Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Gastroenterology > Liver Cirrhosis > Flashcards

Liver Cirrhosis Flashcards

1
Q

what is the classic sign of cirrhosis?

A

regenerative nodules (hence bumpy), fibrotic tissue and collagen

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

what combine to make the sinusoid?

A

portal vein and hepatic artery

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

what is in the perisinusoidal space?

A

stellate cells, which usually store vitamin A

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

when hepatocytes are injured they signal stellate cells to secrete?

A

TGF B, which produces collagen

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

what does build up of collagen cause?

A

increased pressure in sinusoid- portal hypertension

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

complications of portal hypertension?

A

congestive splenomegaly
ascites
portosystemic shunt
renal vasoconstriction- hepatorenal failure
toxins in brain hepatic encephalopathy
gynaecomastia
spider angiomata
palmar erythema
jaundice
hypoalbuminaemia
coagualtion issues

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

what toxic mainly causes hepatic encephalopathy?

A

ammonia- hence asterixis possibly coma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

oestrogen is converted to metabolites in liver, what may be the complications of it not?

A

palmar erythema, gynaecomastia and spider angiomata

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

symptoms of cirrhosis?

A

asymptomate, weight loss, weakness fatigue, jaundice and pruritus, ascites, confusion and easy bruising

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

gold standard diagnosis of cirrhosis?

A

liver biopsy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

what do you find in lab findings?

A

elevated bilirubin, and enzymes AST more than ALT and low platelets

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

treatment of cirrhosis?

A

treat underlying cause (alcohol or antiviral treatment)
transplant

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

causes of cirrhosis?

A

alcohol, viral hep b and c and non alcoholic fatty liver disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

other ways to diagnose?

A

transient elastography scan (Hep C over 50 units alcohol men over 35 female)
or acoustic radiation force impulse imaging

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

for NAFLD NICE recommend using?

A

enhanced liver fibrosis score

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

further investigations?

A

upper endoscopy to check for varices with new diagnosis for cirrhosis and liver US every 6 months

17
Q

rarer causes of liver cirrhosis?

A

Autoimmune hepatitis
Primary biliary cirrhosis
Haemochromatosis
Wilsons Disease
Alpha-1 antitrypsin deficiency
Cystic fibrosis
Drugs (e.g. amiodarone, methotrexate, sodium valproate)

18
Q

what is a tumour marker for hepatocellular carcinoma?

A

alpha fetoprotein every 6 months

19
Q

what is first line investigation for cirrhosis?

A

enhanced liver fibrosis blood test for non-alcoholic fatty liver disease

20
Q

what does ELF blood test contain?

A

markers HA, PIIINP and TIMP-1

21
Q

what level indicated severe/ moderate fibrosis?

A

7.7 and 9.8

22
Q

cirrhosis on Ultrasound?

A

nodularity, corkscrew appearance of arteries, enlarged portal vein with reduced flow, ascites , splenomegaly

23
Q

what does child-pugh score of cirrhosis include?

A

bilirubin, albumin, INR, ascites and encephalopathy

24
Q

MELD score is for?

A

compensated cirrhosis every 6 months- creatnine, bilirubin, INR and sodium and dialysis

25
Q

how to deal with the complication of malnutrition?

A

low sodium to minimise fluid retention, high protein and calorie, avoid alcohol, regular meals

26
Q

portal vein comes from?

A

superior mesenteric and spelnic vein

27
Q

varices occur at?

A

gastro-oesphageal junction, ileocaecal junction, rectum and anterior abdominal wall vie umbilical vein caput medusae

28
Q

treatment of stable varices?

A

propanolol
elastic band ligation
injection of sclerosant
TIPS

29
Q

how to treat bleeding oesophageal varices?

A

vasopressin analogues terlipressin
correct coagulopathy vit K andfresh frozen plasma
broad spectrum antibiotics
intubation
urgent endoscopy- elastic band ligation or sclerosant
sengstaken blakemore tube only when endoscopy fails

30
Q

cirrhosis cause?

A

transudative ascites

31
Q

presentation of spontaneous bacterial peritonitis?

A

asymptomatic, fever abdominal pain, deranged bloods, ileus hypotension

32
Q

what organisms cause SBP?

A

ecoli, klebsiella, gram positive cocci: staphylococcus and enterococcus

33
Q

management of SBP?

A

IV cephalosporin e.g cefotaxime

34
Q

how to manage hepatic encephalopathy?

A
  1. laxatives- excretion of ammonia
  2. antibiotics rifaximin- reduce number of intestinal bacteria producing ammonia
    nutritional support
35
Q

precipitating factors of hepatic encephalopathy?

A

constipation electrolyte distubance, infection, GI bleed, high protein diet, medications

36
Q

what is the most sensitive and specific lab finding for diagnosing liver cirrhosis?

A

thrombocytopenia

Gastroenterology (20 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions