Liver Flashcards
what level of MELD can get someoner on tx list?
15
3 diagnostic signs for hepatopulmonary syndrome?
cirrhosis, widened Aa gradient, intrapulmonary vasodilation
signs for intrapulmonary vasodilations?
microbubbles on TTE within 3-6 cardiac cycles
tx for hepatopulmonary syndrome?
liver transplantation, supportive care,
sings of a hepatic hydrothorax?
right sided pleural transudate
refractory hepatic hydrothorax?
consider tx
Portopulmonary HTN- PAP? PVR? wedge?
PAP >25 mmhg, PVR >3 woods uits, wedge <15 mmhg
mechanism of fluid retention in chronic cirrhosis?
splanchnic vasodilation because of increased NO, CO
on biopsy findings of mallory hyaline, hepatocyte necrosis, portal fibrosis, macrovesicular steatosis?
alcoholic hepatitis
cause of type 1 HRS?
predisposing bacterial infection
which HRS happens faster?
type 1- acute and rapid
thrombotic or non thrombotic obstruction of hepatic venous outflow?
budd chiari syndrome
young patient with hypergoaculable disease and liver failure?
budd chiari
epidemiology of Hepatitis A?
travel to endemic countries like Asia
goal INR and plt before a pracentisis?
INR <8.7 and plt >19
albumin to give post paracentisis?
1.5g/kg
first line therapy for HRS?
noreepinepherine and albumin
Mechanism of HRS?
splanchnic arterial vasodilation theory- creates a functional renal hypoperfusion
severe alcoholic hepatitis?
MELD>20=20% mortality
steroids in AH?
prednisolone recommended but high rate of failure, give it a week and if no improvement then stop
CT findings of mottled liver with hepatomegaly with IVC narrowing, delayed hepatic vein filling?
budd chiari
tx for budd chiari?
stent, AC, thromboylsis, TIPPS
infected ascites growing multiple organisms?
secondary bacterial peritonitis
poor prognostic factors in non APAP liver failure?
PT >100, time from jaundice to encephalopathy greater than 7 days, grade 3 or 4 encephalopathy
tx for Hep B induced liver failure
lamivudine
tx for amanita phalloides?
forced diuresis and charcoal, IV silibinin
