Liver Cirrhosis

Question 1

What is it?

Answer 1

• chronic
• fibrosis - scaring of liver tissue
• permanent/irreversible

Question 2

Liver cirrhosis affects blood flow, what can this result in?

Answer 2

• portal hypertension
• bleeding esophagus
• fluid retention

Question 3

Symptoms?

Answer 3

• weight loss
• malnutrition
• bleeding gums
• breast enlargement in men
• clay coloured stool
• swelling in legs
• abdominal pain

Question 4

Causes?

Answer 4

• alcohol
• fats
• autoimmune
• hepatitis
• copper accumulation

Question 5

Diagnosis?

Answer 5

• blood and urine test
• ultrasound
• Biopsy
• CT scan
• physical examination

Question 6

Types of liver cirrhosis

Answer 6

• alcohol induced
• bile cirrhosis
• post-necrotic

Question 7

Is alcohol induced liver cirrhosis reversible or irreversible

Answer 7

Reversible - if drinking stops

Question 8

What is compensated liver cirrhosis?

Answer 8

• The liver adapts damage
• continues to function with few/no symptoms

Question 9

What is decompensated liver cirrhosis?

Answer 9

Liver function is impaired with noticeable symptoms

Question 10

Is there a cure?

Answer 10

No

Question 11

Management/treatment options?

Answer 11

• lifestyle: reduce alcohol, reduce weight if over weight, hygiene to prevent infections
• diuretics
• antivirals
• vaccinations
• liver transplant

Question 12

Which drug can help manage bleeding gums?

Answer 12

Propranolol

Question 13

Bleeding occurs due to liver failing to make blood clots, what is the treatment for this?

Answer 13

Vitamin K

Question 14

Encephalopathy is a complication of liver cirrhosis - describe what this is

Answer 14

Brain is unable to clear out toxins properly due to liver cirrhosis

Question 15

Hepatocellular carcinoma is a complication of liver cirrhosis, what is this

Answer 15

Cancer of the liver

Question 16

Cirrhosis classification system - stage 1

Answer 16

Compensated

No Ascites
No varices

Question 17

Cirrhosis classification system - stage 2

Answer 17

Compensated

No Ascites
Yes varices

Question 18

Cirrhosis classification system - stage 3

Answer 18

Decompensated

Ascites -/+ varices

Question 19

Cirrhosis classification system - stage 4

Answer 19

Decompensated

Bleeding -/+ Ascites

Question 20

Pathiopysiology of Portal HTN

Answer 20

Due to damage of the liver (cirrhosis), there is a resistance in blood flow in portal vein. This increase the blood pressure.

Blood struggles to travel through the liver, so the body forms collateral veins around the liver, to bypass the obstructed blood flow, which end up twisting and rupture leading bleeding variceals.

Also due to the increase pressure portal vein, fluid leaked into the lower abdominal cavity, accumulating in the lower abdomen, results in Ascties.

Question 21

Treatment? Of portal hypertension

Answer 21

Bleeding vercites- propranolol
Ascities - duiretics

Question 22

Diagnosing?

Answer 22

• endoscopy
• hx
• biopsy