Phtn First 6 Only Flashcards
When is hematemis is emergency
When the liver is the cause of
P htn triad
Splenomegaly الاهم
Ascites
Hematemsis الاخطر
Contra of vasopressin
Preg
Hf
Bud chiari triad
Pain
Rapid filling ascites
Jaundice
Liver biospsy is done after
Correction of coagulapthy when pt more 60%q
Whcich is more compication sclerotherapy or ligation for esophageal varices
Sclerotherapy
Metion surgical measures of portal htn and prefered use
Porto systemc shunt for pre-hepatic causes
Tipss for hepatic causes
Liver transplantion end stage liver dx
What are the potential complications of esophageal varices?
Complications include hematemesis (vomiting of blood), which can be life-threatening, and anemia due to chronic blood loss.
Describe the treatment options for esophageal varices.
Treatment includes beta-blockers to reduce portal pressure, endoscopic band ligation, and in severe cases, transjugular intrahepatic portosystemic shunt (TIPS) or surgery.
What investigations are recommended for diagnosing portal hypertension?
Investigations include ultrasound with Doppler, CT or MRI of the abdomen, endoscopy to detect varices, and liver function tests.
What are the causes of ascites in liver disease?
Causes include portal hypertension, hypoalbuminemia, and sodium retention due to liver dysfunction.
How is ascites managed in patients with liver disease?
Management includes sodium restriction, diuretics (e.g., spironolactone), paracentesis for symptomatic relief, and treatment of the underlying liver disease.
What are the prehepatic causes of portal hypertension?
Prehepatic causes include portal vein thrombosis and splenic vein thrombosis.
What are the hepatic causes of portal hypertension?
Hepatic causes include cirrhosis, hepatitis, and hepatic fibrosis.
What are the posthepatic causes of portal hypertension?
Posthepatic causes include Budd-Chiari syndrome and right-sided heart failure.
What is the significance of caput medusae in portal hypertension?
Caput medusae refers to dilated periumbilical veins and is a sign of severe portal hypertension.
What is the role of albumin in managing ascites?
Albumin helps maintain oncotic pressure and can be used in conjunction with paracentesis to prevent circulatory dysfunction.
What are the indications for a transjugular intrahepatic portosystemic shunt (TIPS)?
Indications include refractory ascites, recurrent variceal bleeding, and hepatorenal syndrome.
What are the complications of TIPS?
Complications include hepatic encephalopathy, shunt stenosis, and infection.
What is hepatorenal syndrome, and how is it managed?
Hepatorenal syndrome is a type of kidney failure in patients with severe liver disease. Management includes albumin infusion, vasoconstrictors (e.g., terlipressin), and liver transplantation.
What are the common causes of hematemesis in liver disease?
Common causes include bleeding from esophageal varices, gastric ulcers, and portal hypertensive gastropathy.
What is the management of acute variceal bleeding?
Management includes resuscitation, vasoactive drugs (e.g., octreotide), endoscopic therapy, and antibiotics to prevent infection.
What is the role of beta-blockers in preventing variceal bleeding?
Beta-blockers reduce portal pressure and are used for primary and secondary prevention of variceal bleeding.
What are the signs of chronic liver disease on physical examination?
Signs include jaundice, spider angiomas, palmar erythema, ascites, and caput medusae.
What are the laboratory findings in chronic liver disease?
Findings include elevated liver enzymes, low albumin, prolonged prothrombin time, and thrombocytopenia.
What is the significance of thrombocytopenia in liver disease?
Thrombocytopenia is often due to splenomegaly and decreased production of thrombopoietin by the liver.
What are the causes of pancytopenia in liver disease?
Causes include hypersplenism, bone marrow suppression, and nutritional deficiencies.
What is the management of hypersplenism in liver disease?
Management focuses on treating the underlying liver disease. In severe cases, splenectomy may be considered.
What are the complications of cirrhosis?
Complications include portal hypertension, ascites, hepatic encephalopathy, hepatorenal syndrome, and hepatocellular carcinoma.
What is hepatic encephalopathy, and how is it managed?
Hepatic encephalopathy is a neuropsychiatric complication of liver disease. Management includes lactulose, rifaximin, and treatment of precipitating factors.
What are the precipitating factors for hepatic encephalopathy?
Factors include infection, gastrointestinal bleeding, electrolyte imbalances, and constipation.
What is the role of lactulose in hepatic encephalopathy?
Lactulose reduces ammonia absorption in the gut and is used to treat and prevent hepatic encephalopathy.
What are the indications for liver transplantation in cirrhosis?
Indications include decompensated cirrhosis, hepatocellular carcinoma within Milan criteria, and acute liver failure.
What are the contraindications for liver transplantation?
Contraindications include active infection, severe cardiopulmonary disease, and extrahepatic malignancy.
What is the MELD score, and how is it used in liver transplantation?
The MELD score predicts survival in patients with liver disease and is used to prioritize patients for liver transplantation.
What are the common causes of hepatocellular carcinoma (HCC)?
Common causes include chronic hepatitis B and C, alcoholic liver disease, and non-alcoholic steatohepatitis (NASH).
What are the screening recommendations for hepatocellular carcinoma?
Screening includes ultrasound every 6 months in patients with cirrhosis or chronic hepatitis B.
What are the treatment options for hepatocellular carcinoma?
Treatment options include surgical resection, liver transplantation, radiofrequency ablation, and systemic therapies like sorafenib.
What is the significance of alpha-fetoprotein (AFP) in hepatocellular carcinoma?
AFP is a tumor marker used in the diagnosis and monitoring of hepatocellular carcinoma.
What are the common causes of acute liver failure?
Causes include viral hepatitis, drug-induced liver injury (e.g., acetaminophen), and autoimmune hepatitis.
What is the management of acute liver failure?
Management includes supportive care, treatment of the underlying cause, and consideration for liver transplantation.
What are the signs of acute liver failure?
Signs include jaundice, coagulopathy, encephalopathy, and hypoglycemia.
What is the role of N-acetylcysteine in acute liver failure?
N-acetylcysteine is used as an antidote for acetaminophen overdose and may have benefits in other causes of acute liver failure.
What are the common causes of chronic hepatitis B?
Causes include perinatal transmission, unsafe injection practices, and unprotected sex.
What is the management of chronic hepatitis B?
Management includes antiviral therapy (e.g., tenofovir, entecavir), regular monitoring, and vaccination of close contacts.
What are the complications of chronic hepatitis B?
Complications include cirrhosis, hepatocellular carcinoma, and liver failure.
What is the significance of HBeAg in chronic hepatitis B?
HBeAg indicates active viral replication and infectivity in chronic hepatitis B.
What are the common causes of chronic hepatitis C?
Causes include injection drug use, unsafe medical practices, and blood transfusions before 1992.
What is the management of chronic hepatitis C?
Management includes direct-acting antiviral agents (e.g., sofosbuvir, ledipasvir) and regular monitoring.
What are the complications of chronic hepatitis C?
Complications include cirrhosis, hepatocellular carcinoma, and liver failure.
What is the significance of HCV RNA in chronic hepatitis C?
HCV RNA is used to diagnose active infection and monitor response to treatment.
What are the common causes of alcoholic liver disease?
Causes include chronic alcohol abuse, genetic predisposition, and nutritional deficiencies.
What is the management of alcoholic liver disease?
Management includes abstinence from alcohol, nutritional support, and treatment of complications like cirrhosis.
What are the complications of alcoholic liver disease?
Complications include alcoholic hepatitis, cirrhosis, and hepatocellular carcinoma.
What is the significance of AST:ALT ratio in alcoholic liver disease?
An AST:ALT ratio greater than 2:1 is suggestive of alcoholic liver disease.
What are the common causes of non-alcoholic fatty liver disease (NAFLD)?
Causes include obesity, diabetes, hyperlipidemia, and metabolic syndrome.
What is the management of non-alcoholic fatty liver disease?
Management includes lifestyle modifications (diet, exercise), control of metabolic risk factors, and monitoring for disease progression.
What are the complications of non-alcoholic fatty liver disease?
Complications include non-alcoholic steatohepatitis (NASH), cirrhosis, and hepatocellular carcinoma.
What is the significance of liver biopsy in non-alcoholic fatty liver disease?
Liver biopsy is the gold standard for diagnosing NASH and assessing fibrosis.
What are the common causes of autoimmune hepatitis?
Causes include genetic predisposition, environmental triggers, and immune dysregulation.
What is the management of autoimmune hepatitis?
Management includes immunosuppressive therapy (e.g., prednisone, azathioprine) and regular monitoring.
What are the complications of autoimmune hepatitis?
Complications include cirrhosis, liver failure, and hepatocellular carcinoma.
What is the significance of autoantibodies in autoimmune hepatitis?
Autoantibodies like ANA, SMA, and anti-LKM1 are used in the diagnosis of autoimmune hepatitis.
What are the common causes of primary biliary cholangitis (PBC)?
Causes include autoimmune destruction of intrahepatic bile ducts, genetic predisposition, and environmental factors.
What is the management of primary biliary cholangitis?
Management includes ursodeoxycholic acid (UDCA), obeticholic acid, and liver transplantation in advanced cases.
What are the complications of primary biliary cholangitis?
Complications include cirrhosis, portal hypertension, and hepatocellular carcinoma.
What is the significance of anti-mitochondrial antibodies (AMA) in primary biliary cholangitis?
AMA is a hallmark serological marker for primary biliary cholangitis.
What are the common causes of primary sclerosing cholangitis (PSC)?
Causes include autoimmune processes, genetic predisposition, and association with inflammatory bowel disease.
What is the management of primary sclerosing cholangitis?
Management includes ursodeoxycholic acid, endoscopic therapy for strictures, and liver transplantation in advanced cases.
What are the complications of primary sclerosing cholangitis?
Complications include cholangiocarcinoma, cirrhosis, and liver failure.
What is the significance of MRCP in primary sclerosing cholangitis?
MRCP is used to visualize bile duct abnormalities and diagnose primary sclerosing cholangitis.
What are the common causes of hemochromatosis?
Causes include genetic mutations (e.g., HFE gene), excessive iron intake, and chronic liver disease.
What is the management of hemochromatosis?
Management includes phlebotomy, iron chelation therapy, and treatment of complications like cirrhosis.
What are the complications of hemochromatosis?
Complications include cirrhosis, diabetes, cardiomyopathy, and hepatocellular carcinoma.
What is the significance of transferrin saturation in hemochromatosis?
Elevated transferrin saturation is a key diagnostic finding.
What is the significance of transferrin saturation in hemochromatosis?
Elevated transferrin saturation is a key diagnostic finding in hemochromatosis.
What are the common causes of Wilson’s disease?
Causes include genetic mutations (e.g., ATP7B gene), leading to copper accumulation in the liver and other organs.
What is the management of Wilson’s disease?
Management includes copper chelation therapy (e.g., penicillamine, trientine), zinc supplementation, and liver transplantation in severe cases.
What are the complications of Wilson’s disease?
Complications include cirrhosis, neurological symptoms, and psychiatric disorders.
What is the significance of ceruloplasmin in Wilson’s disease?
Low ceruloplasmin levels are a hallmark of Wilson’s disease.
What are the common causes of alpha-1 antitrypsin deficiency?
Causes include genetic mutations leading to abnormal alpha-1 antitrypsin production and accumulation in the liver.
What is the management of alpha-1 antitrypsin deficiency?
Management includes avoiding smoking, augmentation therapy, and liver transplantation in severe cases.
What are the complications of alpha-1 antitrypsin deficiency?
Complications include emphysema, cirrhosis, and hepatocellular carcinoma.
What is the significance of alpha-1 antitrypsin levels in diagnosis?
Low serum levels of alpha-1 antitrypsin are diagnostic for the deficiency.
What are the common causes of Budd-Chiari syndrome?
Causes include hepatic vein thrombosis, hypercoagulable states, and myeloproliferative disorders.
What is the management of Budd-Chiari syndrome?
Management includes anticoagulation, thrombolysis, and transjugular intrahepatic portosystemic shunt (TIPS) or liver transplantation in severe cases.
What are the complications of Budd-Chiari syndrome?
Complications include liver failure, portal hypertension, and hepatocellular carcinoma.
What is the significance of Doppler ultrasound in Budd-Chiari syndrome?
Doppler ultrasound is used to detect hepatic vein thrombosis and assess blood flow.
What are the common causes of portal vein thrombosis?
Causes include hypercoagulable states, abdominal infections, and cirrhosis.
What is the management of portal vein thrombosis?
Management includes anticoagulation, thrombolysis, and treatment of underlying causes.
What are the complications of portal vein thrombosis?
Complications include portal hypertension, variceal bleeding, and mesenteric ischemia.
What is the significance of CT angiography in portal vein thrombosis?
CT angiography is used to visualize the thrombus and assess the extent of thrombosis.
What are the common causes of hepatic encephalopathy?
Causes include liver failure, portosystemic shunts, and precipitating factors like infection or gastrointestinal bleeding.
What is the management of hepatic encephalopathy?
Management includes lactulose, rifaximin, and treatment of precipitating factors.
What are the complications of hepatic encephalopathy?
Complications include coma, brain edema, and death in severe cases.
What is the significance of ammonia levels in hepatic encephalopathy?
Elevated ammonia levels are associated with hepatic encephalopathy, though levels do not always correlate with severity.
What are the common causes of hepatorenal syndrome?
Causes include advanced liver disease, portal hypertension, and renal vasoconstriction.
What is the management of hepatorenal syndrome?
Management includes albumin infusion, vasoconstrictors (e.g., terlipressin), and liver transplantation.
What are the complications of hepatorenal syndrome?
Complications include acute kidney injury, multi-organ failure, and death.
What is the significance of creatinine levels in hepatorenal syndrome?
Elevated creatinine levels indicate renal dysfunction in hepatorenal syndrome.
What are the common causes of hepatocellular carcinoma?
Causes include chronic hepatitis B and C, alcoholic liver disease, and non-alcoholic steatohepatitis (NASH).
What is the management of hepatocellular carcinoma?
Management includes surgical resection, liver transplantation, radiofrequency ablation, and systemic therapies like sorafenib.
What are the complications of hepatocellular carcinoma?
Complications include liver failure, metastasis, and death.
