Module 9: cirrhosis

Question 1

Cirrhosis =scar tissue caused by chronic ___/___ to the ____

End results of chronic _______ and ____changes

Answer 1

injury/irritation to the hepatocytes

chronic liver damage, and inflammatory changes

Question 2

liver fibrosis is due to the chronic cycle of ___and ____

Answer 2

injury and healing

Question 3

Portal hypertension causes ___,___,____

Answer 3

ascites, variceal bleeds, splenomegaly

Question 4

cirrhotic liver cannot ___drugs, ____hormones, or _____proteins

Answer 4

metabolize drugs, process hormones, synthesize proteins

Question 5

Poor liver function =
vSynthesis of ___factors
vSynthesis of ____
vDetoxification-(ie ^estrogen =__, ammonia=__)
Jaundice d/t liver inability to process/excrete __

Answer 5

vClotting factors
vAlbumin=fluid retention
^Estrogen=spider angiomas
^Ammonia= confusion, hepatic encephalopathy 
bilirubin

Question 6

Portal hypertensive gastropathy= chronic _____loss

Gastric antra vascular ectasia can result in ___

Answer 6

blood loss

bleeding

Question 7

Portopulmonary syndrome d/t portal htn causes ___ arterial vasoconstriction and vascular ____
MAP=25+

Answer 7

causes pulmonary vasoconstriction, vascular remodeling

Question 8

Hepatopulmonary syndrome = ____ and ____ arteriovenous dilation and a ___to___ shunt

Answer 8

hypoxemia and intrapulmonary dilation

right to left shunt (=hypoxemia)

Question 9

Hepatorenal-functional renal failure seen in alcoholic cirrhosis
type 1

Answer 9

type 1- rapid onset. d/t vCO d/t GI bleed +vBP

Question 10

Hepatorenal-functional renal failure seen in alcoholic cirrhosis
Type 2 associated with _____
d/t _____ constriction d/t accumulation of (4)

Answer 10

type 2-associated w refractory ascites, d/t intrarenal constriction d/t accumulation of angiotensin, vasopressin, prostaglandins, and catecholamines not cleared by liver=kidney damage

Question 11

Best indicator of encephalopathy is presence of ___on physical examination

Answer 11

asterixis (hand FLAP NOT tremors)

Question 12

encephalopathy causes

type A, B, C

Answer 12

A-acute liver failure
B-portosystemic bypass
C-cirrhosis

Question 13

Grade 1 encephalopathy

Answer 13

lack awareness, anxiety , altered attention span, can’t add/subtract, impaired sleep

Question 14

Grade 2 encephalopathy

Answer 14

apathetic, lethargic, disoriented to time, dyspraxia, asterixis, personality changes

Question 15

Grade 3 encephalopathy

Answer 15

overt, semi stuporous, responsive to stimuli, obv confusion disoriented to space, bizarre behavior

Question 16

grade 4 encephalopathy

Answer 16

overt, coma, no response to painful stimuli, risk for resp failure,

Question 17

GI bleed causes with cirrhosis (3)

maybe ___

Answer 17

esophageal varices, hypertensive gastropathy, gastric antra vascular ectasia
maybe infection