Liver Disease Flashcards
1
Q
Investigations required for ptns with liver cirrhosis (alcoholic/non alcoholic)
A
Cbc - macrocytic anemia (b12, folate deficiency) - thrombocytopenia (hypersplenism) LFT - deranged liver enzymes ( AST, ALT) - albumin decrease, bilirubin increase (impaired metabolism) RP - increase BU (hepatorenal syndrome) - hypokalemia, hypomagnesemia Bleeding profile - PT, PTT, INR Imaging - liver ct to confirm liver cirrhosis Alcoholics - alcohol breath test, urine drug screening
2
Q
Complications in liver failure/disease
A
Jaundice Portal hypertension Ascites Hepatic encephalopathy Hepatorenal syndrome Hepatopulmonary syndrome GI bleed Impaire drug metabolism
3
Q
Preop mx
A
Thiamine (vit b1), folate - anemia,
Nutritious diet with multivitamins and supplement
Coagulopathy - FFP/ platelet transfusion
Benzodiazepine (lorazepam prn short acting, diazepam maintenance scheduling long acting) - delirium tremens
Diuretics - portal hypertension, ascites, pulmonary edema
Lactulose - prevent hepatic encephalopathy by enteric bacteria formn of ammonia
