Signs and Symptoms Flashcards
What might you see in and surrounding the eyes on a cirrhosis examination?
xanthelasma (normally primary biliary cirrhosis)
Kayser-Fleisher rings (Wilson’s disease = copper build up)
What are the physical signs of liver cirrhosis?
Vascular: spider naevi and palmar erythema
Trophic changes: leuconychia and finger clubbing
Hormonal changes: gynaecomastia, testicular trophy, psuedo-cushingoid
Movement changes: Dupuytren’s contracture and asterixis (“liver flap”)
What is ascites?
Excessive accumulation of fluid in the abdominal cavity.
What are the signs of liver failure?
Severe fluid retention; disordered blood clotting, hepatic encephalopathy; renal impairment.
What is the difference between hypoalbumniaemia and ascites?
Hypoalbumniaemia is where level of albumin in the blood serum are abnormally low and cause generalised oedema due to a decrease in oncotic pressure; ascites is specifically peritoneal fluid excess and can be removed.
What is hepatic encephalopathy? What is it caused by? How is it treated?
The occurrence of confusion, altered level on consciousness and possible coma as a result of liver failure. It is caused by bacterial action on non-absorbed, accumulated proteins in the gut which produce amines and ammonia. The liver fails to remove these products which reach the brain and act as false neurotransmitters. Treated with laxatives, correction of precipitant and liver transplantation.
What is disordered blood clotting? What does it cause and how is it temporarily treated?
Markedly prolonged prothrombin time (INR) due to failure to synthesis clotting factors. It is not reversible with vitamin K. It causes spontaneous bleeding and bruising. It may be temporarily treated with fresh frozen plasma or specific clotting factors intravenously.
