Liver Stuff Flashcards
Where are the 4 common places for varies?
gastro oesophageal junction
ileocaecal junction
rectum
anterior abdominal wall
what is the treatment for stable varies?
Propanolol
Elastic band ligation
Injection of sclerosant
Transjugular intra-hepatic portosystemic shunt (TIPS)
How are bleeding varies treated?
Vasopressin - terlipressin
Prophylactic broad spectrum antibiotic
intubation + intenstive care
Vitamin K and fresh frozen plasma
Endocropy: injection of sclerosant or band ligation
what can be used as a tamponade in oesophageal bleeding?
Sengstaken-Blakemore tube
What is ascites?
fluid in the peritoneal cavity - caused by increased pressure in the portal system causing fluid to leak out of the capillaries.
What is the kidney response to ascites?
theres a reduced blood pressure in the kidneys, kidneys release renin, secretes aldosterone - causes reabsorption of fluid and sodium in the kidneys - leading to even worse ascites.
what type of ascites is liver cirrhosis?
Transudate ascites (low protein)
Management of ascites?
low sodium anti-aldosterone diuretics (spironolactone) ascitic tap Antibiotics TIPS procedure Liver transplant
what is hepatic encephalopathy?
encephalopathy caused by the build up of toxins entering the brain.
What is a common cause of hepatic encephalopathy?
Ammonia
What are precipitating factors for hepatic encephalopathy?
constipation
infection
medications
electrolyte disturbance
What is the management for hepatic encephalitis?
laxatives - to excrete ammonia
antibiotics
nutritional support
Presentation of hepatic encephalopathy?
reduced consciousness confusion change in personality memory change mood change
