Liver cirrhosis Flashcards
What are the four most common causes of liver cirrhosis?
- ALD
- NAFLD
- Hep B + C (worldwide)
Briefly describe the pathophysiology leading to liver cirrhosis
Chronic inflammation of liver cells results in scarring (cirrhosis)
Which scoring tool is used to assess the severity of liver cirrhosis?
Child-Pugh score
What is the key complication of liver cirrhosis?
How is this screened for in these patients?
HCC
6 monthly USS and alpha fetoprotein
Where do varices commonly occur?
Why do varices occur?
Gastro-oesophageal junction
Ileocecal junction
Rectum
Anterior abdominal wall (via umbilical vein)
Varices occur due to increased resistance to blood flow through a cirrhotic liver, which causes increased back-pressure into the portal venous system
Which medical and interventional treatments can be used for stable varices?
Medical:
- Beta blockers
Interventional:
- Elastic band ligation
- TIPS (transjugular intrahepatic portosystemic shunt) procedure
What complication can occur secondary to ascites?
What are the clinical features of this complication? How would you investigate?
Spontaneous bacterial peritonitis
Fever and abdo pain (but may be asymptomatic)
Ascitic tap and fluid culture
Which organism is typically responsible for causing SBP?
E coli
How would you treat SBP?
Broad spec abx e.f. cefotaxime
