liver disease Flashcards
becoming the most common cause of liver disease
NAFLD
world percent of HCV infected
3%
blood supply of the liver
dual blood supply
portal vein (60-90%)
hepatic artery
three requirements for development of cirrhosis
cell death
deposition of aberrant ECM
Vascular disorganization
collagen in cirrhosis around portal tract
Type I and III from stellate cells that become myofibroblast
Management of hepatic encephalopthy
lactulose
binds ammonia
diarrhea
Recent hepatic encpelopahty
Rifaximin
esophagel varices tx
endoscopic banding
beta blockers
patients without any symptoms of cirrhoisis with dx screened for esophageal varices?
2-3 years
Patients with high risk for varices?
non-selective beta blockers who have small varices
with cirrhosis but ithout increased risk
beta blockers not proven to help
patients with cirrhosis, small varices, and on beta blocker therapy and are apporirately maxximized on tx
no screening anymore
cirrhosis and large variceszz that haven’t bled
not at high risk: non-selective beta blockers
with high risk:
non-selective beta blockrs or variceal band ligation for primary prophylaxis
Survived a variceal hemorrhage
beta blcoker plus band ligationzz
repeat bleedng
TIPS procedure
