Portal HTN

Question 1

portal HTN

Answer 1

persistently elevated BP in portal system

Question 2

etiology

Answer 2

cirrhosis

Question 3

cmplx

Answer 3

• ascites
• portosystemic shunts
• splenomegaly

Question 4

how can ascites occur

Answer 4

inc BP –> inc CHP –> fluid shifts into interstitial space –> into abd cavity

Question 5

how do portosystemic shunts occur

Answer 5

• inc pressure in hepatic portal system is displaced into accessory vessels by creating collateral vessels (channels) b/w hepatic portal system and rest of systemic vessels
• caput medusae
• ruptured varix (causes bleeding + hemorrhoids)
• dec blood flow to liver (ammonia + toxins go straight into blood stream to brain –> hepatic encephalopahy)

Question 6

how does splenomegaly occur

Answer 6

• inc pressure in portal system –> blood backs up into splenic vein –> inc blood vol in spleen –> inc in CHP –> fluid shift into interstitial space of spleen –> enlarged spleen

Question 7

massive splenomegaly results in what

Answer 7

hypersplenism (overactive spleen)

Question 8

hypersplenism

Answer 8

• spleen’s fx to filter old and damaged blood cells in body is exaggerated causing inc scavenging on blood cells, incl platelets and WBCs
• can result in anemia + cytopenias