

Question 4

tx for hepatopulmonary syndrome?

Answer 4

liver transplantation, supportive care,

Question 5

sings of a hepatic hydrothorax?

Answer 5

right sided pleural transudate

Question 6

refractory hepatic hydrothorax?

Answer 6

consider tx

Question 7

Portopulmonary HTN- PAP? PVR? wedge?

Answer 7

PAP >25 mmhg, PVR >3 woods uits, wedge <15 mmhg

Question 8

mechanism of fluid retention in chronic cirrhosis?

Answer 8

splanchnic vasodilation because of increased NO, CO

Question 9

on biopsy findings of mallory hyaline, hepatocyte necrosis, portal fibrosis, macrovesicular steatosis?

Answer 9

alcoholic hepatitis

Question 10

cause of type 1 HRS?

Answer 10

predisposing bacterial infection

Question 11

which HRS happens faster?

Answer 11

type 1- acute and rapid

Question 12

thrombotic or non thrombotic obstruction of hepatic venous outflow?

Answer 12

budd chiari syndrome

Question 13

young patient with hypergoaculable disease and liver failure?

Answer 13

budd chiari

Question 14

epidemiology of Hepatitis A?

Answer 14

travel to endemic countries like Asia

Question 15

goal INR and plt before a pracentisis?

Answer 15

INR <8.7 and plt >19

Question 16

albumin to give post paracentisis?

Answer 16

1.5g/kg

Question 17

first line therapy for HRS?

Answer 17

noreepinepherine and albumin

Question 18

Mechanism of HRS?

Answer 18

splanchnic arterial vasodilation theory- creates a functional renal hypoperfusion

Question 19

severe alcoholic hepatitis?

Answer 19

MELD>20=20% mortality

Question 20

steroids in AH?

Answer 20

prednisolone recommended but high rate of failure, give it a week and if no improvement then stop

Question 21

CT findings of mottled liver with hepatomegaly with IVC narrowing, delayed hepatic vein filling?

Answer 21

budd chiari

Question 22

tx for budd chiari?

Answer 22

stent, AC, thromboylsis, TIPPS

Question 23

infected ascites growing multiple organisms?

Answer 23

secondary bacterial peritonitis

Question 24

poor prognostic factors in non APAP liver failure?

Answer 24

PT >100, time from jaundice to encephalopathy greater than 7 days, grade 3 or 4 encephalopathy

Question 25

tx for Hep B induced liver failure

Answer 25

lamivudine

Question 26

tx for amanita phalloides?

Answer 26

forced diuresis and charcoal, IV silibinin