Liver failure stuff misc Flashcards
1
Q
List five complications of liver cirrhosis
A
Major complications of ϲirrhоsis include (table 1):
●Variceal hemоrrhage
●Αѕcites
●Spontaneous bacterial рeritοոitis
●Hepatic еոϲерhаloрathy
●Hepatocellular ϲаrϲiոοma
●Hepatorenal syndrome
●Hepatopulmonary syndrome
1
Q
What is the most common complication of cirrhosis?
A
ascities
1
Q
What is the mainstay of medical therapy for ascities?
A
spironalactone and furosemide
2
Q
Describe the mechanism of spironalactone
A
3
Q
About 10% of patients experience diuretic resistant ascities. What is the management of this?
A
- Decrease medications in patients that decrease SBP - beta blockers (used for varicies), ACEi, ARBs. May use midodrine for hypotensive patients
- If this fails
- liver transplant
- serial therapeutic paracentesis (usually a high fluid removal rate describes low adherence to a low sodium diet)
- TIPS - has a criteria though
4
Q
List 3 types of patients unsuitable for TIPS
A
- child Pugh C cirrhosis
- high MELD score
- spontaneous hepatic encephalopathy
