Liver cirrhosis

Question 1

What is liver cirrhosis?

Answer 1

stelate cells in perisinusoidal space become active after injury, producing collagen which causes fibrotic tissue to build.

This can then cause the fibrosis to build and push on the portal vein causing stenosis which leads to portal hypertension.

Question 2

Causes of liver cirrhosis?

Answer 2

Alcoholic liver disease
Non-alcoholic fatty liver disease
Hep B
Hep c

Question 3

Sign of cirrhosis?

Answer 3

Jaundice
Hepatosplenomegaly
Splenomegaly
Spider naevi
Palmer eryhtma
Testicular atrophy
bruising
ascites

Question 4

Testing for cirrhosis?

Answer 4

Enhanced liver fibrosis test
Ultrasound
Fibroscan ( Check elasticity of liver)
Endoscopy
CT + MRI scan
Liver biopsy

Question 5

Managment of cirrhosis?

Answer 5

Ultrasound + alpha fetoprotein every 6 months

Endoscopy every 3 years

High protein, low sodium diet

Meld score every 6 months

Consider liver transpalnt

Question 6

Managment of cirrhosis?

Answer 6

Ultrasound + alpha fetoprotein every 6 months

Endoscopy every 3 years

High protein, low sodium diet

Meld score every 6 months

Consider liver transplant

Question 7

Complications of liver cirrhosis?

Answer 7

Malnutrition
Portal hypertension

Question 8

What is 3 types of portal hyper tension and the cause?

Answer 8

Prehepatic = portal vein thrombosis

Intrahepatic = Cirrhosis

Posthepatic = Right sided heart failure

Question 9

3 Connections of portal vein to sytemic venous system?

Answer 9

S: Superior portion of anal canal
I: Inferior portion of oesophagous
R: Round ligament

Question 10

Symptoms of portal hyper tension?

Answer 10

A: Ascites
B: Bleeding
C: Caput medusae
D: Diminished liver function
E: Enlarged spleen

Question 11

Treatment for portal hypertension?

Answer 11

Beta blockers

Diuretics

Octreotide