Liver Cirrhosis

Question 1

is cirrhosis reversible?

Answer 1

irreversible

Question 2

causes of cirrhosis?

• which types of hepatitis are a cause?

Answer 2

alcohol (chronic use)
NAFLD
Viral hepatitis B or C

Question 3

signs of liver cirrhosis

Answer 3

leuconychia (low albumin) 
terry's nail (white proximally but distal 1/3 reddened)
clubbing 
spider naevi 
ascites

Question 4

complications:
- explain hepatic failure complications?
- explain portal HTN complications ?

Answer 4

• encephalopathy
• coagulopathy
• ascites (low albumin)
• sepsis
• oesophageal varices
• ascites
• splenomegaly

Question 5

most sensitive finding on blood test for cirrhosis

Answer 5

presence of thrombocytopenia (low platelets) resulting from portal HTN with hypersplenism

Question 6

most sensitive imaging test for cirrhosis?

Answer 6

transient elastography (fibroscan) - measures stiffness of liver

Question 7

who is transient elastography offered to?

Answer 7

people with Hep C virus infection
men who drink >50 units per week
people with alcohol liver disease

Question 8

people who have cirrhosis - what it is the definitive tx?

how would you manage patient previous to this?

Answer 8

liver transplant

Diuretic therapy (spironolactone + furosemide) for ascites