Liver Cirrhosis

Question 1

why so scary??????

Answer 1

ENDGAME - yer deed

Question 2

what is it

Answer 2

develops from chronic liver disease (>6 months)

irreversible stage of liver disease involving fibrosis and necrosis separating hepatocyes

Question 3

outcome if compensated

Answer 3

can survive since have no symptoms

Question 4

outcome if decompenated

Answer 4

yer fucked mate

Question 5

what causes it

Answer 5

alcohol abuse, PBC, hep C and B, autoimmune disease, NAFLD, drugs (methotrexate), haemochromatosis, PSC, wilsons disease, budd-chiari, alpha-1-anitrypsin deficiency

Question 6

what is alpha-1-antitrypsin deficiency

Answer 6

inherited autosomal recessive disorder of production of an enzyme inhibitor - doesnt protect anymore
cytoplasmic globules of unsecreted globules of protein in liver cells

Question 7

what is symptoms (majority of the signs of liver disease)

Answer 7

spider naevi 
jaundice 
leukonycia 
telangiectasia 
duputrens contracture 
clubbing 
palmar erythema

Question 8

how is it diagnosed

Answer 8

LFTs deranged - PT useful
FBC, U&Es, CRP
Virology, serum vitamins and minerals
US shows liver size and shape 
CT shows hepatosplenomagaly
Child-pugh score predicts prognosis

Question 9

how is it treated

Answer 9

manage complications
laxatives to prevent hepatic encephalopathy
liver transplant - UKELD score 49 or greater

Question 10

how is the complication ascites treated

Answer 10

treat underlying cause
avoid salt 
sprionolactone (works at distal tubule)
furosemide (loop of henle)
paracentesis 
TIPS (shunt placed between portal vein and hepatic vein)

Question 11

what are complications

Answer 11

ascites, hepatic encephalopathy, malnutrition, portal hypertension, bacterial infections, renal failure